Cyl^iQ^^j)y^^ O^ju^ PSYCHOPATHIA SEXUALIS fn/i^Sia^U.--^,^^ (The above portrait was given by the author to the translator.; Psychopathia Sexualis WITH ESPECIAL REFERENCE TO ANTIPATHIC SEXUAL INSTINCT A MEDICO-FORENSIC STUDT Dr. R. v. KRAFFT-EBING O. b. PROF. FiJR PSYCHIATRIE UND NEKVENKRANKHEITEN AN DER K. K. UNIVERSITAT WIEN THE ONLY AUTHORISED ENGLISH TRANSLATION OF THE TENTH GERMAN EDITION BY F. J. REBMAN NEW YORK LONDON RKBMAN COMPANY REBMAN LIMITED lo West 230 Street 129 Shaftesbury Ave., W. C. Entered at Stationers" Hall PREFACE TO THE FIRST EDITION. Few people are conscious of the deep influence exerted by sexual life upon the sentiment, thought and action of man in his social relations to others. Schiller, in his essay " Die Weltweisen," touches upon this subject in these memorable words : "So long as philosophy keeps together the structure of the Universe so long does it maintain the world's machinery by hunger and love ". From the standpoint of the philosopher sexual life takes a subordinate position. Schopenhauer (" Die Welt als Wille und Vorstellung," third edition, vol. ii., p. 586, etc.) considers it peculiar that love has hitherto offered material to the poet only and not also to the philosopher, the scant researches by Plato, Eousseau and Kant always excepted. Whatever Schopenhauer, and after him E. von Hart- mann, the philosopher of the unknown, discuss about sexual relationship, is so thoroughly incorrect and illogical that, so far as science is concerned, empirical psychology and the metaphysics of man's .sexual existence are simply virgin soil. Michelet's (" L'amour ") and Mantegazza's ("Physiology of Love") are merely clever causeries, and cannot be considered in the hght of scientific research. The poet is the better psychologist, for he is swayed rather by sentiment than by reason, and always treats his subject in a partial fashion. He cannot discern deep shadows because he is dazed by the blazing light, and overcome by the benign heat of the subject. Although VI PREFACE TO THE FIRST EDITION. the " Physiology of Love " provides inexhaustible material for the poetry of all ages and of all peoples, nevertheless the poet will not discharge his arduous task adequately without the active co-operation of natural philosophy and, above all, that of medicine, a science which ever seeks to trace all psychological manifestations to their anatomical and physiological sources. In these efforts medicine succeeds, perhaps, in forming a connection between the pessimistic reflections of the philosopher of the stamp of Schopenhatier and Hartmann,^ and the gay and naive creations of the poet. It is not intended to build up in this book a system of the psychology of sexual life, still from the close study of psychopathology there arise most important psychological facts which it behoves the scientist to notice. The object of this treatise is merely to record the various psychopathological manifestations of sexual life in man and to reduce them to their lawful conditions. This task is by no means an easy one, and the author is well aware of the fact that, despite his (varied) far-reaching experience in psychiatry and criminal medicine, he is yet unable to offer anything but an imperfected system. The importance of the subject, however, demands scientific research on account of its forensic bearing and its deep influence upon the common weal. The medical barrister only then finds out how sad the lack of our knowledge is in the domain of sexuality when he is called upon to express an opinion as to the responsibility of the accused whose life, liberty arnd honour are at stake. He then begins to appreciate the efforts that have been made to bring light into darkness. ' Hartmann' s philosophical conception of love (" Philosophy of the Unknown," Berlin, 1869, p. 583) is : " Love causes more pain than pleasure. Pleasure is only an illusion. Reason would demand the avoidance of love were it not for that fatal sexual instinct. Hence it would be better to be castrated." Schopenhauer expresses the same view in his work : " Die Welt als WiUo und Voistellung," third edition, vol. it. p. 586, etc. PREFACE TO THE FIRST EDITION. Vll Certain it is that so far as sexual crimes are concerned erroneous ideas prevail, unjust decisions are given, and the law as well as public opinion are prima facie prejudiced against the offender. The scientific study of the psychopathology of sexual life necessarily deals with the miseries of man and the dark sides of his existence, the shadow of which contorts the sublime image of the deity into horrid caricatures, and leads astray aestheticism and morality. It is the sad privilege of medicine, and especially that of psychiatry to ever witness the weaknesses of human nature and the reverse side of life. The physician finds, perhaps, a (satisfaction) solace in the fact that he may at times refer those manifestations which offend against our ethical or aesthetical principles to a diseased condition of the mind or the body. He can save the honour of humanity in the forum of morality, and the honour of the individual before the judge and his fellow-men. It is from the search of truth that the exalted duties and rights of medical science emanate. The author adopts the saying of Tardieu {" Des at- tentats aux moeurs ") : " Aucune misere physique ou morale, aucune plaie, quelque corrompue quelle soit, ne doit effrayer celui qui s'est voue a la science de Thomme, et le ministere sacre du medecin, en I'obligeant a tout voir, lui permet aussi de tout dire ". He appeals to men engaged in serious study in the domains of natural philosophy and medical jurisprudence. A scientific title has been chosen, and technical terms are used throughout the book in order to exclude the lay reader. For the same reason certain portions are written in Latin. PREFACE TO THE TENTH EDITION. This edition is entirely rewritten and considerably en- larged. The (exceptionally) favourable criticisms which have been accorded in professional circles to former edi- tions are a guarantee that the book exercises a beneficent influence upon legislation and jurisprudence, and will assist in removing erroneous ideas and superannuated laws. Its commercial success is the best proof that large numbers of unfortunate people find in its pages instruction and relief in the frequently enigmatical manifestations of sexual life. The hosts of letters that have reached the author from all parts of the world substantiate this as- sumption. Compassion and sympathy are strongly elicited by the perusal of these letters, which are chiefly written by men of refined thought and of high social and scientific standing. They reveal sufferings of the soul in compari- son to which all the other afflictions dealt out by Fate appear as trifles. May it continue to convey solace and social elevation to its readers. The number of technical terms has been increased, and the Latin language is more frequently made use of than in former editions. New observations, to which no reference has been made in the ninth edition, will be found in Nos. 58, 59, 67, 75, 76, 79, 80, 85, 87, 88, 101, 102, 116-20, 132, 139, 176, 188, 190, 192, 196, 203. May the same kind reception be accorded to this edition which was enjoyed by its predecessors. That it may prove of utility in the service of science, justice and humanity is the wish of the AUTHOE. Vienna, 1899. PUBLISHERS' PREFACE. The publishers sincerely trust that this translation from the Tenth German Edition of PsycJiopathia Sexualis by Dr. E. V. Krafft-Ebing will be received with favour by those for whom the book is written, and that its readers will derive that benefit which the author has in view. The sale of the book is rigidly restricted to the members of the medical and legal professions. Any communications intended for the translator should be addressed to "Translator" (Krafft-Ebing), care of Rebman, Limited, 129 Shaftesbury Avenue, London. THE PUBLISHERS. London, 1899. CONTENTS. I. FRAGMENTS OF A SYSTEM OF PSYCHOLOGY OF SEXUAL LIFE l Force of sexual instincts, 1 — Sexual instinct the basis of ethical sentiments, 2 — Love as a passion, 3 — Historical development of sexual life, 3 — Chastity, 3 — Christianity, 4 — Monogamy, 3 — Position of woman in Islam, 5 — Sensuality and morality, 7 — Cultural demoralisation of sexual life, 7 — Episodes of the , moral decay of nations, 8 — Development of sexual desire; puberty, 8 — Sensuality and religious fanaticism, 9 — Re- lation between religious and sexual domains, 10 — Sensuality and art, 12 — Idealisation of first love, 13 — True love, 14 — Sentimentality, 14 — Platonic love, 15 — Love and Friendship, 15 — Difference between the love of the man and that of the woman, 15— Celibacy, 15— Adultery, 16— Matrimony, IB- Fondness of dress, 16— Facts of physiological fetichism, .18 . — Religious and erotic fetichism, 18 — Hair, hand, foot of the female as fetiches, 20 — Eye, smell, voice, psychical qualities as fetich, 21. II PHYSIOLOGICAL FACTS 26 Puberty, 26— Time limit of sexual life, 27— Sexual sense, 27— Localisation, 28 — Physiological development of sexual life, 28 — Erections ; Centre of erection, 29 — Sphere of sexuality and olfaction, 31— Flagellation as a stimulant for sexual life, 34— Sect of flagellants, 35—" Flagellum Salutis " of Paulini, 37 — "Erogenous" (hyperaesthetic) zones, 37 — Control of sexual instinct, 40 — Coitus, 41— Ejaculation, 42. IIL-GENERAL NEUROPATHOLOGY AND PSYCHO- PATHOLOGY OF SEXUAL LIFE .... 43 Frequency and importance of pathological manifestations, 44 — Sexual neuroses systematised, 44 — Influences stimulating the erectile tissues, 45 — Paralysis of the erectile tissues, 45— Temporary impotence, 45— Neurosis of the nerve centres of ejaculation, 46 — Neurosis produced by cerebral causes, 46 XIV CONTENTS. — Paradoxia, i.e., sexual instinct outside the period of ana- tomical-physiological processes, 47 — Sexual instinct in early childhood, 48— Sexual instinct reappearing in old age, 50 — Sexual perversions in seniles due to impotence or dementia, 51 — Anesthesia sexualis, i.e., absence of sexual instinct, 54 — con- genital, 54 — acquired, 61 — Hypercesthesia, i.e., pathologically exaggerated sexual instinct, 62 — Conditions and manifestations of this anomaly, 63 — ParcBstliesia or perversion of the sexual instinct, 75 — Perversion and perversity, 76 — Sadism, an attempted explanation of sadism, 76 — Sadistic lust murder, 82 — Anthropophagy, 85 — Mutilation of corpses, 90— Maltreat- ment of women by cutting or flogging, etc., 95 — Defilement of female persons, 102 — Symbolical sadism, i.e., brutal force em- ployed against female persons, 105 — Sadism practised on any other object, 106 — Flogging of boys, 106 — Sadistic acts on animals, 109 — Sadism in vyoman, 112 — Kleist's " Penthesilea," 114 — Masochism, 115 — Essence and clinical manifestations of masochism, 115 — Maltreatment and humiliation invited for the purpose of sexual gratification, 117 — Passive flagellation and its relations to masochism, 133 — Frequency and practices of masochism, 146 — Symbolical masochism, 148 — Ideal masochism, 150 — Jean Jacques Rousseau, 154 — Masochism in scientific and belletristical literature, 157 — Latent masochism, 159 — Shoe and foot fetichism, 159 — Koprolagnia, 178 — Masochism in woman, 187 — An attempted explanation of masochism, 191 — Sexual bondage, 194 — Masochism and sadism, 202 — Fetichism, definition of, 207 — Cases in which the fetich is a part of the female body, 213 — Hand fetichism, 214 — Bodily defects as fetiches, 223 — Hair fetichism, 228 — • Hair despoilers, 229 — The fetich is a part of female attire, 235 — Mania for (theft of) female handkerchiefs, 243 — Shoe fetichism, 248 — The fetich consists of some special fabric, 255 — Fur, silk, velvet fetichism, 257 — Beast fetichism, 267 — Antipathic sexual instinct, 269 — Acquired sexual inversion in either sex, 273 — Neurotic taint a condition of antipathic sexual instinct, 275 — Grades of acquired perversion, 276 — Simple in- version of sexual instinct, 276 — Eviration and defemination, 284 — Insanity among the Scythians, 290 — Mujerados, 291 — Transi- tion to tnetamorplwsis sexualis, 292 — Metamorphosis sexualis paranoica, 316 — Congenital antipathic sexuality, 323 — Various clinical forms thereof, 325 — General symptoms, 325 — At- tempted explanation of this anomaly, 330 — Congenital anti- pathic sexuality in the male, 339 — Psychical hermaphrodism, 342 — Homosexuality, 357— Urnings, Z51—Effemination, 373 — Androgyny, 384 — Congenital antipathic sexuality in the female, 390 — Other manifestations of sexual perversion, 428— Diag- nosis, prognosis and therapy of sexual inversion, 431. CONTENTS. XV PAGE IV. SPECIAL PATHOLOGY 445 The manifestations of pathological sexual life in the various forms and conditions of mental disturbance, 446— Inhibition of psychical development, 446 — Acquired mental debility, 449 — Dementia following psychosis or apoplexy, 449 — Or injuries to the head, 450— Or lues cerebralis, 451 — Dementia parahjtica, 451— Epilepsy, 453— Periodical dementia, ^Ql—Psyclwpathia sexualis periodica, 463 — Mania, 465— Symptoms of sexual excitement in maniacs, 465— Satyriasis and nymphomania, 465 — Chronic satyriasis and nymphomania, 466 — Melancholia, 467— Hysteria, 467— Paranoia, 469. V. PATHOLOGICAL SEXUAL LIFE BEFORE THE CRIMINAL FORUM 472 Sexual crimes endanger the common weal, 472 — On the increase, 473— Probable causes, 478 — Clinical researches, 474 — Sexual crimes not properly understood by the law profession, 475 — Points for the proper judgment of sexual crimes, 475 — Con- ditions for the cessation of responsibility, 476 — Points for the psycho-pathological importance of sexual crimes, ilG—Sexiial ■ crimes classified, 476— Exhibitionists, 477 — Frotteurs, 496 — De- filers of statues, 499 — Rape and lust-murder, 500 — Bodily injury, violation of things, cruelty to animals caused by sadism, 507 — Masochism and sexual bondage, 513 — Bodily injury, robbery, theft emanating from fetichism, 517 — Immorahty with persons under the age of fourteen, 521— Violation, 530 Unnatural abuse, 530 — Violation of animals, sodomy, bestiality, 530 — Zooerasty, 539 — Unnatural sexual relations with persons of the same sex, pederasty, 539 — In relation to sexual inversion, 541 — Necessity to distinguish between patho- logical and normal conditions of pederasty, 541 — Forensic opinion on congenital sexual inversion and when pathologically acquired, 542 — Letter from an urning, 542 — Reasons why legal proceedings against homosexual acts should be stopped, 547— Cultivated pederasty (not pathological), 554— Causes of the vice, 554 — Social life of pederasts, 556 — A woman-hater's ball in Berlin, 559 — Various categories of niale-loviug men, 562 — Pcrdicatio mulierum, 563 — Amor lesbicus, 576 — Necro- philia, 580— Incest, 580— Violation of wards, 582. INDEX 583 I. FEAGMENTS OF A SYSTEM OF PSYCHOLOGY OF SEXUAL LIFE. The propagation of the human* race is not left to mere accident or the caprices of the individual, but is guaran- teed by the hidden laws of nature which are enforced by a mighty, irresistible impulse. Sensual enjoyment and physical fitness are not the only conditions for the en- forcement of these laws, but higher motives and aims, such as the desire to continue the species or the individu- ality of mental and physical qualities beyond time and space, exert a considerable influence, Man puts himself at once on a level with the beast if he seeks to gratify lust alone, but he elevates his superior position when by curbing the animal desire he combines with the sexual functions ideas of morality, of the sublime, and the beau- tiful. Placed upon this lofty pedestal he stands far above nature and draws from inexhaustible sources material for nobler enjoyments, for serious work and for the realisation of ideal aims. Maudsley ("Deutsche Klinik," 1873, 2, 3) justly claims that sexual feeling is the basis upon which social advancement is developed : — If man were deprived of sexual distinction and the nobler enjoyments arising therefrom, all poetry and prob- ably all moral tendency would be eliminated from his life. Sexual life no doubt is the one mighty factor in the individual and social relations of man which disclose his powers of activity, of acquiring property, of establishing a I PSYCHOPATHIA SEXUALIS. home, of awakening altruistic sentiments towards a person of the opposite sex, and towards his own issue as well as towards the whole human race. Sexual feeling is really the root of all ethics, and no doubt of aistheticism and religion. The subliiuest virtues, even the sacrifice of self, may spring from sexual life, which, however, on account of its sensual power, may easily degenerate into the lowest passion and basest vice. Love unbridled is a volcano that burns down and lays waste all around it ; it is an abyss that devours all — honour, substance and health. It is of great psychological interest to follow up the gradual development of civilisation and the influence exerted by sexual life upon habits and morality.^ The gratification of the sexual instinct seems to be the primary motive in man as well as in beast. Sexual intercourse is done openly, and man and woman are not ashamed of their nakedness. The savage races, e.g., Australasians, Polynesians, Malays of the Philippines are still in this stage {vide Ploss). Woman is the common property of man, the spoil of the strongest and mightiest, who chooses the most winsome for his own, a sort of instinctive sexual selection of the fittest. Woman is a " chattel," an article of commerce, exchange or gift, a vessel for sensual gratification, an implement for toil. The presence of shame in the manifestations and exercise of the sexual functions, and of modesty in the mutual relations between the sexes are the foundations of morality. Thence arises the desire to cover the nakedness ("and they saw that they were naked") and to perform the act in private. The development of this grade of civilisation is furthered by the conditions of frigid climes which necessitate the 1 Cf. Lombroso, " The Criminal " ; Westeniiarck, " The History of Marriage"; Ploss, "Das Weib in der Natur- und Volkerkunde," third edition, vol. ii., p. 413-90. A SYSTEM or PSYCHOLOGY OF SEXUAL LIFE. 3 protection of the whole body agaiust the cold. It is an anthropological fact that modesty can be traced to much earlier periods among northern races. ^ Another element which tends to promote the refined development of sexual life is the fact that woman ceases to be a " chattel ". She becomes an individual being, and, although socially stdl far below man, she gradually acquires rights, independence of action, and the privilege to bestow her favours where she inclines. She is wooed by man. Traces of ethical sentiments pervade the rude sensual appetite, idealisation begins and community of woman ceases. The sexes are drawn to each other by mental and physical merits a^d exchange favours of preference. In this stage woman is conscious of the fact that her charms belong only to the man of her choice. She seeks to hide them from others. This forms the foundation of modesty, chastity and sexual fidelity so long as love endures. This development is hastened wherever nomadic habits yield to the spirit of colonisation, where man establishes' a household. He feels the necessity for a companion in life, a housewife in a settled home. The Egyptians, the Israelites, and the Greeks reached this level at early periods, so did the Teutonic races. Its principal characteristics are high appreciation of virginity, chastity, modesty and sexual fidelity in strong contrast to the habits of other peoples where the host places the personal charms of the wife at the disposal of the guest. The history of Japan furnishes a striking proof that this high grade of civilisation is often the last stage of moral development, for in that country to within ten years ago prostitution was not considered to impair in any way the social status of the future wife. Christianity raised the union of the sexes to a sublime 1 According to Wcstermarck, op. cit., it was " not the feeling of shame which suggested the garment, but the garment engendered shame. The desire to make themselves more attractive originated the habit among men and women to cover their nakedness." 4 PSYCHOPATHIA SEXUALIS. position by making woman socially the equal of man and by elevating the bond of love to a moral and religious institution.^ Thence emanates the fact that the love of ^ This assertion may be modified in so far that the symbolical and sacramental character of matrimony was clearly defined only by the Council of Trent, although the spirit of Christianity always tended to raisa woman from the inferior position which she occupied in previous centuries and in the Old Testament. The tradition that woman was created from the rib of the sleeping man (see Genesis) is one of the causes of delay in this direction, for after the fall she is told " thy will shall be subject to man ". According to the Old Testament, woman is responsible for the fall of man, and this became the corner-stone of Christian teaching. Thus the social position of woman had to be neglected, as it were, until the spirit of Christianity had con- quered tradition and scholastic tenets. It is a remarkable fact that the gospels (barring divorce. Matt. xix. 9) contain not a word in favour Oj." woman. The clemency shown towards the adulteress and the penitent Magdalen do not affect the position of woman in general. The epistles of St. Paul definitely insist that no change can be permitted in the position of woman (2 Cor. xi. 3-12 ; Eph. V. 22, "woman shall be subject to man," and 23, "woman shall fear man"). How much the fathers of the Church are prejudiced against woman on account of Eve's part in the temptation may be easily learned from TertulUan, " Woman, thou shouldst ever go in mourning and sackcloth, thy eyes filled with tears. Thou hast brought about the ruin of mankind.' St. Jerome has aught but good to say about woman. " Woman is the gate of the devil, the road of evil, the sting of the scorpion " (" De Cultu Femin- arum," i. 1). Canon law declares: "Man only is created to the image of God not womon ; therefore woman shall serve him and be his handmaid ". The Provincial Council of Macon (sixth century) seriously discussed the question whether woman had a soul at all. These opinions of the Church had a sympathetic influence upon the peoples who embraced Christianity. Among the converted Germanic races the dower value of woman fell considerably {J. Falke, "Die ritter- liche Gesellschaft," Berlin, 1862, p. 49. Be the valuation of the two sexes among the Jews, cf. 3 Moses, xxvii. 3-4). E\en polygamy, which is distinctly recognised in the Old Testament, (Deut. xxi. 15) is nowhere in the New Testament definitely prohibited. In fact many Christian princes {e.g. the Merovingian kings : Chlotar I., Charibert I., Pippin I. and other Frankish nobles) indulged in polygamy without a protest being raised by the Church at the time (Weinhold, " Die deutschen Frauen im Mittelalter," ii., p. 15 ; cf. linger, " Marriage," etc., and Lotiis Bridel, " La Femme et le Droit," Paris, 1884). A SYSTEM OF PSYCHOLOGY OF SEXUAL LIFE. 5 man, if considered from the standpoint of advanced civilisa- tion, can only be of a monogamic nature and must rest upon a staple basis. Even though nature should claim merely the law of propagation, a community (family or state) cannot subsist without the guarantee that the offspring thrive physically, morally and intellectually. From the moment when woman was recognised the peer of man, when monogamy became a law and was consolidated by legal, religious and moral conditions, the Christian nations obtained a mental and material superiority over the poly- gamic races, and especially over Islam. Mohammed strove to raise woman from the position of the slave and mere handmaid of enjoyment, to a higher social and matrimonial grade ; yet she remained still far below man, who alone could obtain divorce, and that on the easiest terms. Above all things Islamism excludes woman from public life and enterprise, and stifles her intellectual and moral advancement. The Mohammedan woman is simply a means for sensual gratification and the propagation of the species ; whilst in the sunny balm of Christian doctrine, blossom forth her divine virtues and her qualities of housewife, companion and mother. What a contrast ! Compare the two religions and their standard of future happiness. The Christian expects a heaven of spiritual bhss absolutely free from carnal pleasure ; the Mohammedan au eternal harem, a paradise among lovely houris. Yet, in spite of the aid which religion, law, education and the moral code offer him, the Christian (to subdue his sensual inclination) often drags pure and chaste love from its sublime pedestal and wallows in the quagmire of sensual enjoyment and lust. Life is a never-ceasing duel between the animal in- stinct and morality. Only will-power and a strong character can emancipate man from the meanness of his corrupt nature, and teach him how to enjoy the pure pleasures of love and pluck the noble fruits of earthly existence. 6 PSTCHOPATHIA SEXUALIS. It is an open question whether the moral status of mankind has undergone an improvement in our times. No doubt society at large shows a greater veneer of modesty and virtue, and vice is not as flagrantly practised as of yore. The reader of Scherr (" Deutsche Culturgeschichte ") will gain the impression that our moral code is not so gross as was that of the middle ages, even if only more re- fined manners have taken the place of former coarseness. In comparing the various stages of civilisation it be- comes evident that, despite periodical relapses, public morality has made steady progress, and that Christianity is the chief factor in this advance. We are certainly far beyond sodomitic idolatry, the public life, legislation and religious exercises of ancient Greece, not to speak of the worship of Phallus and Priapus in vogue among the Athenians and Babylonians, or the Bacchanalian feasts of the Eomans and the privileged posi- tion held by the courtesans of those days. There are stagnant and fluctuating periods in this slow progress, but they are only like the ebb- and flood- tide of sexual hfe in the individual. The episodes of moral decay always coincide with the progression of effeminacy, lewdness and luxuriance of the nations. These phenomena can only be ascribed to the hifrher and more stringent demands which circumstances make upon the nervous system. Exaggerated tension of the nervous system stimulates sensuality, leads the indi- vidual as well as the masses to excesses, and undermines the very foundations of society, and the morality and purity of family life. The material and moral ruin of the com- munity is readily brought about by debauchery, adultery and luxury. Greece, the Roman Empire, and France under Louis XIV. and XV., are striking examples of this assertion. In such periods of civic and moral decline the most monstrous excesses of sexual life may be observed, which, however, can always be traced to ps5xho-patho- A SYSTEM OF PSYCnOLOGY OF SEXUAL LIFE. / logical or neuro-pathological conditions of the nation in- volved.^ Large cities are hotbeds in which neuroses and low morality are bred, vide the history of Babylon, Nineveh, Rome and the mysteries of modern metropolitan life. It is a remarkable fact that among savages and half-civilised races sexual intemperance is not observed (except among the Aleutians and the Oriental and Nama- Hottentot women who practise masturbation).^ The study of sexual life in the individual naturally deals with its various phases, beginning with the stage of puberty to the extinction of sexual feeling. Mantegazza (" Physiology of Love ") draws a beautiful picture of the bodings and yearnings of awakening love, of the mysterious sensations, foretastes and impulses that fill the heart, long before the period of puberty has arrived. Psychologically speaking, this is, perhaps, the most mo- mentous epoch of life, for the wealth of ideas and senti- ments engendered through it, forms the standard by which psychic activity may be measured. The advance of puberty develops the impulses of youth, hitherto vague and undefined, into conscious realisation of the sexual power. The psychological reactions of animal passion manifest themselves in the irresistible desires of intimacy, and the longing to bestow the strange affections of nature upon others. Religion and poetry frequently become the temporary haven of rest, even after the period of storm and stress is passed. Religious enthusiasm is more commonly met with in the young than the old. The lives of the saints^ ^ Cf. Friedldnder ^ " Sittengeschichte Roms " ; Wiedemeister, " Der Casarenwahnsinn " ; Suetonius, Moreau, " Des aberrations du sens gendsique ". 2 Friedreich (" Hdb. der gerichtlicharztlich. Praxis," 1843, i. p. 271) ia of a different opinion, for according to him the Red Indians of America are addicted to the practice of pederasty. Cf. also Lombroao, p. 42. ^ Cf. Friedreich (" Gerichtl. Psychologic, " p. 3S9) who quotes numerous examples. For instance, Blankebin, the nun, was constantly tormented 8 PSYCHOPATHIA SEXUALIS. are replete with remarkable records of temptations. The religious feasts of the ancients often degenerated into orgies, or into mystic cults of a voluptuous character. Even the meetings of certain modern sects dissolve themselves simply into obscene practices. On the contrary we find that the sexual instinct, when disappointed and unappeased, frequently seeks and fends a substitute in rehgion. Even where psycho-pathological conditions are diag- nosed beyond dispute, this relation between religious and sexual feelings can easily be established. The cause of re- hgious insanity is often to be found in sexual aberration. In psychosis a motley mixture of religious and sexual delu- sions is observable, viz., in female lunatics who imagine that they are or will be the mother of God, and especially in persons slaves to masturbation. The cruel, sensual acts of chastisement, violation, emasculation and even crucifix- ion perpetrated upon self by religious maniacs, bear out this assertion.^ Any attempt to explain the psychological relations be- by the thought of what could have become of that part of Christ which was removed in circumcision. Veronica Juliani, beatified by Pope Pius II., in memory of the divine lamb, took a real lamb to bed with her, kissed it and suckled it on her breasts. St. Catharine of Genoa often burned with such intense inward fire that in order to cool herself she would throw herself upon the ground crying, " Love, love, I can endure it no longer ". At the same time she felt a peculiar inclination to her confessor. One day lifting his hand to her nose she noticed a peculiar odour which penetrated to her heart " a heavenly perfume that would awaken the dead ". St. Armelle and St. Elizabeth were troubled with a similar longing for the Infant Jesus. The temptations of St. Anthony, of Padua, are known to the world. Of significance is an old Protestant prayer : " Oh 1 that I had found thee, bless'd Emanuel ; that thou wert with me in my bed, to bring delight to body and soul. Come and be mine. My heart shall be thy resting place." ^ Cf. Friedreich, " Diagnostik der psych. Krankheiten," p. 247 etc.; Neumann, Lehrb. d. " PsychiatriCj" p. 80. A SYSTEM OF PSYCHOLOGY OF SEXUAL LIFE. 9 tween religion and love must needs meet with difficulties, for analogous instances are met with in great numbers. Sexual inclinations and religious leanings (if considered as psychological factors), are composed of two elements. Schleiermacher recognised the primary feeling of depen- dence as the paramount element in religion, long before modern anthropological and ethnographic research in the domain of primitive causes, arrived at the same conclu- sions. The secondary and truly ethical element, i.e., the love of God, enters the religious sentiment only when a higher stage of culture is attained. At first, the double-faced, now benevolent, now angry, chimeras of complicated mythologies, take the place of the evil spirits, until they in turn are dislodged by the benign form of the deity, the giver of perpetual happiness, whether it be in the shape of Jehovah as the author of all earthly blessings, or Allah who bestows physical delight in Paradise, or Christ who is gone before to prepare mansions of eternal light and bliss, or Nirvana who reigns in the heaven of the Buddhist. The primary element of sexical preference is love, i.e., the expectation of unsurpassed pleasure. The secondary element is the feeling of dependence, although it is in reality the root from which both spring alike, as the former may be entirely absent. It certainly exists in a stronger measure in woman, on account of her. social position, and the passive part which she takes in the act of procreation ; but at times it is also found in men who are of a feminine type. Eeligion as well as sexual love is mystical and trans- cendental. In sexual love the real object of the instinct, i.e., propagation of the species, is not always present to the mind during the act, and the impulse is much stronger than could be justified by the gratification that can possibly be derived from it. Keligious love strives for the possession of an object that is absolutely ideal, and cannot be defined by experimental knowledge. Both 10 PSYCHOPATHIA SEXUALIS. are metaphysical processes which give unlimited scope to imagination. They converge, however, in a similar indefinite focus ; for the gratification of the sensual appetite promises a boon which far surpasses all other conceivable pleasures, and faith has in store a bliss that endures for ever. In either condition the mind is conscious of the enor- mous importance of the object to be obtained ; thus im- pulses often become irresistible and overcome all opposing motives. But because neither of them can at times grasp the real object of their existence they easily degenerate into fanaticism, in which intensity of emotion overbalances clearness and stability of reason. Expectation of un- fathomed bliss is now coupled with reckless resignation and unconditional submission. Owing to this conformity it happens that under high tension one dislodges the other, or that both make their appearance together ; for every violent upheaval in the soul must necessarily sweep along its surroundings. Nature, always the same, draws alike upon these two spheres of conception, now forcing one then the other into stronger activity, which degenerates even into acts of cruelty either actively exercised, or passively endured. In religious life this may assume the shape of self- sacrifice or self-destruction, prompted by the idea that the victim is necessary for the material sustenance of the deity. The sacrifice is brought as a sign of reverence or submission, as a tribute, as an atonement for sins com- mitted, or as a price whei-ewith to purchase happiness. If, however, the offering consists in self-punishment — and that occurs in all rehgions ! — it serves not only as a symbol of submission, or an equivalent in the exchange of present pain for future bliss, but everything that is thought to come from the deity, all that is done in obedience to divine mandates or to the honour of the Godhead, is felt directly as pleasure. Thus religious exuberance leads to ecstasy, a condition in which con- A SYSTEM OP PSYCHOLOGY OP SEXUAL LIFE. li sciousness is so preoccupied with feelinf::;s of mental pleasure, that distress is stripped of its painful quality. Exaggerated reii,i;ious enthusiasm also finds pleasure in the sacrifice of another person, when rapture combines with sympathy. Similar manifestations may be observed in sexual life, as will be shown later on und(?r the headings of Sadism and Masochism. Thus the relations existing between religion, lust, and cruelty,^ may be condensed into the fornmla : Eeligious and sexual hyperaesthesia at the acme of development show the same volume of intensity and the same quality of excitement, and may therefore under given circum- stances interchange. Both will in certain pathological states degenerate into cruelty. Sexual influence is just as potent in the awakening of aesthetic sentiments. What other foundation is tlicre for the plastic art or poetry? From (sensual) love arises that warmth of fancy which alone can inspire the creative mind, and the fire of sensual feeling kindles and preserves the glow and fervour of art. This explains the sensual natures of great poets and artists. The world of fancy keeps pace with the development of sexual power. Whoever during that period cannot be animated by the ideals of all that is great, noble and beautiful remains a "Philistine" all his life. Even the dolt tries his hand at poetry when in love. On the borders of physiological reaction may be observed those mysterious processes of maturing puberty, which give origin to obscure yearnings and moods of ' This may be observed in the actual life as well as in the fiction and the plastic arts of degonerato eras. For instance, Bernmi's carving, which roprosents St. Teresa " sinking in a hysterical faint upon a marble cloud, whilst an amorous angel plunges the arrow (of divine love) into her heart.'' — Lilbke. 12 PSYCHOPATHIA SEXUALIS. despondency and Weltschmerz, rendering life tedious, and coupled with the impulse to inflict pain and sorrow upon others (weak analogies of a psychological connection be- tween lust and cruelty). First love for ever trends in a romantic idealising direction. It wraps the beloved object in the halo of perfection. In its incipient stages it is of a platonic character, and turns rather to forms of poetry and history. With the approach of puberty it runs the risk of trans- ferring the idealising powers upon persons of the opposite sex, even though mentally, physically and socially they be of an inferior station. To this may easily be traced many cases of misalliance, abduction, elopement and errors of early youth, and those sad tragedies of passionate love that are in conflict with the principles of morality or social standing, and often terminate in murder, self-destruction, and double suicide. Purely sensual love is never true and lasting, for which reason first love is, as a rule, but a passing infatuation, a fleeting passion. True love is rooted in the recognition of the moral and mental qualities of the beloved person, and is equally ready to share pleasures and sorrows and even to make sacrifices. True love shrinks from no dangers or obstacles in the struggle for the undisputed possession of the beloved. Deeds of daring and heroism lie in its wake. But un- less the moral foundation be solid it will lead to crime, and jealousy often mars its beauty. The love of the feeble-minded is based upon senti- mentality, and when unrequited results in suicide. Sentimental love is hkely to degenerate into a burlesque, especially when the sensual element lacks force {e.g. the Knight of Joggenburg, Don Quixote, and many of the minstrels and troubadours of the middle ages). This kind of love is nauseating and has a repulsive or ludicrous effect on others, whilst true love and its mani- festations command sympathy, respect, and even fear. A SYSTEM OF PSYCHOLOGY OP SEXUAL LIFE. 13 Love when weak is frequently turned away from its real object into different channels, such as voluptuous poetry, bizarre aesthetics, or rehgion. In the latter case it readily falls a prey to mysticism, fanaticism, sectarianism or religious mania. A smattering of all this can always be found in the immature love of early puberty. The poetical effusions of that period of life are only then worthy of perusal when emanating from the pen of the truly endowed genius. Ethical surroundings are necessary in order to elevate love to its true and pure form, but, notwithstanding sensuahty will ever remain its principal basis. Platonic love is a platitude, a misnomer for " kindred spirits ". Since love imphes the presence of sexual desire it can only exist between persons of different sex capable of sexual intercourse. When these conditions are wantinsr or destroyed it is replaced by friendship. The sexual functions of man exercise a very marked influence upon the development and preservation of char- acter. Manliness and self-reliance are not the qualities which adorn the impotent onanist. Gynrkovechky (" Mannl. Impotenz," Wien, 1889) is correct in his observation that virility establishes the ratio of difference between old men and young, and that im- potence impairs health, mental freshness, activity, self- confidence and imagination. The damage stands in proportion to the age of the subject and the extent of his debauchery. The sudden loss of the virile powers often produces melancholia, or is the cause of suicide when life without love is a mere blank. In ca'-es where the reaction is less pronounced, the victim is morose, peevish, egotistical, jealous, narrow- minded, cowardly, devoid of energy, self-respect and honour. 14 PSYCnOPATIIIA SEXUAI.IS. The Skopzes for instance after castration rapidly degenerate. This m itter will be further elucidated under the heading of " Effeminatio " {v. i.). In the sedate matron this condition is of minor psy- chological importance, though it is noticeable. The biological change affects her but little if her sexual career has been successful, and loving children gladden the ma- ternal heart. The situation is different, however, where sterility has denied that happiness, or where enforced celibacy prevented the performance of the natural func- tions. These facts characterise strongly the differences that prevail in the psychology of sexual life in man and woman, and the dissimilarity of sexual feeling and desire in both. Man has beyond doubt the stronger sexual appetite of the two. From the period of pubescence he is instinc- tively drawn towards woman. His love is sensual, and his choice is strongly prejudiced in favour of physical attractions. A mighty impulse of nature makes him aggressive and impetuous in his courtsliip. Yet the law of nature does not wholly fill his psychic being. Having won the prize, his love is temporarily eclipsed by other vital and social interests. Woman, however, if physically and mentally normal, and properly educated, has but little sensual desire. If it were otherwise, marriage and family life would be empty words. As yet the man who avoids women, and the woman who seeks men are sheer anomalies. Woman is wooed for her favour. She remains passive. Her sexual organisation demands it, and the dictates of good breeding come to her aid. Nevertheless, sexual consciousness is stronger in woman than in man. Her need of love is greater, it is continual not periodical, but her love is more spiritual A SYSTEM OF PSYCHOLOGY OF SEXUAL LIFE. 15 than sensual. Man primarily loves woinaij as his wife, and then as the mother of his children ; the first place in woman's heart helon^s to the father of her child, the second to him as husband. Woman is influenced in her choice more by mental than by physical qualities. As mother she divides her love between offspring and husband. Sensuality is merged in the mother's love. Thereafter the wife accepts marital intercourse not so much as a sensual gratification than as a proof of her hus- band's affection. Woman loves with her whole soul. To woman love is life, to man it is the joy of life. Misfortune in love bruises the heart of man ; but it ruins the life of woman and wrecks her happiness. It is really a psychological question worthy of consideration whether woman can truly love twice in her life. Woman's mind certainly inclines more to monogamy than that of man. In the sexual demands of man's nature will be found the motives of his weakness towards woman. He is enslaved by her, and becomes more and more dependent upon her as he grows weaker, and the more he yields to sensuality. This accounts for the fact that in the periods of decline and luxury sensuousness was the predominant factor. Whence arises the social danger when courtesans and their dependants rule the State and finally encompass its ruin. History shows that great (states)men have often been the slaves of women in consequence of the neuropathic conditions of their constitution. It shows a masterly psychological knowledge of human nature that the Roman Catholic Church enjoins celibacy upon its priests in order to emancipate them from sensu- ality, and to concentrate their entire activity in the pursuit of their calling. Nevertheless it is a pity that the celibate state deprives the priest of the ennobling influence exer- cised by love and marital life upon the character. From the fact that by nature man plays the aggressive 16 PSTCHOPATHIA SEXUALIS. rdle in sexual life, he is exposed to the danger of over- stepping the limits set by law and morality. The unfaithfulness of the wife, as compared with that of the husband, is morally of much wider bearing, and should always meet with severer punishment at the hands of the law. The unfaithful wife not only dishon- ours herself, but also her husband and her family, not to speak of the possible uncertainty of paternity. Natural instincts and social position are frequent causes of disloyalty in man (the husband), whilst the wife is surrounded by many protecting influences. Sexual intercourse is of different import to the spinster and to the bachelor. Society claims of the latter modesty, but exacts of the former chastity as well. Modern civil- isation concedes only to the wife that exalted position, in which woman sexually furthers the moral interests of society. The ultimate aim, the ideal, of woman, even when she is dragged in the mire of vice, ever is and will be marriage. Woman, as Mantegazza properly observes, seeks not only gratification of sensual desires, but also protection and support for herself and her offspring. No matter how sensual man may be, unless also thoroughly depraved, he seeks for a consort only that woman whose chastity he cannot doubt. The emblem and ornament of woman aspiring to this state, truly worthy of herself, is modesty, so beautifully defined by Mantegazza as "one of the forms of physical self-esteem ". To discuss here the evolution of this, the most graceful of virtues in woman, is out of place, but most likely it is an outgrowth of the gradual rise of civilisation. A remarkable contrast may be found in the occasional exposure of physical charms, conventionally sanctioned by the world of fashion, in which even the most discreet maiden will indulge when robed for the ball-room, theatre, or similiar social functions. Although the reasons for such A SYSTEM OF PSYCHOLOGY OF SEXUAL LIFE. 17 a display are obvious, the modest woman is fortunately no more conscious of them, than of the motives which underlie periodical fashions that bring certain forms of the body into undue prominence, to say nothing of corsets, etc. In all times, and among all races, the women are fond of toilet and finery. In the animal kingdom nature has distinguished the male with the greater beauty. Men designate women as the beautiful sex, a gallantry which clearly arises from their sensual requirements. So long as woman seeks only self-gratification in this personal adornment, and so long as she remains unconscious of the psychological reasons for thus making herself attrac- tive, no objection can be raised against it, but when done with the fixed purpose to please men it degenerates into coquetry. Under analogous circumstances man would make him- self ridiculous. Woman far surpasses man in the natural psychology of love, partly because evolution and training have made love her proper element, and partly because she is ani- mated by more refined feelings {Mantegazza). Even the best of breeding concedes to man that he looks upon woman mainly as a means by which to satisfy the cravings of his natural instinct, though it confines him only to the woman of his choice. Thus civilisation establishes a binding social contract which is called mar- riage, and grants by legal statutes protection and support to the wife and her issue. It is important, and on account of certain 4)athological manifestations (to be referred to later on) indispensable, to examine into those psychological events which draw man and woman into that close union which concentrates the fulness of affection upon the beloved one only, to the ex- clusion of all other persons of the same sex. If one could demonstrate design in the processes of nature — adaptation cannot be denied them — then the fact 18 PSYCHOPATHIA SEXUALIS. of fascination by one person of the opposite sex with in- difference towards all others, as it occurs between true and happy lovers, would appear as a wonderful provision to ensure monogamy for the promotion of its object. The scientific observer finds in this loving bond of hearts by no means simply a mystery of souls, but he can refer it nearly always to certain physical or mental pecu- harities by which the attracting power is qualified. Hence the words fetich and fetichism. The word fetich signifies an object, or parts or attributes of objects, which by virtue of association to sentiment, personality, or absorbing ideas, exert a charm (the Portuguese " fetisso "), (jr at least produce a peculiar individual impression which is in no wise connected with the external appearance of the sign, symbol or fetich.^ The individual valuation of the fetich extending even to unreasoning enthusiasm is called fetichism. This in- teresting psychological phenomenon may be explained by an empiricial law of association, i.e., the relation existing between the notion itself and the parts thereof which are essentially active in the production of pleasurable emotions. It is most commonly found in religious and erotic spheres. lielifjious fetichism finds its original motive in the delusion that its object, i.e., the idol, is not a mere symbol, but possesses divine attributes, and ascribes to it peculiar wonder-working (relics) or protective (amulets) virtues. Erotic fetichism makes an idol of physical or mental qualities of a person or even merely of objects used by that person, etc., because they awaken mighty associations with the bel^jved person, thus originating strong emotions of sexual pleasure. Analogies with religious fetichism are always discernible ; for, in the latter, the most in- significant objects (hair, nails, bones, etc.) become at times fetiches which produce feelings of delight and even ecstasy. ^ Cf. Max Mullcr who derives the word teticli etymologically from faciitius, i.e., artificial, iusiguificaut. A SYSTEM OF PSYCIiOLOGy OF SEXUAL LIFE. 19 The germ of sexual love is probably to be found in the individual charm (fetich) with which persons of opposite sex sway each other The case is simple enough when the sight of a person of the opposite sex occurs simultaneously with sexual excitement, whereby the latter is intensified. Emotional and optical impressions combine and are so deeply embedded in the mind that a recurring sensation awakens the visual memory and causes renewed sexual excitement, even orgasm and pollution (often only in dreams), in which case the physical appearance acts as a fetich. Binet, inter alia, contends that mere peculiarities, whether physical or mental, may have the effect of the fetich, if their perception coincides with sexual emotion. Experience shows that chance controls in a large measure this mental association, that the nature of the fetich varies with the personality of the individual, thus arousing the oddest sympathies or antipathies. These physiological facts of fetichism often account for the affections that suddenly arise between man and woman, the preference of a certain person to all others of the same sex. Since the fetich assumes the form of a distinctive mark it is clear that its effect can only be of an individual character. Being accentuated by the strongest feelings of pleasure, it follows, that existing faults in the beloved are overlooked ("Love is Wind") and an infatuation is produced which appears incomprehensible or silly to others. Thus it happens that the devoted lover who worships and invests his love with quahties which in reality do not exist, is looked upon by others simi.ly as mad. Thus love exhibits itself now as a mere passion, now as a pronounced psychical anomaly which attains what seemed impossible, renders the ugly beautiful, the profane sublime, and obliterates all consciousness of existing duties towards others. Tarda ("Archives de I'Anthropologie Criminolle," vol. 20 PSTCHOPATHIA SEXUALIS. v., No. 30) argues that the type of this fetich(ism) varies with persons as well as with nations, but that the ideal of beauty remains the same among civilised peoples of the same era. Binet has more thoroughly analysed and studied this fetichism of love. From it springs the particular choice for slender or plump forms, for blondes or brunettes, for particular form or colour of the eyes, tone of the voice, odour of the hair or body (even artificial perfume), shape of the hand, foot or ear, etc., which constitute the individual charm, the first link in a complicated chain of mental processes, all converging in that one focus, love, i.e., the physical and mental possession of the beloved. This fact establishes the existence of physiological fetichism. Without showing a pathological condition the fetich may exercise its power so long as its leading qualities represent the integral parts, and so long as the love en- gendered by it comprises the entire mental and physical personality. Normal love can only be synthetic, a generalisation. Max Dessoir (pseudonym Ludwig Brunn) ^ in an article, " The Fetichism of Love," cleverly says : — " Normal love appears to us as a symphony of tones of all kinds. It is roused by the most varied agencies. It is, so to speak, polytheistic. Fetichism recognises only the tone-colour of a single instrument ; it issues forth from a single motive ; it is monotheistic." Even moderate thought will carry the conviction that the term real love (so often misused) can only apply where the entire person of the beloved becomes the phy- sical and mental object of veneration. Of course, there is always a sensual element in love, i.e., the desire to enjoy the full possession of the beloved object, and, in union with it, to fulfil the laws of nature. 1 " Deutsclies Montagsblatt," Berlin 20, 8, 80 A SYSTEM OF PSYCHOLOGY OF SEXUAL LIFE. 2] But where the body of the beloved person is made the sole object of love, or if sexual pleasure only is sought without regard to the communion of soul and mind, true love does not exist. Neither is it found among the disciples of Plato, who love the soul only and despise sexual en- joyment. In the one case the body is the fetich, in the other the soul, and love is fetichism. Instances such as these represent simply transitions to pathological fetichism. This assumption is enlianced by another criterion of true love, viz., the mental satisfaction derived from the sexual act.^ A striking phenomenon in fetichism is that among the many things which may serve as fetiches there are some which gain that significance more commonly than others ; for instance, the hair, the hand, the foot of woman, or the expression of the eye. This is important in the pathology of fetichism. Woman certainly seems to be more or less conscious of these facts. For she devotes great attention to her hair and often spends an unreasonable amount of time ^ Magnan's "spinal cerebral posterieur" who finds gratification with any sort of woman, is only animated by lust. Meretricious love that is purchased cannot be genuine {Mantegazza). Whoever coined the adage: " Sublata lucerna muUum discrimen inter feminas," was a cynic, indeed. The power to perform love's act is by no means a guarantee of the noblest enjoyment of love. There are urnings who are potent for women — men who do not love their wives, but are nevertheless able to perform the marital "duty ". In the majority of these cases even lustful pleasure is absent ; for it is simply an onanistic act rendered possible by the aid of imagination which sub- stitutes another beloved being. This deception may, indeed, superinduce sexual pleasure, but, rudimentary gratification as it is, it can only arise from a psychic trick, just as in solitary onanism voluptuous satisfac- tion is obtained chiefly with the assistance of fancy. As a matter of fact that degree of orgasm which completes the lustful act is entirely dependent upon the intervention of fancy. Where psychic impediments exist (such as indifference, disgust, aversion, fear of contagion or impregnation, etc.) the feeling of sexual gratification seems to be wanting altogether. 22 PSYCHOrATniA sexualis. and money upon its cultivation. How carefully the mother looks after her little daughter's hair ! What an important part the hairdresser plays ! The falling out of the hair causes despair to many a young lady. The author remembers the case of a vain woman who fell into melanchoHa on account of this trouble, and finally committed suicide. A favourite subject of conversation among ladies is coijf^ires. They are envious of each other's luxuriant tresses. Beautiful hair is a mighty fetich with many men. In the legend of the Lorelei, who lured men to destruction, the "golden hair" which she combs with a golden comb appears as a fetich. Frequently the hand or the foot possesses an attractiveness no less powerful ; but in these instances masochistic and sadistic feelings often — though not always — assist in determining the peculiar kind of fetich. By a transference through association of ideas, gloves or shoes obtain the significance of a fetich. Max Dessoir {op. cit.) points out that among the cus- toms of the middle ages diinking 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 role in the legend of Aschenbrodel. The expression of the eye is particularly important as a means of kindling the spark of love. A neuropathic eye frequently affects persons of either sex as a fetich. "Madame, vos beaux yeux me font mourir d'amour." {Moliere). There are many examples showing that odours of the body become fetiches. This fact is taken advantage of in the " Ars amandi " by 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 lavish use of strong scents. Jdger, in his " Discovery of the Soul," calls attention to many olfactory sympathies. A SYSTEM OF PSYCHOLOGY OF SEXUAL LIFE. 23 Cases are known where men have married ugly women solely because their personal odours were exceedingly pleasing. Binct makes it probable that the voice also may act as a fetich. Belot in his novel " Les baigneuses de Trouville" makes the same assertion. Binet thinks that many marriages with singers are due to the fetich (^f their voices. He also observes that among the singing birds the voice has the same sexual significance as odours among the quadrupeds. The birds allure by. their song, and the male that sings most beautifully is joined at night by the charmed mate. The pathological facts of masochism and sadism show that mental peculiarities may also act as fetiches but in a wider sense. Thus the fact of idiosyncrasies is explained, and the old proverb " De cjustihus non est disputandum " retains its force. With regard to fetichism in woman, science must at least for the present time be content with mere con- jectures. This much seems to be certain, that being a a physiological factor, its effects are analogous to those in men, i.e., producing sexual sympathies towards persons of the same sex. Details will come to our knowledge only when medical women enter into the study of this subject. We may take it for granted that the physical as well as the mental qualities of man assume the form of the female fetich. In most cases, no doubt, physical attributes in the male exercise this power without regard to the existence of conscious sensuality. On the other hand it will be found that the mental superiority of man con- stitutes the attractive power where physical beauty is wanting. In the upper "strata" of society this is more apparent, even if we disregard the enormous influence exercised by "blue l)lood" and high breeding. The 24 PSYCHOPATHIA SEXUALIS. possibility that superior intellectual development favours advantcement in social position, and opens the way to a brilliant career, does not seem to v^^eigh heavily in the balance of judgment. The fetichism of body and mind is of importance in progeneration ; it favours the selection of the fittest and the transmission of physical and mental virtues. Generally speaking the follov^ing masculine virtues impose on v^oman, viz., physical strength, courage, nobility of mind, chivalry, self-confidence, even self-assertion, inso- lence, bravado, and a conscious show of mastery over the weaker sex. A "Don Juan" impresses many women and elicits admiration, for he establishes the proof of his virile powers, although the inexperienced maiden can in no wise suspect the many risks of lues and chronic urethritis she runs from a marital union with this otherwise interestincr rake. The successful actor, musician, or vocal artiste, the circus rider, the athlete, and even the criminal, often fasci- nate the bread and butter miss as well as the maturer woman. At any rate women rave over them, and inun- date them with love letters. It is a well-known fact that the female heart has pre- dominant weakness for military uniforms, that of the cavalry-man ever having the preference. The hair of man, especially the beard, the emblem of virility, the secondary symbol of generative power — is a predominant fetich with woman. In the measure in which women bestow special care upon the cultivation of their hair, men who seek to attract and please women, cultivate the elegant growth of the beard, and especially that of the moustache. The eye as well as the voice exert the same charm. Singers of renown easily touch woman's heart. They are overwhelmed with love letters and offers of marriage. Tenors have a decided advantage. A SYSTEM OF PSYCHOLOGY OF SEXUAL LIFE. 25 Binet (op cit.) refers to an observation of this character made by Dumas in his novel "La maison du vent". A woman who falls in love with a tenor-voice loses her virtue. 'J he author has thus far not succeeded in obtaining O facts with regard to pathological fetichism io woman. II. PHYSIOLOGICAL FACTS. During the time of the physiological processes in the reproductive glands, desires arise in the consciousness of the individual, vi^hich have for their purpose the perpetua- tion of the species (sexual instinct). Sexual desire during the years of sexual maturity is a physiological law. The duration of the physiological pro- cesses in the sexual organs, as well as the strength of the sexual desire manifested, vary, both in individuals and in races. Eace, climate, heredity and social circumstances have a very decided influence upon it. The greater sensu- ality 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, recognisable in the de- velopment of the body and the occurrence of a periodical flow of blood from the genitals (menstruation), usually begins about the thirteenth to the fifteenth year ; in men puberty, recognisable in the deepening of the voice, the appearance of hair on the face and mons veneris, and the occasional occurrence of pollutions, etc., takes place about the fifteenth year. In the inhabitants of tropical countries, however, sexual development obtains 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 (26) PHYSIOLOGICAL FACTS. 27 and sexual power. Thus there are famihcs in which, with threat physical strenf^th and longevity, great libido and virility are preserved until a great age, while in other families the vita sexualis develops late and is early ex- tinguished. In woman the period of activity of the reproductive glands is shorter than in man, in whom sexual power may last until a great age ; ovulation ceases about thirty years after puberty. The period of waning activity of the ovaries is called the change of life {climacterium, meno- paiise). This biological phase does not represent merely a cessation of functional potency and final atrophy of the reproductive organs, but a transformation of the whole organism. In Middle Europe the sexual maturity of man begins about the eighteenth year, and virility reaches its acme at forty. After that age it slowly declines. The potentia gencrandi ceases usually at the age of sixty-two, but po- tcntia coeundi may be present much longer. The existence of the sexual instinct is continuous during the time of sexual hfe, but it varies in intensity. Under physiological conditions it is never periodical in the human male, as it is in animals ; it manifests an organic variation of intensity in consonance with the collection and expenditure of semen. In woman the degree of sexual desire coincides with the process of ovulation in such a way that libido sexualis is intensified 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. This psycho- sexual centre is nothing more than a junction and crossing of principal paths which lead on the one hand to the sensi- tive motor apparatus of the sexual organs, and on the other hand to those nerve centres of the visual and olfactory organs which are the carriers of that consciousness which distinguishes between the "male" and the " female ". 28 PSYCHOPATHIA SEXUALIS. Owing to the close relations which exist between the sexual instinct and the olfactory sense/ it is to be pre- sumed that the sexual and olfactory centres lie close together in the cerebral cortex. The development of sexual life has its beginning in the organic sensations which arise from the maturing reproductive glands. These excite the attention of the individual. Reading and the experiences of every-day life (which, unfortunately, are now-a-days too early and too frequently suggestive), con- vert these notions into clear ideas, which are accentuated by organic sensations of a pleasurable character. With this accentuation of erotic ideas through lustful feelings, an impulse to induce them is developed (sexual desire). 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 (hypereemia, secretion of semen, ovulation), give rise to sexual ideas, images, and impulses. The cerebral cortex, by means of preconceived or re- produced sensual ideas, reacts on the reproductive organs, including hyperaemia, production of semen, erection, ejacu- lation. This is effected by means of centres for vasomotor innervation and ejaculation, which are situated in the lumbar regions of the cord, and lie close together. Both are reflex centres. The centre of erection {Goltz, Eckhard) is an inter- mediate 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 ^The olfactory centre is presumed by Ferrier ("Functions of the Brain") to be in the region of the gyrus icncinatus. Zuckerkandl (" Ueber das Riechcentrum," 1837), from researches in comparative anatomy, con- cludes that the olfactory centre has its seat in the Hippocampus major. PHYSIOLOGICAL FACTS. 29 cord, as well as by peripheral irritation of the sensory nerves (penis, clitoris and annexa). It is not directly sub- ordinated to the will. The excitation of this centre is conveyed to the corpora cavernosa by means of nerves {nervi erigentes — Eckhard) running into the first three sacral nerves. The action of the nervi erigentes, which renders erec- tion possible, is inhibitory in so far as it inhibits the ganghonic nervous mechanism in the corpora cavernosa, upon the action of which the smooth muscle-fibres of the corpora cavernosa are dependent (ZoZZi/cer a,nd 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 the contraction of the hulho cavernosus and Erector penis muscles, which extend by means of an aponeurosis over the dorsal surface of the penis. The erection-centre is under the influence of both exciting and inhibitory innervation arising from the cere- brum. Ideas and sense-perceptions of sexual content have an exciting effect. According to observations made on men that have been hung, it is evident that the erection-centre may also be aroused 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. Keflex 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 (gonorrhoea), of the 30 PSYCHOPATHIA SEXUALIS. rectum (hoomorrhoids, oxyuris), of the bladder (distension with urine, especially in the morning ; irritation of cal- culi); by distension of the vesicula3 senjinales with semen; by hyperaemia 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 will-power and emotions, (fear of unsuccessful coitus, surprise inter actum scx7ialem, 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 dura- tion 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 point of 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 feehngs, 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 susceptible to both central ari,d peripheral stimuli. Central stimuH, in the form of organic excitation, may be due to diseases of the cerebral cortex. Physiologically they are dominated by psychical impressions (memory and sensory perceptions, lascivious stories, touch, pressure of the hand, kiss, etc.). Auditory and olfactory perceptions certainly play but a veiy subordinate role. Under patho- logical conditions {v. infra), the latter have a very decided influence in inducing sexual excitement. PHYSIOLOGICAL FACTS. 31 In beasts the influence of olfactory perception on the sexual sense is unmistakable. AUhmis (" Beitraij^e zur Ph3^siol. und Pathol, des Olfactorius," " Archiv fiir 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 perception, and that almost all animals, at the time of rutting, emit a specially distinct odour 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 up, the male was unable to distinguish the female. Again, an experiment by Mantegazza ("Hygiene of Love"), who re- moved the eyes of rabbits and found that the defect con- stituted 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 on their sexual organs, glands which secrete substances having a very strong odour. AUhaus also shows that in man there are certain re- lations existing between the olfactory and sexual senses. He mentions Gloquet (" Osphresiologie," Paris, 182G), who calls attention to the sensual pleasure excited by the odour of flowers, and tells how Richelieu lived in an atmosphere laden with the heaviest perfumes, in order to excite his sexual functions. ZipjjG ("Wien. Med. Wochenschrift," 1879, No. 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 can- not be doubted that the olfactory sense stands in remote connection with the sexual apparatus. Odours 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 Sol(.nnon's observation. In the 32 PSYCHOPATHIA SEXUALIS, Orient the pleasant perfumes are esteemed for their re- lation to the sexual organs, and the women's apartments of the Sultan are redolent with the fragrance of flowers.'' Most, professor in Eostock (c/. 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 HI. shows that contact with a person's perspiration may be the exciting cause of passion- ate love. At the betrothal feast of the King of Navarre and Margaret of Valois, he accidently 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 Conde, 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 Jciger, the " discoverer of the soul," refers to the same thing in his well-known book (2nd. 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 Floss (" 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 Jagor, is remarkable. When it becomes necessary for an 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. PHYSIOLOGICAL FACTS. 33 The love of certain libertines and sensual women for perfumes ^ indicates a relation between the olfactory and the sexual senses. A case mentioned by Heschl ("Wiener Zeitschrift f. pract. Heilkunde," 22nd March, 1861) is remarkable, where the absence of both olfactory lobes was accompanied by imperfectly developed genitals. It was the case of a man aged forty-five, 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 dnnensions. 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, for in the psychoses of both sexes superinduced by mas- turbation, as well as in insanity due to disease of the female organs, or during the climacterium, olfactory hal- lucinations are especially frequent, while in cases where a sexual cause is wanting they are very infrequent. 1 am incHned to doubt ^ that, under normal conditions, olfactory impressions in man, as in animals, play an im- portant role m the excitation of the sexual centre. On ' Cf. Laycock, who (" Nervous Diseases of Women," 1840) found that in women the love for musk and similar perfumes was related to sexual excitement. 2 The following case, reported by Binet, seems to be in opposition to this idea. Unfortunately nothing is said concerning the mental char- acteristics of the person. In any event, it is certainly confirmatory of the relations existing between the olfactory and sexual senses: — D., a medical student, was seated on a bench in a public park, read- ing a book (on pathology). Suddenly a violent erection disturbed him. He looked up and noticed that a lady, redolent with perfume, had taken a seat upon the other end of the bench. D. could attribute the erection to nothing but the unconscious olfactory impression made upon him 3 34 PSYCHOPATHIA SEXUALIS, ' account of the importance of this consenaus for the under- standing of pathological cases, it is necessary here to thoroughly consider the relations existing between the olfactory and sexual senses. With reference to these physiological relations it may be mentioned as an interesting fact that there exists a certain histological conformity between the nose and the genitals, for both have erectile tissue (likewise the nipple), Interesting physiological and clinical observations by /. N. Mackenzie may be found in the " Journal of Medical Science," April, 1884 [and "Journal of Laryngology," etc., March, 1898. — Translator]. He finds : (1) that in certani women with normal olfactory organs regularly with menstruation a swelling of the erectile tissue of the nose occurs which disappears again with the floodmg ; (2) that menstruation is at times replaced by epistaxis, which disappears when the uterine flow begins, but in some cases always recurs with the menstrual functions ; (3) irritations of the nasal organs such as violent sneezing, etc., occur at the time of sexual excitement ; (4) Stimula- tion of the genital tracts is occasioned by affections of the nasal organs. He also observes that nasal affections in women grow worse during the time of menstruation ; that venereal excesses produce inflammation of the Schneiderian mem- brane, or intensify it where it already exists. He also points out that masturbators very frequently suffer from nasal disease, are troubled with abnormal sensations of olfaction, and are subject to epistaxis. According to his experience there are affections of the nose which stubbornly resist all treatment until the con- comitant (and causal) genital disease is removed. Other interesting observations and elucidations about the consensus nariuyn et (jenitalium may be found in a book by Fliess recently published : " Die Beziehungen zwischen Nase und weiblichen Geschlechtsorganen," Vienna (Deuticke), 1897. PHYSIOLOGICAL FACTS. 35 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 excite the erection-centre by means of centripetal influence (stimulus resulting from distension of the seminal vesicles ; enlarged Graafian follicles ; any sensory stimulus, how- ever produced, about the genitals ; hypereemia and tur- gescence 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).^ This fact is important for the proper 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 mass turbation. 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 widespread in the thirteenth and fifteenth centuries. They were accustomed to whip themselves, partly as an atonement and partly to mortify the flesh (in accordance with the principle of chastity pro- mulgated by the Church — i.e., the emancipation of the soul from sensuality). These sects were at first favoured by the Church ; but, ^ Meibomius, " De flagiorum usu in re medica," Londou, 17G5 ; Boileau, " The History of the Flagellants," London, 1783 ; Dojypet, •' Aphrodisiaque externe," Paris, 17-88. ^ Corvin, Hist. Denkmalc des christlichen Fanatismus, II., Leipzig, 1847 ; Foerstcmann, Die christlichen Gcisslcrgcsellschaftcn, Ilalle, 1828. 36 PSYCHOPATHIA SEXUALIS. since sensuality was only the more excited by flagellation, and this fact became apparent in unpleasant occurrences, the Church was finally compelled to oppose it. The fol- lowing facts from the lives of the two heroines of flagella- tion, Maria Magdalena of Pazzi and Elizabeth of Genton, clearly show the significance of flagellation as a sexual excitant. The former, the daughter of distinguished parents, was a Carmelite nun in Florence (about 1580), and, by her flagellations, and still more through the re- sults obtained by them, she became quite celebrated, and is mentioned in the " Annals ". It was her greatest delight to have her hands bound by the prioress behind her back, and her naked loins whipped 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 ("Ent- zLTckungen "). 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 raved when, ex- cited by unusual flagellation, she believed herself united with her "ideal". This condition was so exquisitely pleasant to her that she would frequently cry out, "0 love, eternal love, O love, 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. PHYSIOLOGICAL FACTS. 37 These facts find an interesting confirmation in the following experiences, taken from PaulUms " i^'lagellum Salutis " (1st ed., 1698 ; reprint, Stuttgart, 1847) :— "There are some nations, viz., the Persians and Kussians, where the women regard blows as a peculiar sign of love and favour. Strangely enough, the Kussian women are never more pleased and delighted than when they receive hard blows from their husbands, as John Barclarus relates in a remarkable narrative. A German, named Jordan, went to Eussia, and, pleased with the country, settled there and took a Eussian wife, whom he loved dearly, and to whom he was always kind in every- thing. But she always wore an expression of dissatisfac- tion, 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 uncon- sciously 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.' When Jordan adopted the custom his wife began to love him dearly. Similar stories are told by Peter Petreus, of Erlesund, who adds that husbands, immediately after the wedding, among other indispensable household articles, provide themselves with a whip." On page 73 of this remarkable book, the author says further: "The celebrated Count of Mirandula, JoJm Plcus, 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, unless he had been whipped till the -blood came. For this purpose he had a suitable whip made, which was placed in vinegar the day before using 38 SYCHOPATHIA SEXUALIS. 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 punish- ment. Not being a bad man in other respects he under- stood and hated his weakness." Coelnis Bhodigin relates a similar story, as does also the celebrated jurist, Andreas Tiraqnell. In the time of the skilful physician, Otte^i 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 knew a Venetian, who had to be beaten and driven before he could have intercourse, just as reluctant Cupid was driven by his followers with sprays of hyacinths. A few years ago there was in Liibeck a cheesemonger, living on Mill Street, who, on a complaint to the authorities of un- faithfulness, was ordered to leave the city. The prostitute with whom he had been, went to the judges and begged on his behalf, teUing 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 in- capable, and could do nothing without blows. On the decree of the authorities, however, he was not only re- moved from his position, but also severely punished. A reliable friend, ia physician in an important city of the kingdom, related to me 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 expos- incf his naked buttocks, commanded them to belabour him well. They obeyed, and it is easy to conjecture what he then did with them. Not only men have thus been ex- PHYSIOLOGICAL FACTS. 39 cited and inflamed to lasciviousness, but also women, that they too might experience greatei- intensity of pleasure. For this reason the Koman woman had herself whipped and beaten by the hcpercis. Thus Juvenal writes : — " Steriles moriuntur, et illis Turgida non prodest condita psycido Lj'de : Nee prodest agili palmas prrebere Luperco." In men, as well as in women, erection and orgasm, or even ejaculation, may be induced by irritation of various oLher regions of the skin and mucous membrane. These " hyperaesthetic " 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 "Typographical Anatomy," 1865, Bd. i., p. 552, Hyrtl cites Val. Hildenbrandt, who observed a peculiar anomaly of the sexual instinct in a girl, which he called suctusstupratio. She had her mamma? sucked by her lover, and after a while, by constantly pull- ing her nipples, she was enabled to suck them bcrself, an act tbat 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, No. 21), in an interest- ing article on " Sensualit}^ and Love of Kin," points out how zealously the nursing mother gives herself to the nursing of 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, although correct in itself, but one-sided, that, according to Ilouzeaufi experience, among the majority of animals the relations between mother and offspring are close only during the time of nursing, and thereafter indifferent, also speaks in favour of this assumption. 40 PSTCHOPATHIA SEXUALIS. Bastian found the same thing (blunting of the feeling for the offspring after weaning) among savages. Under pathological conditions, as is shown by Cham- hard, among others, in his thesis for tbe doctorate, other portions of the body (in hysterical persons) about the mammse and genitals may attain the significance of " hyperaesthetic " zones. In man, physiologically, the only " hyperaesthetic " zone is the glans penis and perhaps the skin of the ex- ternal genitals. Under pathological conditions the anus may become a " hyperaesthetic " area. Thus anal automasturbation, which seems to be only too frequent, and passive pederasty would be explained. {Of. Gamier, " Anomahes sexuelles," Paris, p. 514; A. Moll, " Contrare Sexualempfindung," 2nd ed., p. 222 ; Frigerio, " Archivio di Psichiatria," 1893; Cristiani, "Archivio delle Psicopatie sessuali," p. 182, " autopederastia in un ahenato, affetto da follia periodica ".) The psycho-physiological process comprehended in the idea of sexaal 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 ac- centuates the feeling of pleasure, by appropriate conceptions and activity of the imagination ; and the pleasurable sen- sations are increased to lustful feeling by excitation of the erection centre and the consequent hypersemia of the genitals (entrance of Hquor prostaticus into the urethra, etc.). If circumstances favour the satisfactory performance of the sexual act, the ever-increasing desire is gratified; if, however, conditions are unfavourable, inhibition occurs, checks the central erectile power, and prevents the sexual act. THE ACT OF COHABITATION. 41 To civilised man the ready presence of ideas which inhibit sexual desire is of distinct import. The moral freedom of the individual, and the decision vv^hether, under certain circumstances, excess, and even crime, be committed or not, depend, on the one hand, upon the strength of the instinctive impulses and the accompany- ing organic sensations ; on the other, upon the powder of the inhibitory ideas. Constitution, and especially organic influences, have a marked effect upon the instinctive impulses ; education and cultivation of self-control coun- teract the opposing influences. The exciting and inhibitory powers are variable quantities. For instance, over-indulgence in alcohol is very fatal in this respect, since it awakens and increases libido sexualis, while at the same time it weakens moral resistance. The Act of Cohabitation.^ The essential condition for the man is sufficient erec- tion. Anjd (" Arch, fiir Psych.," viii., H. 2) calls attention to the fact that in sexual excitement not alone the erection centre is influenced but the nervous excitement is distri- buted over 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 eye- balls, dilatation of the pupils, cardiac palpitation (resulting from paralysis of the vasomotor nerves of the heart, which arise from the cervical sympathetic, and the resulting dilation of the cardiac arteries, and the increased stimula- tion of the cardiac gangha induced by the consequent hyperaemia of the cardiac walls). The sexual act is accompanied by a pleasurable feeling, which, in the male, is evoked by the passage of semen through the ductus ejaculatorii to the urethra, in consequence of the sensory ' Cf. Eoubaud, " Traite de I'impuissance et de la sterilite," Paris 1878. 42 PRYCHOPATHIA SEXUALIS. stimulation of the genitals. This pleasurable sensation occurs earlier in the male than in the female, grows rapidly in intensity up to the moment of commencing ejaculation, reaches its acme in the instant of free emis- sion, 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 semen from the vcsicula seminales into the pars membranacea urethra, a reflex effect of stimulation of the glans penis. As soon as the collection of semen, with ever-increasmg pleasurable sensation, has reached a sufficient amount to be effectual as a stimulus of the ejaculation-centre, this centre acts. The reflex motor path lies in the fourth and fifth lumbar nerves. The action consists of a convulsive excitation of the l)ulbo-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. In- hibition of the ejaculation centre is possible as a result of cortical influence (want of desire in coitus, emotions in general, influence of the will). 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 comfort- able feehng of lassitude. III. GENERAL PATHOLOGY.* (NEUROLOGICAL AND PSYCHOLOGICAL.) Anomalies of the sexual functions are met with especially in civiHsed 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 chiefly the signs of an inherited diseased condition of the central nervous system ("functional signs of degeneration "). 1 Literature : Parent-Duchatelet, " Prostitution dans la villa de Paris," 1837. Rosenbaum, " Bntstehung der Syphilis," Halle, 1839— also, " Die Lustseuche im Alterthum," Halle, 1839. Descuret, " La medocine des Passions," Paris, 1860. Casper, " Klin. Novellen," 1860. Bastion, " Der Mensch in der Geschichte ". Friedldnder, " Sittengeschichte Roms " Wiedcmeister, " Casarenwahnsinn ". Scherr, " Deutsche Kultur um: Sittengeschichte," Bd. i. , cap. ix. Jeannel, " Die Prostitution," deutsch von Miiller, Erlangen, 1869. v. Krafft, " Neue Forschungen auf dem Gebietc der Psychopathia sexualis," 2 Aufl., Stuttgart, 1891. Taxil, " La Prosti tution contemporaine," Paris, 1884. Frank Lydston, " Philadelph. Med. and Surg. Reports, 1889. Urquhardt, Journal of Mental Science, Jan. 1891. Antonini, " Achiv. di Psichiatria," xii., 1,2. Cantarano, Zeitschr- " La Psichiatria," v. , 2, 3. Krauss, " Psychologie des Verbrechcns," 1884. Kicrnan, "Medic. Standard," Nov., 1889. Delcourt, " Le Vice a Paris," 1889. Lombroso, " L'uomo Delinquente," 2 Aufl., 1878. Toulmuuche, " Annal. d'hygiene," 18G8. GirakUs et Horteloup, ibidem, 1876, {i. 419. Eidenburg, " Klin. Handb. d. Harn- und Sexualorgane," 1894,4 Abthl., p. 36. Moll, " Untersuchungen iiber die Libido sexualis," 1897 ; " Archivio dollo psicopatic sessuali," Naples (1896), volume unico. Tardieu, " Dos attentats aux mcEurs," 7 edit., 1878. Emminghaus, " Psychopathol," pp. 98, 225, 230, 232. Schille, " Handbuch der Geisteskrankhcitcn," p. 114. Marc, "Die Geistcskrankheiten," ii., p. 123. v. Krafft, " Lehrh. d. Psj'chiatrie," 5 Aufl. i., p. 83; " Lehrb. d. ger. Psychopathol," 3 Aufl., p. 279; " Archiv f. Psychiatrie," vii., 2. Morcau, "Des Aberrations du sens G6n6siquc," Paris, 1880. Kirn, " Allg. Zoitschr. f. Psychiatric," 39, Heft 2 u. 3. Lombroso, " GeschlGchtstrieb und Verbrochon in (43) 44 PSYCHOPATHIA SEXUALIS. Since the generative organs stand in important func- tional relation to the entire nervous system, and especially to its psychical and somatic functions, the frequency of general neuroses and psychoses arising in sexual, (func- tional or organic), disturbances, is easy to understand. SCHEDULE OF THE SEXUAL NEUKOSES. I. Peeipheeal. 1. Sensory. fl) Anaesthesia ; (&) Hypersesthesia ; (c) Neuralgia. 2. Secretory. (a) Aspermia ; (&) Polyspermia. 3. Motor. (a) Pollutions (spasm) ; (b) Spermatorrhoea (paralysis). II. Spinal Neueoses. 1. Affections of the Erection Centre. (a) Irritation (priapism) arises from reflex action of peripheral sensory irritants {e.g., gonorrhoea) ; directly, from organic irritation of the nerve-tracts leading 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 dura- tion of erection, with libido sexualis. In reflex or direct organic irritation, libido sexualis may be wanting, and the priapism may even give rise to disgust. ihren gegenseitigen Beziehungen " (GoUdammer's "Archiv," Bd. 30). Tarnowsky, " Die krankhaften Erscheinungen des Geschlechtssinnes,'' Berlin, 1886. Ball, "La folie erotique," Paris, 1888. Serieux, " Re- cherches cliniques sur les anomalies de I'instinct sexuel," Paris, 1888' Hammond, " Sexual Impotence," 1889. Among modern novelists who deal with the subject of sexual perver- sion the French are most pre-eminent, viz. : Catulle Mendes, Pdladan, Lemonnier, Dubut de la Forest (" L'homme de joie "), Huysmans (" La bas "), Zola. SPINAL NEUROSES. 45 (b) Paralysis arises from the 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 over-stimulation (sexual excess, especially onanism), or from alcoholic intoxication, abuse of bromides, etc. It may also originate from cerebral anaesthesia, or that of the external genitals. Cerebral hypersesthesia is more frequent in such cases (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 to whom sexual contact with their virtuous wives does not supply the necessary stimulus for an erection, but in whom it occurs when the act is attempted with a prostitute, or in the form of some unnatural sexual act. So far as psychical stimuli are concerned, they may be inadequate {v. infra, paraesthesia and perversion of sexual instinct). (c) Inhibition. The erection centre may become in- capable of function through cerebral influence. This inhibitory influence is an emotional process (disgust, fear of contagion), or fear^ of impotence. There are men who have an unconquerable antipathy to woman, or fear of infection, or are suffering with perverse sexual instinct. In the latter condition are those neuropathic individ- uals (neurasthenics, hypochondriacs), frequently weakened sexually (masturbators), who have reason, or think they have, to mistrust their sexual power. This idea acts as an inhibitory impulse, and makes the act with the person of the opposite sex temporarily or absolutely impossible. {d) Irritable Weakness. In this condition there is ab- ' An interesting instance of how an imperative conception of non- sexual content can exert an infiuence is related by Magnan (" Ann. Med. Psych.," 1885) : Student, aged twenty-one, strongly predisposed heredi- tarily, previously a masturbator, constantly struggles with the number thirteen as an imperative conception. As soon as he attempts coitus the imperative idea inhibits erection and renders the act impossible. iQ PSYCHOPATHIA SEXUALIS. normal impressionability of the centre, but accompanied by rapid diminution of its energy. There may be func- tional disturbance of the centre itself, or weakness of the innervation through the nervi erigentes ; or there may be weakness of the erector penis muscle. Cases in which erection is abortive on account of abnormally early ejaculation, form a transition to the following anom- alies : — 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 hypersesthesia of the urethra, by virtue of which the escaping semen induces an immediate and excessive reflex action of the ejaculation centre. In such cases simple proximity to the female genitals may be sufficient to induce ejaculation {ante portam). In cases of hyperaesthesia of the urethra (as a cause), ejaculation may be accompanied by painful, instead of pleasurable sensations. Usually in cases where there is hypergesthesia of the urethra, there is at the same time irritable weakness of the centre. Both these functional disturbances are important in the production of pollutio nimia and diurna. The accompanying pleasurable feeling may be patho- logically absent. This occurs in defective men and women (anaesthesia, aspermia?), and, further, as a result of disease (neurasthenia, hysteria) ; or (in prostitutes) it fol- lows over-stimulation and the blunting thus induced. The intensity of the pleasurable feeling accompanying the sexual act depends on the degree of psychical and motor excitement. Under pathological conditions this may CEREBRAL NEUROSES. 4? become so pronounced, that the movements of coitus assume the character of involuntary convulsive actions, and even pass into general convulsions. (6) Abnor^nally 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 connec- tion with anaesthesia of the genitals and paralysis of the erection centre. Or, it is the result of a lesion of the reflex arc or of peripheral anaesthesia (urethra), or of aspermia. The ejaculation occurs either not at all, or tardily, in the course of the sexual act, or only afterward, in the form of a pollution. III. Cerebbal Neuroses. (1) Paradoxia, i.e., sexual excitement occurring inde- pendently of the period of the physiological processes in the generative organs. (2) Ancesthesia (absence of sexual instinct). Here all organic impulses arising from the sexual organs, as well as all impulses, and visual, auditory and olfactory sense impressions fail to sexually excite the individual. This is a physiological condition in childhood and old age. (3) Hyperesthesia (increased desire, satyriasis). In this state there is an abnormally increased impressionability of the vita scxualis to organic, psychical and sensory stimuli (abnormally intense libido, lustfulness, lascivious- ness). The stimulus may be central (nymphomania, satyriasis) or peripheral, functional or organic. (4) Paroisthesia (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 anomahes may occur in combination with the former ; but as a rule they affect persons free from mental disease. They may occur in various combinations, and become the cause of 48 PSTCHOPATHIA SBXUALIS. sexual crimes, for which reason they demand considera- tion 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 inde- pendently of Physiological Processes. 1. Sexual Instinct Manifested in Childliood. Every physician conversant with nervous affections and diseases incident to childhood is aware of the fact that manifestations of sexual instinct may occur in very young children. The observations of Ultzmann concerning masturbation in childhood^ are worthy of attention in relation to it. It is necessary here to differentiate between the numerous cases, in which, as a result of phimosis, balanitis, or oxyuris in the rectum or the vagina, young children have itching of the genitals, and experience a kind of pleasurable sensation from manipulations occa- sioned thereby, and thus come to practise 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 premature manifestation of sexual instinct. In such cases it may always be regarded as an accompanying symptom of a neuropsychopathic consti- tutional condition. A case of Marcs ("Die Geisteskrankheiten," etc., von Ideler, i., p. 66) illustrates very well these conditions. The subject was a girl eight years of age, of respectable family, who was devoid of all child-like and moral feehngs, and ^ Louyer-Villcrmay spea,ks oi masturbation in a girl of three or four years, and Morcaii ("Aberrations du sens gjnesique," 2 edit., p. 209) of the same in one of two years. See further Maudsley, " Physiology and Pathology of Mind"; Hirschsprung (Kopenhagen), "Berlin, klin. Wo- chenschr.," 1886, Nr. 38 ; Lombroso, " The Criminal," cases 10, 19, and 21. CEREBRAL NEUROSES — PARADOXIA. 49 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 kilHng her parents, that she might become her own mistress and give herself up to pleasure with men. In these cases of premature manifestation of libido the children begin early to masturbate ; and, since they are greatly predisposed constitutionally, they often sink into dementia, or become subjects of severe degenerative neu- roses 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 to 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 practise masturba- tion 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 mastur- bate — one at the age of seven, the other at the age of four. Zamhaco (" L'Encephale," 1882, Nr. 1, 2) tells the disgusting story of two sisters affected with premature and perverse sexual desire. The elder, B., masturbated at the age of seven, practised 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. Cf. also Magnan, " Lectures on Psychiatry," in German by Mohius (vols. ii. and iii., p. 27), giving the case of pre- mature and preverse vita sexualis in a girl of twelve with hereditary tamt. Utner cases, ibidem p. 120-121. 50 PSYCHOPATIIIA SEXUALIS. 2. Be-awakenmg of Sexual Insthict in Old Age} Cases in which the sexual instinct prevails until a great age are rare. " Senectus non quidem annis sed viribus magis aestiniatur " (Z ittmann) . Oesterlen (" Maschka, Handb.," iii., p. 18) mentions the case of a man aged eighty- three, who was sentenced to three years' imprisonment by a court in Wiirtemberg on account of sexual mis- demeanours. Unfortunately nothing is said of the nature of the crime or of the mental condition of the criminal. The manifestation of sexual instinct in old age is not in itself pathological. Presumption of pathological conditions must neces- sarily 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, mani- fests itself with greater strength, and strives for even perverse satisfaction in a shameless and impulsive manner. In such cases a presumption of pathological condi- tions suggests itself at once. Medical science recognises 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 manifesta- tions of intellectual weakness. The attentive and expe- rienced 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 first objects for the attempts of these semle subjects of brain ^ Cf. Kirn, " Zeitschr. f. Psych.," Bd. xxxix. Legrand du Saulle, "Auuftl. d'hyg.," Oct., 18G8. CEREBEAL NEUROSES — rARADOXIA. 51 atrophy and psychical degeneration are cbildreii. This sad and dangerous fact is explained by the better oppor- tunity they have in succeeding with children, but more especially by a feeling of imperfect sexual power. De- fective sexual power, and greatly diminished moral sense, explain the additional fact of the perversity of the sexual acts of such aged men. They are the equivalents of the impossible physiological act. The annals of legal medicine distinguish as such, ex- hibition of the genitals,^ lustful handling of the genitals of children,' inducing them to perform manustupration on the seducer, and performing masturbation ^ or flagellation on the victim. In this stage the intellect may still be sufficiently in- tact 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 tbe same way. Case 49, in the author's " Text-Book of Legal Psycho- pathology," second edition, p. 161, demonstrates how enormously increased sexual lust may be during the ' Cases, vide Las4gue ■: "Lea exhibitiouistes," Union medicalo, 1877, Ist May. * Legrand du Saulle, " La folio dcvunt los tribunaux," p. 530. 'Kirn, Maschka's " Ilandb. d. ger. Mod.," pp. 373, 371 ; " Allg. Zeifc- «chrift f. I'sychiatrie," Bd. xxxix., p. 220. 52 PSYCHOPATHIA SEXUALIS. course of senile dementia. Quum sen&x lihidinosus ger- manam siiain filiam cemulatione motus necaret et adspeeti* pectoris scissi puellcB ^noribimdcB 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. Eene, always given to indulgence in sen- suality and sexual pleasures, but always with regard for decorum, has shown, since his seventy-sixth year, a pro- gressive 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 publicly so obnoxious that it was necessary to place him in an asy- lum. 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 SawZZe, " La Folic," 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,'^ 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). Gratification is obtained by passive pederasty, or, as I ascertained in the following case, by mutual masturbation : — Case 2. Mr. X., aged eighty, of high social standing, born of a family with hereditary taint. He was always very sensual and a cynic, of uncontrollable temper, and, 1" Die Welt als Wille und Vorstellung," 1859, Bd. ii., p. 461 et seq. CEREBRAL NEUROSES— PARADOXIA. 53 according to his own confession, as a young man, pre- ferred masturbation to coitus. However, he never showed signs of sexual perversion, and kept mistresses, raising a child by one. At the age of forty-eight he married, out of inchnation, and begat six children, and never gave his wife cause for complaint. I could obtain but an incom- plete 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's temper, always pecuhar and quick, has for years been growing more violent. He has become exceedingly suspicious, and shght opposition to his wishes induces attacks of anger which may turn into actual raving, in which he may raise his hand even against his wife. For a year there have been unmistakable signs of incipient senile dementia. The patient has become forgetful, locahses past events incorrectly, and has false ideas of time. For four- teen 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 favourite with favours 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 favourite undis- turbed, 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 practised mutual masturbation. By these practices absolute demoralisation was brought about in the house- hold. The family was powerless ; for any opposition caused violent outbreaks of anger and even threats against his relatives. The patient was completely without apprecia- tion of his perverse sexual acts ; and therefore the only 54 PSYCIIOrATITIA SEXUALIS. course left to the afflicted family was to remove all authority from his hands and place him in an asylum. No erotic inclination towards 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 lovers. B. Anaesthesia 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 cere- bral causes, in which, in spite of generative organs normally developed and the performance of their functions (secre- tion of semen, menstruation), the corresponding emotions of sexual life are absolutely wanting. These functionally sexless individuals are rare cases, and, indeed, always persons having degenerative defects, in whom other func- tional cerebral disturbances, states of psychical degenera- tion, and even anatomical signs of degeneration, may be observed. Lcgrand du Saulle describes a classical case that falls under this head ("Annales Medico-psychol," May, 1876). Case 3. D., aged thirty-three, had a mother who suffered from insanity of persecution. The mother's father also suffered with persecutionary 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 abnormal characters. 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 signs of degcncra- CEREBRAL NEUROSES— ANAESTHESIA SEXUALIS. 55 tion ; genitals normal. At seventeen or eighteen he had enjissions of semen ; had never masturbated or had sexual feehng, and never had sought intercourse with women. Case 4. P., aged thirty-six, common labourer, was received at my clinic in the beginning of November on account of spastic spinal paralysis. He declared he came 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 awakening in the morning with a full bladder, and without a trace of sexual feeling. Pollutions very infrequent — about once a year, m 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 ac- companied by any pleasurable sensation. Patient does not feel this absence of sexual sensation. He gives the assurance that his brother, aged thirty-four, is in exactly the same sexual condition as himself, and he makes it seem probable that a sister, aged twenty-one, is in a similar state. A younger brother, he says, is sexually normal. The examination of his genitals reveals nothing abnormal beyond phimosis. Hammond (" Sexual Impotence "), even with his wide experience, reports only the following three cases of anassthesia .sexualis : — Case 5. Mr. W., aged thirty-three; 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 pros- titutes. On the occasion of such attempts he experienced only disgust, with even a feehng of nausea, and became 56 PSYCHOPATHIA SEXUALIS. 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. Im- portant interests demanded that he should marry. He had no horror femina, 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 twenty-seven ; genitals normal; never felt libido. Mechanical or thermic stimuli easily induced erection, but instead of libido sexualis there was regularly a desire for alcohoHc indulgence. Such excesses also induced erections, and he then sometimes masturbated. He had a disincHnation 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 hyperemia. Case 7. Mrs. 0., normally developed, healthy, men- struated regularly ; aged thirty-five ; 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 experi- ence pleasure in it, but she never had a vsdsh for repetition of cohabitation. In connection with such genuine cases of anaesthesia,^ ^No doubt Swift, the great satirist, was a case of anaesthesia sexualis. Adolf Stern says in his biography of Swift (" Aus dem 18. Jahrhundert; Biographische Bilder und Skizzen," Leipzig, 1874) : "It seems that he was totally devoid of the sensual elements of love ; his candid cynicism, found in many of his letters, is almost definite proof of it. Whoever properly grasps certain passages in ' Gulliver's Travels,' and especially the account which Swift gives of the marriage and progeny of the Houyhnhnms, the noble steeds of the last chapters, can scarcely doubt that this great satirist abhorred marriage, and never felt the impulse which draws the sexes together." Practically speaking, the enigmatical side of Swift's CEREBRAL NEUROSES — ANESTHESIA SEXUALIS. 57 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 (c/. 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 mastur- bation before it attains development. These represent the transitional cases from the congenital to the acquired (psychical) anesthesia sexualis. This danger threatens many masturbators of vitiated constitution. It is psycho- logically 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 flir Psychiatric," vii., are given here as illustrations worthy of consideration : — Case 8. F. X, aged nineteen, 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 towards 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 vacillation 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 feehng toward the opposite sex. Once he indulged in intercourse, experienced no sexual feeling in the act, found coitus character, and several of his works, m^., " Diary to Stella" and "Gulli- ver's Travels," can only be understood if Swift i3 considered sexualW anaesthetic. 58 PSTCnorATHIA sexualis. 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 pecuharly 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 pen- knife has been taken from him. If he had it, he would open his veins as Seneca did — in the bath. At one time a friend had given him, instead of a poison as he sup- posed, a cathartic. Instead of having been a means of sending him to the other world it had sent him to the water-closet. Only the Great Operator could eradicate his foolish and fatal idea with the scythe of death, 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 himself 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 tunc in reading and frivolities, and busied himself with the thought of founding a new Christianity, CEREBRAL NEUROSES — AN/ESTIIERIA SEXUALIS. 59 because Christ had been subject to grand dehisions and had deceived the world with miracles (!). After remaining at home some years the sudden occurrence of a maniacal outbreak brought him back to the asylum. He presented a mixture of primordial delirium of persecution (devil, antichrist, persecution, poisoning, persecuting 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 thirty, 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 liis 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, of cas- trating himself, in order to have no part in increasing un- happiness 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 practise GO PSYCHOPATHIA SEXUALIS. 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 gratification 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 leg. No evidence of onanism could be discovered. He is moody, defiant, irritable. Social feehngs are abso- lutely foreign to him. With the exception of imperfect sleep and frequent headaches, there are no functional dis- turbances. From cases of this kind, depending on cerebral causes, there must be distinguished others in which the absence of function arises from an absence or malformation of the generative organs, as in certain hermaphrodites, idiots and cretins. UUzmanns ^ observations show that ancesthesia sexualis is not caused simply by aspermia. He shows that even in congenital aspermia the vita sexualis and sexual power may be entirely satisfying ; an additional proof that de- fective libido ah origine is to be sought for in cerebral con- ditions. The naturcB frigidce of Zacchias are examples of a milder form of anaesthesia. They are met more frequently among women than among men. The characteristic signs of this anomaly are : shght inclination to sexual intercourse, or pronounced disinchnation to coitus without sexual equiva- lent, and failure of corresponding psychical, pleasurable excitation during coitus, which is indulged in simply from K'Ueber mannliche Sterilitat," Wiener med. Presse, 1878, Nr. 1. "Ueber Potentia generandi et coeundi," Wiener Klinik, 1885, Heft 1, S. 5. CEREBRAL NEUROSES— ANESTHESIA SEXUALIS. 61 sense of duty. I have often had occasion to hear com- plaints 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 Ancesthesia. Acquired dimmution 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 hfe have a great influence upon the intensity of the vita sexualis. Intense mental activity (hard study), physical exertion, emotional depression, and sexual con- tinence 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 chmacterium, 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 functions of the generative glands, and that the facts mentioned are ex- ceptional manifestations. As peripheral causes of diminu- tion 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 and abuse of cocaine. In the same way, the disappearance of libido in general disturbances of 62 rSYCIIOPATIIIA SEXUALIS. nutrition (diabetes, morphinism, etc.) may be explaiiied. Finally, the atrophy of the testicles should be remem- bered, 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 or- ganically induced by cortical disease (dementia paralytica in its advanced stages) ; functionally, by hysteria (cen- tral ana3sthesia ?) and emotional insanity (melanchoHa, hypochondria). C. Hypersesthesia (Abnormally Increased Sexual Desire). Pathology has no easy task, even in the single case, when it has to decide whether the impulse to sexual satis- faction has reached a pathological degree. Emmimjhaus (" Pychopathologie," p. 225) declares that the immediate re-awakening of desire after satisfaction, absorbing the entire attention of the mind, and no less the excitation of libido by the sight of persons and things which in them- selves 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 ; it is strongest from the twentieth to the fortieth year, and then slowly de- creases. Married hfe seems to preserve and control the instinct. Sexual intercourse with many persons increases the desire. Since woman has less sexual need than man, a pre- dominating sexual desire in her arouses a suspicion of its pathological significance ; and the more, when this finds expression in desire for adornment, coquetry, or male society, which, passing beyond the limits set by good breeding and manners, becumes quite noticeable. CEREBRAL NEUROSES — HYPERiESTHE£IA. 68 The constitution, in both sexes, is of the greatest significance. An abnormally strong sexual instinct is frequently accompanied by a neuropathic constitution; and such individuals pass a great part of their lives heavily burdened with the weight of this constitutional anomaly of their sexual life. The power of the sexual impulse in such cases may at times rise to the importance of an organic necessity, and really endanger tbe freedom of the will. The want of satisfaction of this impulsive desire may, under such conditions, induce a condition alhed to actual rutting, or a psychical condition, accompanied by emotions of anxiety, in which the individual yields to the impulse, and responsibility becomes doubtful. If the individual does not give himself up to his power- ful impulse, he is in danger, by reason of his enforced abstineuce, of ruining his nervous system by inducing a neurasthenia, or seriously increasing the evil effects of such a condition if it be already present. In normally constituted individuals, too, the sexual instinct is an inconstant quantity. Aside from the tem- porary indifference following satisfaction, and the diminu- tion of sexual desire in long-continued continence after a certain reactionary stage of sexual desire is overcome, tlie manner of life exerts great influence. Those living in large cities, who are constantly reminded of sexual things and incited to sexual enjoyment, certainly have more sexual desire than those living in the country. A dissi- pated, luxurious, sedentary manner of life, preponderance of animal food, and the consumption of spirits, spices, etc., have a stimulating influence on the sexual life. In woman the sexual inclination is post-menstrually increased. At this period, in neuropathic women, the excitement may reach a pathological degree. The great libido of consumptives is remarkable. Hof- mann tells of a consumptive peasant who satisfied his wife sexually on the evening before his death. The sexual acts are coitus (eventually rape), faute de 64 PSTCHOPATHIA SEXUALIS. mieux, masturbation, and with defective moral sense, pederasty or bestiality. If sexual power is diminished or extinct, with excessive sexual desire all manner of per- versity of sexual acts become possible. Excessive libido may be peripherally or centrally in- duced. The former manner of origin is the more infre- quent. Pruritus and eczema of the genitals may cause it, and likewise certain substances, like cantharides, which powerfully stimulate sexual desire. Not infrequently in women at the climacteric period sexual excitement occurs, occasioned by pruritus, and also in cases where there is neuropathic taint. Magnan ("Annales medico-psychol.,"1885, p. 157) reports the case of a lady who was afflicted in the mornings with attacks of frightful erethismus genitalis, and the case of a man aged fifty-five who was tormented at night by unbearable priapism. In each case there was a neurosis. The central origin of sexual excitement can often be traced^ in persons having neurotic taint or hysteria and in conditions of psychical exaltation. When the cortex and the psycho-sexual centre are in a condition of hyper- assthesia (abnormal excitability of the imagination, in- creased ease of association), not only visual and tactile impressions, but also auditory and olfactory sensations, may be sufficient to call up lascivious conceptions. Magnan {ojj. cit.) reports the case of a young woman ^ In individuals in whom intense sexual hyperjesthesia is associated with acquired irritable weakness of the sexual apparatus, it happens that simply at the sight of a pleasing female figure, without peripheral irritation of the genitals, the psycho-sexual centre may excite into action not only the mechanism of erection, but also that of ejaculation. For such individuals, all that is necessary to induce orgasm or even ejacula- tion is to imagine themselves in a sexual situation with a female that sits opposite them in a railway carriage or a drawing-room. Hanwiond [op. cit., p. 40) describes several cases of this kind that came to him for treatment of subsequent impotence, and he mentions that these indi- viduals used the term " ideal coitus " for the act. Dr. Moll, of Berlin, told me of a similar case, and in this instance the same designation was chosen for the act. CEREBRAL NEUROSES — HYPERESTHESIA. 65 who had an increasing sexual desire from puberty, and satisfied it by masturbation. Gradually she grew to be- come sexually excited at the sight of any man pleasing to her ; and, since she was unable to control herself, she would sometimes shut herself up in a room until the storm had passed. At last she gave herself up to men of her choice, that she might get rest from her tormenting desire, but neither coitus nor masturbation brought relief, and she went to an asylum. The case of a mother of five children is added, who, in despair about her inordinate sexual impulse, attempted suicide, and then sought an asylum. There her condition improved, but she never trusted herself to leave it. There are several illustrative cases in men and women in the author's article, " On Certain Anomahes of Sexual Instinct," cases 6 and 7 (" Archiv fiir Psychiatric," vii., 2) ; cases 3 and 5 are given here. Case 1 0. On the afternoon of 7th July, 1874, Clemens, engineer, being on his way, on business, from Trieste to Vienna, left the train at the town of Brack, and, passing through the town to the neighbouring village of St. Eu- precht, attempted a rape on an old woman, aged seventy, whom he found alone in a house. He was seized by the neighbours and arrested by the local police. At his hearing he declared that he had tried to find the pound, in order to satisfy his sexual desire with a bitch. He said that he often suffered with such sexual excitement. He did not deny his act, but excused it as the result of disease. The heat, the motion of the cars, and anxiety about his family, to whom he wished to go, had confused him and made him ill. Shame and remorse were not shown. His conduct was open, his mien gay ; eyes red and bright, head hot, tongue coated; pulse full, soft, beating over 100 ; fingers somewhat tremulous. The statements of the accused were precise but hurried ; his glance uncer- tain, and with an unmistakable expression of lascivious- 5 66 PSYCHOPATHIA SEXUALIS. ness. To the medical expert summoned to examine him he gave the impression of one suffering with disease — as if he were in the beginning of alcohoHc insanity. C. is forty-five years old, married, father of one child. He does not know what diseases his parents or other members of his family have had. In childhood he was weak and neuropathic. At the age of five his head was injured by a blow with a hoe. A scar one-half cm. broad by one cm. long, situated on the right parietal and frontal bones, dates from that injury. The bone is here some- what depressed. The overlying skin is united to the bone. Pressure at this point causes pain, which radiates along the lower branch of the trigeminus. This spot is also at times spontaneously painful. In his youth he suffered "fainting spells"; before puberty, pneumonia rheumatism and intestinal catarrh. At the age of seven he experienced a peculiar inclination for men — i.e., for a certain superior. Whenever he saw this man he had a peculiar feeling in his heart; kissed the ground he walked on. At ten he fell in love with a certain deputy. Later he had an enthusiasm for men, though it was entirely platonic. He began to masturbate at the age of fourteen; first intercourse at seventeen. Then the earlier mani- festations of contrary sexual feeling disappeared entirely. At that time he passed through a peculiar acute psycho- pathic condition, which he described as a kind of clair- voyance. From fifteen, haemorrhoids, with symptoms of abdominal plethora. When he had profuse heemorrhoidal haemorrhage, which occurred usually every three or four weeks, he was better. At other times he was constantly in a condition of painful sexual excitement, which he satisfied partly by means of onanism and partly by coitus. Every woman he met excited him ; even when he was among female relatives he was impelled to make indecent proposals. Sometimes it was possible for him to master his desire ; sometimes he was driven to indecent acts. If, after these, he was kicked out of doors, it CEEEBBAL NEUEOSES — HYPEK^STHESIA. (37 seemed perfectly right to him ; for he thought that he needed such correction and support against his powerful impulse, which was a burden to him. No periodicity in this sexual excitement was recognisable. Until 1861 he committed excesses in venery and was several times infected with gonorrhoea and chancres. In 1861, marriage. He was sexually satisfied, but became a burden to his wife on account of his great sensuality. In 1864 he passed through an attack of mania in the hospital at Fiume, and in the same year he again fell ill, and was taken to the insane asylum at Ybbs, where he remained until 1867. There he suffered with recurrent mania, accompanied by great sexual excitement. He says that intestinal catarrh and anxiety were the cause of his illness at that time. Thereafter he was well, but he suffered much on account of his excessive sexual desire. If he were ab- sent from his wife but a short time the impulse became so powerful that man or animal was indifferent to him for the satisfaction of his lust. In summer these impulses were much stronger, and were always accompanied by abdominal plethora. Something that he remembered in medical reading made him think that in his case the ganglionic system was more powerful than the cerebral. In October, 1873, on account of business, he had to leave his wife. From that time until Easter, with the excep- tion of occasional masturbation, there was no sexual indulgence. After that he made use of women and bitches. From the middle of June until 7th July, he had no opportunity for sexual indulgence. He felt nervously excited, related, and as if he were going crazy. Of late he had slept badly. A longing for his wife, who lived in Vienna, drove him to leave his business. He obtained leave of absence. The heat and the noise of the train confused him, and he could no longer hold out against his sexual excitement and the pressure of blood in his abdomen. Everything danced before his eyes. He left 68 PSYCHOPATHIA SEXUALIS. the car at Brnck, and was absolutely confused, not knowing where he went ; and for a moment the thought came to him to throw himself in the water ; all was like a mist before his eyes. Then he saw a woman, exposed his genitals, and tried to embrace her. She cried for help, and thus he was arrested. After the attempt it suddenly became clear to him what he had done. He openly confessed his crime, which he remembered in all its details, but which seemed to him to be something abnormal. He could not help it. For some days after this C. suffered with headache and congestions, and was now and then excited and restless, and slept badly. His mental functions are undisturbed, but he is, nevertheless, a congenitally peculiar man, with a character weak and devoid of energy. The facial expression has something lascivious and'pecuHar about it. He suffers with haemorrhoids. The genitals present nothing abnormal. The cranium is narrow and retreat- ing at the forehead. Body large and well nourished. With the exception of diarrhoea, there is no disturbance of the vegetative functions. Case 1 1 . Mrs. E., aged forty-seven. Uncle on father's side was insane ; father was sanguine, and given to excess in venery. Patient's brother died of an acute cerebral affection. Patient from childhood has been nervous, eccentric, and romantic, and while little more than a child manifested excessive sexual desire, and at ten began sexual indulgence. At nineteen, marriage. Unhappy married life ; her husband, who was normal, did not satisfy her, and until recent years she constantly had other friends besides her husband. She was well aware of the immorality of her life, but felt her powerlessness against her insatiable desire, which she sought to keep, at least outwardlj^, a secret. Later she thought that she had suffered with a " mania for men ". Patient has borne six children. Six years ago she was thrown from a waggon CEEEBEAL NEUROSES — HYPERESTHESIA.. 69 and received a severe cerebral concussion. Following this there was melanchoha, with delusions of persecution, which sent her to the asylum. She is approaching the climacterium, and of late the menses have been profuse and too frequent. Since this period she is pleased to note that the previously powerful sexual impulse has declined. Proper behaviour. Slight degree of descensus uteri and prolapsus ani. Hyperesthesia sexualis may be continuously present with exacerbations, or it may be intermittent or periodic. In the latter case it is a cerebral neurosis per se {vide " Special Pathology "), or an accompanying symptom of a condition of general psychical excitement (mania ; episod- ically in dementia paralytica, dementia senihs, etc.). Lentz has pubhshed a remarkable case of intermittent satyriasis (" Bulletin de la societe de med. legale de Belgique," Nr. 21) :— Case 12. For three years Farmer D., universally re- spected, married, aged thirty-five, has manifested states of sexual excitement with increasing frequency and severity, which during the past year have become true paroxysms of satyriasis. It was impossible to discover hereditary or other organic causes. D. was compelled at times, when his sexual excitement was excessive, to per- form the sexual act from ten to fifteen times in twenty- four hours, without deriving any feeling of satisfaction. Gradually he developed a condition of general nervous hyper-irritability {erethisme general) with increased emo- tional irritability to the extent of pathological outbreaks of anger, and impulse to over indulgence in alcohol, which induced symptoms of alcoholism. His attacks of satyri- asis became so violent that consciousness was interfered with, and the patient raged about in blind impulse to sexual acts. He demanded that his wife give herself to other men or to animils in his presence; that she allow 70 PSTCHOPATHIA SEXUALIS copulation with him, ^jresen^i/ms filiabus, because this would afford him greater enjoyment. Memory for the events of these attacks, in which the extreme irritabihty even led to outbreaks of maniacal rage, was entirely wanting. D. himself thought that he must have had moments in which he no longer had control of his senses, and without satis- faction from his wife would have been compelled to seize the next best female. After an attack of violent emotion these attacks of sexual excitement suddenly disappeared. The two following cases show how powerful, dangerous and painful sexual hyperaesthesia may become in those afflicted with this anomaly : — Case 13. Hypercesthesia Sexualis — Delirium acutum ex abstinentia.—On '29th May, 1882, F., aged twenty-nniCf single, shoemaker, was received at the clinic. Father was of passionate temper ; mother neuropathic, and had an insane brother. Patient had never been seriously ill previously, and was not a drinker ; had always been sexually very passionate. Five days before, he was taken acutely ill mentally. He made two attempts at rape in broad daylight before witnesses, and when arrested talked in delirium only of obscene things, masturbated inces- santly and from the third day on flew into furious rages. On admission he showed all the symptoms of severe acute delirium, with violent motor symptoms of irritation and fever. Under treatment with ergotin a cure was effected. On 5th January, 1888, second admission, in a state of violent mania. On 4th January he had become morose, irritable, lachrymose and sleepless ; and then, after vain assaults on women, had manifested symptoms of increas- ing furious excitement. On 6th January, progress of the condition to severe acute delirium (great disturbance of consciousness, jacta- tion, grinding of the teeth, grimacing, and other motor symptoms of irritation ; temperature as high as 40.7° C.) , CEREBRAL NEUROSES — llYrER^ESTHESIA. j'l impulsive masturbation. Recovery was complete by ilth January, under energetic treatment with ergotin. After bis recovety the patient gives an interesting account of the cause of his illness. Always very passionate sexually ; first coitus at the age of sixteen. Continence caused headache, great psychical irritability, lassitude, great loss of pleasure in work, and sleeplessness. Since he had few opportunities in the country to satisfy his desire, he had recourse to masturbation. It was necessary for him to masturbate once or twice daily. No coitus in two months. Increasing sexual excitement ; could think of nothing save means for the gratification of his impulse. Masturbation was not sufficient to banish the constantly increasing torment ex ahstinentia. During the last few days violent impulse to coitus ; mcreasing sleeplessness and irritability. There was only a summary recollection of the height of the illness. Patient recovered in Decem- ber. A very respectable man ; he considers his inordinate desire decidedly pathologicaf, and is anxious about his future. Case 14. On 11th July, 1884, R., aged thirty-three, servant, was admitted suffering with paranoia perseczitoria and neurasthenia sexualis. Mother was neuropathic ; father died of spmal disease. From childhood he had an intense sexual desire, of which he became conscious as early as his sixth year. From this age, masturbation ; from fifteenth year, /aw^e de mieux, pederasty; occasionally, sodomitic indulgences. Later, ahiisiis coitus in matrimonio cum uxore. Now and then even perverse impulse to commit cunmlingus and to administer cantharides to his wife, because her libido did not equal his own. His wife died after a short period of married life. Patient's cir- cumstances became straitened, and he had no moans to indulge himself sexually. Then masturbation again ; em- ployment of lingua canis to induce ejaculation. At times, priapism and conditions approaching satyriasis. He was 72 PSYCHOPATHIA SEXUALIS. then driven to masturbate, in order to avoid rape. With gradually predominating sexual neurasthenia and hypo- chondria came beneficial diminution of libido nimia. The following case, valuable for an understanding of many Messalinas, some of vi^hom are historically celebrated* is a classical example of pure hypercBsthesia sexualis, vi^hich I take from Trelat's " FoHe lucide " : — Case 1 5. Mrs. V. has suffered v^ith a passion for men since her earliest youth. Of good family, well bred, of pleasant disposition, exceedingly modest, she was, as a little girl, a terror to her family, because she could scarcely be alone with a person of the opposite sex, no matter whether it was with child or man of any age, without exposing herself immediately and demanding satisfaction for her sexual passion, even going so far as to lay hold of him. An attempt was made to cure her by marriage. She loved her husband passionately, but even with him she could not keep from demanding coitus of every one with whom she could be alone, no matter whether it was servant, labourer, or school-boy. Nothing could cure her of this impulse. Even when she became a grandmother, she was still a Messalina. One day she locked a twelve-year-old boy in her room and tried to seduce him. The boy defended himself and escaped. She was severely punished by his brother. All was in vain. She was put in a cloister. There she was an example of morality, and gave not the slightest cause for blame. Immediately after her return the scandal began again. The family banished her, and set aside money to support her. She earned by her own handi- work enough to buy herself lovers. Any one seeing this neatly dressed matron, of good manners and amiable dis- position, would never suspect how recklessly passionate she still was at the age of sixty-five. On 7th January, 1854, her family, in despair at new scandals, placed her CEREBRAL NEUROSES — HYPERESTHESIA. 73 in an asylnm. She lived there until Ma}^ 1858, when she died of cerebral apoplexy, in her seventy-third year. Her conduct in the asylum was exemplary. Left to herself, and under favourable conditions, her sexual impulses manifested themselves shortly before her death. With the exception of this, during an observation of four years by physicians of the asylum, she never showed a sign of mental abnormality. A particular species of hypercesthesia sexualis may be found in females in whom a most impulsive desire for sexual intercourse with certain men imperatively demands gratification. No doubt " unrequited love " for another man may often affect the married woman who does not either psychically or physically {impotentia mariti) ex- perience connubial satisfaction ; but the normal, untainted wife guided by ethical reasons knows how to conquer herself. Of course, pathological conditions change the situation. Fetichism must here be considered. Sexual impulse is overpowering, at times periodically recurrent. The very attempt to overcome it produces most painful attacks of worry and anxiety. This pathological want becomes so powerful that all considerations of shame, convention- ality and womanly honour simply disappear, and it reveals itself in the most shameless manner even to the husband, whilst the normal woman, endowed with full moral con- sciousness, knows how to conceal the terrible secret. Magnan (''FsychiaLtr. VorlesuQgen") quotes two striking instances from his own experience. One is specially instructive. A young woman, mother of three children, with a blameless past, but daughter of a lunatic, tells her husband one day openly that she is in love with a certain young man and that she would kill herself if her intimate relations with him were interfered with. She begs per- mission to live with him for six months in order to quench the fire of her passion, wnen she would return to her 74 PSYCHOrATHIA SEXUALIS. family again. Husband and children have no place in her heart with her present love. The husband took her to a foreign country and placed her there under medical treat- ment. This pathological love of married women for other men is a phenomenon in the domain of psychopathia sexualis which sadly stands in need of scientific explanation. The author has had the opportunity of observing five cases belonging to this category. The pathological conditions were paroxysmal, in one case repeatedly recurrent ; but always sharply distinct from the unaffected, healthy period, duriiig which deep sorrow and contrition over the occurrence were manifested. But it was the sorrow over an unavoidable fatality caused by psychically abnormal conditions. Whilst the pathological conditions lasted, absolute in- difference, even hatred, prevailed towards husband and children, and an utter want of understandmg the bearings and consequences of the scandalous behaviour, jeopardising the honour and dignity of wife and family, were noticeable. It is remarkable that in all these cases the husband and relatives had come to the conclusion that the condition was caused by psychopathia, even before they had obtained 3xpert opinion. As against the " non-psychopathical " but otherwise abnormally hbidinous Messalmas, it is well worthy of note that this sexual aberration is only an episode in the life of the otherwise honourable woman, and that the illicit inter- course was of a strictly monogamic character. This, and particularly the circumstance that the unfortunate woman was not omnium virorum mulier, but only the mistress of one man, establishes a distinct difference from nympho- mania. In three of the cases mentioned above, the grossly sensual momentum was missing, the real motive for marital infidelity was to be found in a letich-like charm, in mental superior qualities, — in one case the voice of the charmer, in two cases unmistakable proofs of hyperesthesia CEREBRAL NEUROSES — PARiESTHESIA OF FEELING. 75 sexualis and of absolute impotence towards the husband were found, whilst the merest touch of the other man produced orgasm, and the sexual act the acme of pleasure. Of course, in these latter cases absolute sexual abandon- ment followed. D. Paraesthesia of Sexual Feeling (Perversion of the Sexual Instinct). In this condition there is perverse emotional colouring, of the sexual ideas. Ideas physiologically and psycho- logically accompanied by feehngs of disgust, give rise to pleasurable sexual feelings ; and the abnormal association finds expression in passionate, uncontrollable emotion. The practical results are perverse acts (perversion of the sexual instinct). This is more easily the case if the pleasurable feelings, increased to passionate intensity, inhibit any opposing ideas with corresponding feelings of disgust ; or the influence of such opposing conceptions may be rendered impossible on account of the absence or loss of all ideas of morality, sesthetics and law. This loss, however, is only too frequently found where the spring well of ethical ideas and feelings (a normal sexual in- stinct) has been poisoned from the beginning. With opportunity Jor the natural satisfaction of the sexual instinct, every expression of it that does not cor- respond with the purpose of nature — i.e., propagation — must be regarded as perverse. The perverse sexual acts re.^^uUing from paropsthesia are of the greatest importance clinically, socially, and forensically ; and, therefore, they must here receive careful consideration ; all aesthetic and moral disgust must be overcome. Perversion of the sexual instinct, as will be seen farther on, is not to be confounded with perversity in the sexual act ; since the latter may be induced by conditions other than psycho-patholf)gical . The concrete perverse act, mon- strous as it niny be, is clinically not decisive. In order 76 PSYCnOPATHIA SEXUALIS. to differentiate between disease (perversion) and vice (per- versity), one must investigate the w^hole personality of the individual and the original motive leading to the per- verse act. Therein will be found the key to the diagnosis {v. infra). Parsesthesia may occur in combination with hyperaes- thesia. This association seems to be frequent clinically. Sexual acts are then confidently to be expected. The perverse direction of sexual activity may be toward sexual ■satisfaction with the opposite or the same sex. Thus two great groups of perversions of sexual life may be dis- tinguished. I. Sexual Inclination Toward Persons of the Opposite Sex, with Perverse Activity of the Instinct. 1. Association of Active Cruelty and Violence with Lust — Sadism} That lust and cruelty often occur together is a fact that has long been recognised and is frequently observed. Writers of all kinds have called attention to this phe- nomenon.'-^ The not infrequent cases where individuals of very exc table sexual natures bite or scratch the com- panion in intercourse fall withm physiological limits.^ The older authors have called attention to the relation between lust and cruelty. Blumrdder (" Ueber Irresein," Leipzig, 1836, p. 51) saw 1 So named from the notorious Marquis de Sade, whose obscene novels treat of, lust and cruelty. In French literature the expression " Sadism" has been applied to this perversion. Eiilcnburg (" Klin. Handb. der Harn- und Sexual-organe " ) uses the term "active algolagnia" in connection with these phenomena. ^U.A.Novalis, in his " Fragments " ; Gorres, "Christliche Mystik,*' Bd. ill., p. 460. *C/. also Alfred de Musset's famous verses to the Andalusian girl: — " Qu'elle est superbe en son desordre — quand elle tombe les seins nus — Qu'on la volt, beante, se tordre — dans un baiser de rage et mordre — En hurlant des mots inconnus ! " SEXUAL INCLINATION TOWAED THE OPPOSITE SEX. 77 a man who had several wounds in the pectoral muscle, which a woman, in great sexual excitement, had bitten at the acme of lustful feeling during coitus. The same author (" Ueber Lust und Schmerz," Friedreich's " Magazin fiir Seelenkunde, 1830, ii., 5) calls especial attention to the psychological connection between lust and murder. In relation to this, he especially refers to the Indian myths of Siva and Durga (Death and Lust) ; to human sacrifice with voluptuous mysteries ; and to sexual instinct at puberty with a lustful impulse to suicide, with whipping, pinching, and pricking of the genitals, in the bhnd im- pulse to satisfy sexual desire. Lombroso (" Verzeni e Agno- letti," Eome, 1874) also cites numerous examples of the occurrence of a desire to murder with greatly increased lust. On the other hand, when homicidal mania has been excited, lust often follows. Lombroso (op. cit.) alludes to the fact mentioned by Mantegazza, that to the terrors of spohation and plunder by bandits generally are added those of brutal lust and rape.^ These examples form transitions to the pronounced pathological cases. The examples of the degenerate Caesars (Nero, Tiberius) are also instructive. They took delight in having youths and maidens slaughtered before their eyes. Not less so is the history of that monster, Marschalls Gilles de Eays {Jacob, " Curiosites de I'histoire de France," Paris, 1858), who was executed in 1440, on account of mutilation and murder, which he had practised for eight years on more than 800 children. As the monster confessed it, it was from reading Suetonius and the descriptions of the orgies of Tiberius, Caracalla, etc., that the idea was gained of 1 During the excitement of battle the idea of lust forces its way into consciousness. Cf. the description of a battle, by a soldier, by Grill- •parzer : — " And as the signal rang out, the armies met, breast to breast — lust of the gods! — here, there, the murderous steel slays enemy, friend. Given and taken — death and life — with wavering change — wildly raging in frenzy" (" Dream a Life," Act i.). 7b PSYCIIOPATHIA SEXUALIS. locking children in his castles, torturing thero, and then killing them. This inhuman wretch confessed that in the commission of these acts he enjoyed inexpressible pleasure. He had two assistants. The bodies of the unfortunate children were burned, and only a number of heads of particularly beautiful children were preserved — as me- morials. Gf. Exdenhurg, op. cit. p. 58, where he gives satisfactory proof of Rays' insanity. In an attempt to explain the association of lust and cruelty, it is necessary to return to a consideration of the quasi-physiological cases, in which, at the moment of most intense lust, very excitable individuals, who are otherwise normal, commit such acts as biting and scratching, which are usually due to anger. It must further be remembered that love and anger are not only the most intense emotions, but also the only two forms of robust (sthenic) emotion. Both seek their object, try to possess themselves of it, and naturally exhaust themselves in a physical effect on it ; both throw the psycho-motor sphere into the most intense excitement, and thus, by means of this excitation, reach their normal expression. From this standpoint it is clear how lust impels to acts that otherwise are expressive of anger.^ The one, like the other, is a state of exaltation, an intense excita- tion of the entire psycho-motor sphere. Thus there irises an impulse to react on the object that induces the stimulus, in every possible way, and with the greatest intensity. Just as maniacal exaltation easily passes to raging destructiveness, so exaltation of the sexual emo- tion often induces an impulse to spend itself in senseless and apparently harmful acts. To a certain extent these are psychical accompaniments ; but it is not simply an unconscious excitation of innervation of muscles (which 1 Schulz (" Wiener Med. Wocheuschrift," No. 49, 1869) reports a re- markable case of a man, aged twenty-eight, who could perform coitus with his wife only after working himself into an artificial fit of anger. SEXUAL INCLINATION TOWARD THE OPPOSITE SEX. 79 also sometimes occurs as blind violence) ; it is a true hyperbole, a desire to exert the utmost possible effect upon the individual giving rise to the stimulus. The most intense means, however, is the infliction of pain. Through such cases of infliction of pain during the most intense emotion of lust, we approach the cases in which a real injury, wound, or death is inflicted on the victim.^ In these cases the impulse to cruelty which may accompany the emotion of lust, becomes unbounded in a psychopathic individual ; and, at the same time, owing to defect of moral feeling, all normal inhibitory ideas are absent or weakened. Such monstrous, sadistic acts have, however, in men, in whom they are much more frequent than in women, another source in physiological conditions. In the inter- course of the sexes, the active or aggressive role belongs to man ; woman remains passive, defensive.^ It affords man great pleasure to win a woman, to conquer her ; and m the ars amandi, the modesty of woman, who keeps her- self on the defensive until the moment of surrender, is an element of great psychological significance and importance. Under normal conditions man meets obstacles which it is his \)Qxi to overcome, and for which nature has given him an aggressive character. This aggressive character, however, under pathological conditions may hkewise be excessively developed, and express itself in an impulse to subdue absolutely the object of desire, even to destroy or kill it.^ 'Concerning analogous acts in rutting animals, vide Lombroso, "The Criminal ". -Among animals it is always the male who pursues the female with proffers of love. Playful or actual flight of the female is not infrequently observed ; and then the relation is like that between the beast of prey and the victim. =*The conquest of woman takes place to-day in the social form of courting, in seduction and deception, etc. From the history of civilisation and antliropology we know that there have been times, as there are aavages to-day that practise it, whore brutal force, robbery, or oven 80 PSYCHOPATHIA SEXUALIS. If both these constituent elements occur together — the abnormally intensified impulse to a violent reaction toward the object of the stimulus, and the abnormally intensified desire to conquer the woman, — then the most violent outbreaks of sadism occur. Sadism is thus nothing else than an excessive and monstrous pathological intensification of phenomena, — possible, too, in normal conditions in rudimental forms, — which accompany 'the psychical vita sexualis, particularly in males. It is of course not at all necessary, and not even the rule, that the sadistic individual should be con- scious of his instinct. "What he feels is, as a rule, only the impulse to cruel and violent treatment of the opposite sex, and the colouring of the idea of such acts with lustful feelings. Thus arises a powerful impulse to commit the imagined deeds. In as far as the actual motives of this instinct are not comprehended by the individual, the sadistic acts have the character of impulsive deeds. When the association of lust and cruelty is present, not only does the lustful emotion awaken the impulse to cruelty, but vice versa; cruel ideas and acts of cruelty blows that rendered a woman powerless, were made use of to obtain love's desire. It is possible that tendencies to such outbreaks of sadism are atavistic. In the " Jahrbiicher fiir Psychologie," ii., p. 128, Schcifer (Jena) refers to the reports of two cases by A. Payer. In the first case states of great sexual exoifceaient were induced by the sight of battles or of paint- ing's of them ; in the second, by cruel torturing of small animals. It is added : " The pleasure of battle and murder is so predominantly an attribute of the male sex throughout the animal kingdom that there can be no question about the close relation existing between this side of the masculine character and male sexuality. I believe, too, that by un- prejudiced observation I can show that, in men who are mentally and physically absolutely normal, the first indefinite and incomprehensible precursors of sexual excitement may be induced by the reading of exciting scenes of the chase and war — i.e., they give rise to unconscious longings for a kind of satisfaction in warlike games (wrestling), in which the fundamental sexual impulse to the most perfect and intense contact with a companion is expressed, with the secondary thought of conquest more or less clearly defined." SEXUAL INCLINATION TOWARD THE OPPOSITE SEX. 81 cause sexual excitement, and in this way are used by perverse individuals.^ A differentiation of original and acquired cases of sadism is scarcely possible. Many individuals, tainted ah origine, for a long time do everything to conquer the perverse instinct. If they are potent,' they are able for some time to lead a normal vita sexualis, often with the assistance of fanciful ideas of a perverse nature. Later, when the opposing motives of an ethical and aesthetic kind have been gradually overcome, and when oft-re- peated experience has proved the natural act to give but incomplete satisfaction, the abnormal instinct suddenly bursts forth. Owing to this late expression, in acts, of an originally perverse disposition, the appearances are those of an acquired perversion. As a rule, it may be safely assumed that this psychopathic state exists ab origine. Sadistic acts vary in monstrousness according to the power exercised by the perverse instinct over the indi- vidual thus afflicted, and in accordance with the strength of opposing ideas that may be present, which nearly always are more or less weakened by original ethical defects, hereditary degeneracy, or moral insanity. Thus there arises a long series of forms which begins with capital crime and ends with paltry acts affording merely symbolic satisfaction to the perverse desires of the sadistic individual. Sadistic acts may be further differentiated according to their nature : either taking place after consummated coitus which leaves the libido nimia unsatisfied ; or, with diminished virihty, being undertaken to merely stimulate the diminished power ; or, finally, where virility is abso- lutely wanting, as becoming simply an equivalent for impossible coitus, and for the induction of ejaculation. ^It sometimes happens that an accidental sight of blood, etc., puts into motion the preformed psychical mechanism of the sadistic individual and awakens the instinct. 6 82 PSYCIIOPATHIA SEXUALIS. In the last two cases, notwithstanding impotence, there is still nitense libido ; or there was, at least, intense libido in the individual at the time when the sadistic acts became a habit. Sexual hyperaesthesia must always be regarded as the basis of sadistic inclinations. The impotence which occurs so frequently in psychopathic and neuropathic individuals here considered, resulting from excesses practised in early youth, is usually de- pendent upon spinal weakness. Often, too, there is a kind of psychical impotence, superinduced by concentra- tion of thought on the perverse act with simultaneous fading of the idea of normal satisfaction. No matter what the external form of the act may be, the mentally perverse predisposition and instinct of the individual are essential to an understanding of it. (a) Lust-Murder^ {Lust Potentiated as Cruelty, M^irdcrous Lust Extending to Anthropophagy). The most horrible example, and one which most pijintedly shows the connection between lust and a de- sire to kill, is the case of Andreas Bichel, which Fcuerbach published in his " Aktenmassige Darstellung merkwiir- diger Verbrechen ". B. puellas stupratas necavit et dissecuit With refer- ence to one of his victims, at his examination he expressed himself as follows: "I opened her breast and with a knife cut through the fleshy parts of the body. Then I arranged the body as a butcher does beef, and hacked it with an axe into pieces of a size to fit the hole which I had dug up in the mountain for burying it. I may say that while opening the body I was so greedy that I trembled, and could have cut out a piece and eaten it." Lombroso, too (" Geschlechtstrieb und Verbrechen in ihren gegenseitigen Beziehungen ". " Goltdammer's Archiv," ^ Gf. " Melzger's ger. Arzueiw., herausgegeben von Rcmcr," p. 539; " Klein's Annalen,"x., p. 17G ; xviii., p. 311 ; Hcinroth, " System der psych. Med.," p. 270 ; Neucr Pitaval, 1855, 23 Th. (" Fall Blaize Ferrage ") SEXUAL INCLINATION TOWARD THE OPPOSITE SEX. 83 Bd. XXX.), mentions cases falling in the same category. A certain Phillipe indulged in strangling prostitutes, post actum, and said: "I am fond of women, but it is sport for me to strangle them after having enjoyed them". A certain Grassi {Lombroso, op. cit., p. 12) was one night seized with sexual desire for a relative. Irritated by her remonstrance, he stabbed her several times in the abdomen with a knife, and also murdered her father and uncle who attempted to hold him back. Immediately thereafter he hastened to visit a prostitute in order to cool in her embrace his sexual passion. But this was not sufficient, for he then murdered his own father and slaughtered several oxen in the stable. It cannot be doubted, after the foregoing, that a great number of so-called lust murders depend upon combined hyperaesthesia and paroesthesia sexuahs. As a result of this perverse colouring of the feelings, further acts of bestiahty with the corpse may result — e.g., cutting it up and wallowing in the intestines. The case of Bichel points to this possibility. A modern example is that of Menesclou (" Annales d'hygiene publique"), who was examined by Lasegue, Brouardel and Motet, declared to be mentally sound, and executed. Case 16. A four-year-old girl was missing from her parents' home, 15th April, 1880. On 16th April, Menes- clou,, one of the occupants of the house, was arrested. The forearm of the child was found in his pocket, and the head and entrails, in a half-charred condition, were taken from the stove. Other parts of the body were found in the water-closet. The genitals could not be found. M., when asked their whereabouts, became embarrassed. The circumstances, as well as an obscene poem found on his person, left no doubt that he had violated the child and then murdered her. M. expressed no remorse, as- serting that his deed was an unhappy accident. His 84 PSTCHOPATHIA SEXUALIS. intelligence is limited. He presents no anatomical signs of degeneration ; is somewhat deaf and scrofulous. M., aged twenty ; convulsions at the age of nine months. Later he suffered from disturbed sleep (enuresis nocturna) ; was nervous, and developed tardily and im- perfectly. With puberty he became irritable, showed evil inclinations, was lazy, intractable, and in all trades proved to be of no use. He grew no better even in the House of Correction. He was made a marine, but there, too, he proved useless. When he returned home he stole from his parents, and spent his time in bad company. He did not run after women, but gave himself up passionately to masturbation, and occasionally indulged in sodomy with bitches. His mother suffered with mania menstrualis periodica. An uncle was insane, and another a drunkard. The examination of M.'s brain showed morbid changes of the frontal lobes, of the first and second temporal con- volutions, and of a part of the occipital convolutions. Case 1 7. Alton, a clerk in England, goes out of town for a walk. He lures a child into a thicket, and returns after a time to his office, where he makes this entry in his note-book : " Killed to-day a young girl ; it was fine and hot ". The child was missed, searched for, and found cut into pieces. Many parts, and among them the genitals, could not be found. A. did not show the slightest trace of emotion, and gave no explanation of the motive or circumstances of his horrible deed. He was a psycho- pathic individual, and occasionally subject to fits of de- pression with tcedinm vitce. His father had had an attack of acute mania. A near relative suffered from mania with homicidal impulses. A. was executed. In such cases it may even happen that appetite for the flesh of the murdered victhn arises, and in consequence of this perverse colouring of the idea, parts of the body may be eaten. SEXUAL INCLINATION TOWARD THE OPPOSITE SEX. 85 Case 18. Leger, vine-dresser, aged twenty-four. From youth moody, silent, shy of people. He starts out in search of a situation. He wanders about eight days in the forest, there catches a girl twelve years old, violates her, mutilates her genitals, tears out her heart, eats of it, drinks the blood, and buries the remains. Arrested, at first he lied, but finally confessed his crime with cynical cold-blooded- ness. He listened to his sentence of death with indiffer- ence^ and was executed. At the post-mortem examination Esquirol found morbid adhesions between the cerebral membranes and the brain {Georget, " Darstellung der Pro- zesse Leger, Feldtmarm," etc., Darmstadt, 1827). Case 19. Tirsch, hospital beneficiary of Prag, aged fifty-five, always silent, peculiar, coarse, very irritable, grumbling, revengeful, was sentenced to twenty years' imprisonment for violating a girl ten years old. He had attracted attention on account of outbursts of anger from insiefiiificant causes, and also on account of tsedium vitse. In 1864, on account of the refusal of an offer of marriage which he made to a widow, he developed a hatred toward women, and on 8th July he went about with the intention of killing one of this hated sex. Vetulam occurrentcm in silvam allexit, coitum poposcit, renitentem prostravit, jugulum femincB conipressit "furore capitis ". Cadaver virga hetula desecta verberare voluit neqiietamen id perfecit, quia conscientia sua haec fieri vetuit, cuUello mammas et genitalia desecta domi cocta proximis diehus cum globis comedit. On 12th Sep- tember, when he was arrested, the remains of this meal were found. He gave as the motive of this act "inner impulse". He himself wished to be executed, because he had always been an outcast. In confinement there were great emotional irritability and occasional outbursts of fury, preceded by refusal of food, which made isolation, lasting several days, necessary. It was authoritatively estabhshed that the most of his earlier excesses were co- incident with outbreaks of excitement and fury (Maschka, 86 PSYCHOPATHIA SEXUALIS. "Prager Vierteljahrsschrift," 1866, i., p. 79. " Gauster bei Maschka, Handb. der gerichtl. Medicin," iv., p, 489). The Whitechapel murderer, who has successfully eluded the vigilance of the police, probably belongs in this category of psycho-sexual monsters.^ The constant absence of uterus, ovaries, and labia in the victims (ten) of this modern Bluebeard allows the presumption that he sought and found still further satisfaction in anthro- pophagy. In other cases of lust-murder, for physical and mental reas )ns (vide supra), violation is omitted, and the sadistic crime alone becomes the equivalent of coitus. The pro- totype of such cases is the following one of Verzeni. The life of his victim hung on the rapid or retarded occurrence of ejaculation. Since this remarkable case presents all the peculiarities which modern science knows concerning the relation of lust to lust-murder with anthropophagy, and especially since it was carefully studied, it receives detailed description here : — Case 20. Vincenz Verzeni, born in 1849 ; since 11th January, 1872, in prison ; is accused (1) of an attempt to strangle his nurse Marianne, foar years ago, while she lay sick in bed ; (2/ of a similar attempt on a married woman, Arsufti, aged twenty- seven ; (3) of an attempt to strangle a married woman, Gala, by gra ping her throat while kneeling on her abdomen ; (4) on suspicion of the following murders : — In December a fourteen-year-old girl, Johanna Motta, set out for a neighbouring village between seven and eight o'clock in the morning. As she did not return, her master set out to find her, and discovered her body near the village, lying by a path in the fields. The corpse was frightfully ^ Cf. Spitzka, " The Journal of Nervous and Mental Disease," Decem- ber, 1888; Kicrnan, "The Medical Standard," November, December, 1888. SEXUAL INCLINATION TOWARD THE OPPOSITE SEX. 87 mutilate'.] with nuinerons wounds. The intestines and genitals had been torn from the open body, and were found near by. The nakedness of the body and erosions on the thighs made it seem probable that there had been an attempt at rape; the mouth, filled with earth, pointed to suffocation. In the neighbourhood of the body, under a pile of straw, were found a portion of flesh torn from the right calf, and pieces of clothing. The perpetrator of the deed remained undiscovered. On 28th August, 1871, a married woman, Frigeni, aged twenty-eight, set out into the fields early in the morning. As she did not return by eight o'clock, her husband started out to fetch her. He found her a corpse, lying naked in the field, with the mark of a thong around her neck, with which she had been sti'angled, and with numerous wounds. The abdomen had been slit open, and the intestines were hanging out. On 29th August, at noon, as Maria Previtali, aged nine- teen, went through a field, she was followed by her cousin, Verzeni. He dragged her into a field of grain, threw her to the ground, and began to choke her. As he let go of her for a moment to ascertain whether any one was near, the girl got up and, by her supplicating entreaty, induced Verzeni to let her go, after he had pressed her hands together for some time. Verzeni was brought before a court. He is twenty- two years old. His cranium is of more than average size, but asymmetrical. The right frontal bone is narrower and lower than the left, the right frontal prominence being less developed, and the right ear smaller than the left (by 1 centimetre in length and 3 centimetres in breadth) ; both ears are defective in the inferior half of the helix ; the right temporal artery is somewhat atheromatous. Bull- necked ; enormous development of the zygoma and inferior maxilla; penis greatly developed, /r«7mm wanting; slight divergent alternating strabismus (insufficiency of the in- ternal rectus muscle, and m^-opia). Lombroso concludes, 88 PSYCHOPATHIA SEXUALIS. from these signs of degeneration, that there is a congenital arrest of development of the right frontal lobe. As seemed probable, Verzeni has a bad ancestry — two micles are cretins ; a third, microcephalic, beardless, one testicle wanting, the other atrophic. The father shows traces of pellagrous degeneration, and had an attack of hypo- chondria pellagrosa. A cousin suffered from cerebral hyperaemia ; another is a confirmed thief. Verzeni's family is bigoted and low-minded. He him- self has ordinary intelligence; knows how to defend himself well ; seeks to prove an alibi and cast suspicion on others. There is nothing in his past that points to mental disease, but his character is peculiar. He is silent and inclined to be solitary. In prison he is cynical. He masturbates, and makes every effort to gain sight of women. Verzeni finally confessed his deeds and their motive. The commission of them gave him an indescribably pleasant (lustful) feeling, which was accompanied by erec- tion and ejaculation. As soon as he has grasped his victim by the neck, sexual sensations were experienced. It was entirely the same to him, with reference to these sensa- tions, whether the women were old, young, ugly, or beautiful. Usually, simply choking them had satisfied him, and he then had allowed his victims to live ; in the two cases mentioned, the sexual satisfaction was delayed, and he had continued to choke them until they died. The gratification experienced in this garrotting was greater than in masturbation. The abrasions of the skin on Motta's thighs were produced by his teeth, whilst sucking her blood in most intense lustful pleasure. He had torn out a piece of flesh from her calf and taken it with him to roast at home ; but on the way he hid it under the straw- stack, for fear his mother would suspect him. He also carried pieces of the clothing and intestines some distance, because it gave him great pleasure to smell and touch them. The strength which he possessed in these moments of intense lustful pleasure was enormous. He had never SEXUAL INCLINATION TOWARD THE OPPOSITE SEX. 89 been a fool ; while committing his deeds he saw nothing around him (apparently as a result of intense sexual ex- citement, annihilation of perception — instinctive action). After such acts he was always very happy, enjoying a feeling of great satisfaction. He had never had pangs of conscience. It had never occurred to him to touch the genitals of the martyred women, or to violate his victims. It had satisfied him to throttle them and suck their blood. These statements of this modern vampire seem to rest on truth. Normal sexual impulses seem to have remained foreign to him. Two sweethearts that he had, he was satisfied to look at ; it was very strange to him that he had no inclination to strangle them or press their hands but he had not had the same pleasure with them as with his victims. There was no trace of moral sense, remorse and the like. Verzeni said himself that it would be a good thing if he were to be kept in prison, because with freedom he could not resist his impulses. Verzeni was sentenced to imprisonment for life {Lombroso, "Verzeni e Agnoletti," Eome, 1873). The confessions which Verzeni made after his sentence are interesting : — " I had an unspeakable delight in strangling women, ex- periencing during the act erections and real sexual pleasure. It was even a pleasure only to smell female clothing. The feeling of pleasure while strangling them was much greater than that which I experienced while masturbating. I took great delight in drinking Motta's blood. It also gave me the greatest pleasure to pull the hair-pins out of the hair of my victims. " I took the clothing and intestines, because of the pleasure it gave me to smell and touch them. At last my mother came to suspect me, because she noticed spots of semen on my shirt after each murder or attempt at one. I am not crazy, but in the inoment of strangling my victims I saw nothing else. After the commission of the deeds I was satisfied and felt well. It never occurred to me to 90 PSTCHOPATHIA SEXUALIS. touch or look at the genitals or such things. It satisfied me to seize the women by the neck and suck their blood. To this very day I am ignorant of how a woman is formed. During the strangling and after it, I pressed myself on the entire body without thinking of one part more than another." Verzeni arrived at his perverse acts quite indepen- dently, after having noticed, when he was twelve years old, that he experienced a peculiar feeling of pleasure while wringing the necks of chickens. After this he had often killed great numbers of them and then said that a weasel had been in the hen-coop {Lombroso, " Goltdammer's Archiv," Bd. xxx., p. 13). Lombroso mentions an analogous case (" Goltdammer's Archiv") which occurred in Vittoria (Spain): — Case 21. A certain Gruyo, aged forty-one, with a blameless past life, having been three times married, strangled six women in the course of ten years. They were almost all public prostitutes and quite old. After the strangling he tore out their intestines and kidneys j^er vaginam. Some of his victims he violated before killing, others, on account of the occurrence of impotence, he did not. He set about his horrible deeds with such care that he remamed undetected for ten years. (b) Mutilation of Corpses. Following on the preceding horrible group of perver- sions, come naturally the necrophiles ; in these cases, just as with lustful murderers and analogous cases, an idea which in itself awakens a feeling of horror, and before which a sane person would shudder, is accompanied by lustful feelings, and thus leads to the impulse to indulge in acts of necrophilia. The cases of mutilation of bbdies mentioned in litera- ture seem to be of a pathological character ; but, with the SEXUAL INCLINATION TOWAED THE OPPOSITE SEX. 91 exception of the celebrated one of Sergeant Bertrand {v. infra), they are far from being described and observed with exactness. In certain cases there may be nothing more than the possibihty that mibridled desire sees in the idea of death no obstacle to its satisfaction. The seventh case mentioned by Moreau is perhaps such a one : — A man, aged twenty-three, attempted to rape a woman, aged fifty-three. Strugglmg, he killed her, and then vio- lated her, threw her in the water, and fished her out again for renewed violation. The murderer was executed. The meninges of the anterior lobes were thickened and ad- herent to the cortex. French writers have recorded numerous examples of ^lecrophilia. Two cases concerned monks performing the watch for the dead. In a tbird case the subject was an idiot, who also suffered from periodical mania, and after commission of rape was sent to an insane asylum, and there mutilated female bodies in the mortuary. In other cases, however, there is undoubtedly direct preference for a corpse to the living woman. When no other act of cruelty — cutting into pieces, etc. — is practised on the cadaver, it is probable that the lifeless condition itself forms the stimulus for the perverse individual. It is possible that the corpse — a human form absolutely without will — satisfies an abnormal desire, in that the object of desire is seen to be capable of absolute subjuga- tion, without possibility of resistance. Bricrrc dc Boismont ("Gazette medicale," 21st July, 1850) relates tbe history of a corpse-violator who, after bribing the watchman, had gained entrance to the corpse of a girl of sixteen belonging to a family of high social position. At nigbt a noise was heard in the death- chamber, as if a piece of furniture had fallen over. The mother of the dead girl effected an entrance and saw a man dressed in his night-shirt springinjj; from the bed where tbe body lay. It was nt first thought that the man was a thief, but the real explanation was soon discovered. 92 PSTCHOPATHIA SEXUALIS. It was afterwards ascertained that the culprit, a man of good family, had often violated the corpses of young women. He was sentenced to imprisonment for life. The story of a prelate, reported by Taxil^ (" La prosti- tution contemporaine," p. 171), is of great interest as an example of necrophilia. From time to time he would visit a certain brothel in Paris and order a prostitute, dressed in white like a corpse, to be laid out on a bier. At the appointed hour he would appear in the room, which, in the meantime had been elaborately prepared as a room of mourning ; then he would act as if reading a mass for the soul, and finally throw himself upon the girl, who, during the whole time, was compelled to play the role of a corpse.^ The cases in which the perpetrator injures and cuts up the corpse are clearer. Such cases come next to those of lust-murder, in so far as cruelty, or at least an impulse to attack the female body, is coimected with lust. It is possible that a remnant of moral sense deters from the cruel act on a hving woman, and possibly the fancy passes beyond lust-murder and rests on its result, the corpse. Here also it is possible that the idea of defencelessness of the body plays a role. Case 22. Sergeant Bertrand, a man of delicate phy- sical constitution and of peculiar character ; from child- hood silent and inclined to solitude. The details of the health of his family are not satis- ^A similar case is related by Ncri (" Arcliivio dalle psicopatie ses- suali," 1896, p. 109). A man, fifty years of age, uses in a Lupanar only girls who clad in white, lie motionless, feigning death. He violated tlie body of his own sister, immissione mentulcB in os mortuce usque ad ejacnlationem! This monster had also fits of fetichism for crines pubis pudlariim, and the trimmings of their fingernails ; eating them caused strong sexual emotions. 2 Simon (" Crimes et delits," p. 209) mentions an experience of La- cassagne's, to whom a respectable man said that he was never intensely excited sexually except when a spectator at a funeral. SEXUAL INCLINATION TOWAED THE OPPOSITE SEX. 93 factorily known ; but the occurrence of mental diseases in his ancestry is ascertained. It is said that while he was a child he was affected with destructive impulses, which he himself could not explain. He would break whatever was at hand. In early childhood, without teaching, he learned to masturbate. At nine he began to feel inclina- tions towards persons of the opposite sex. At thirteen the impulse to sexual intercourse became powerfully aw^akened in him. He now masturbated excessively. When he did this, his fancy always created a room filled with women. He would imagine that he carried out the sexual act with them and then killed them. Immediately thereafter he would think of them as corpses, and of how he defiled them. Occasionally in such situations the thought of carrying out a similar act with male corpses would come up, but it was always attended with a feeling of disgust. In time* he felt the impulse to carry out such acts with actual corpses. For want of human bodies, he obtained those of animals. He would cut open the abdomen, tear out the entrails, and masturbate during the act. He de- clares that in this way he experienced inexpressible pleasure. In 1846 these bodies no longer satisfied him. He now killed dogs, and proceeded with them as before. Toward the end of 1846 he first felt the desire to make use of human bodies. At first he had a horror of it. In 1847, being by accident in a graveyard, he ran across the grave of a newly buried corpse. Then this impulse, with headache and palpitation of the heart, became so powerful that, although there were people near by, and he was in danger of detection, he dug up the body. In the absence of a convenient instrument for cutting it up, he satisfied himself by hacking it with a shovel. In 1847 and 1848, during two weeks, as reported, the impulse, accompanied by violent headache, to conmiit brutalities on corpses actuated him. Amidst the greatest 94 PSYCHOPATHIA SEXUALIS. dangers and difficulties he satisfied this impulse some fifteen times. He dug up the bodies with his hands, in nowise sensible in his excitement to the mjuries he thus inflicted on himself. When he had obtained the body, he cut it up with a sword or pocket-knife, tore out the entrails, and then masturbated. The sex of the bodies is said to have been a matter of indifference to him, though it was ascertained that this modern vampire had dug up more female than male corpses. During these acts he declares himself to have been in an indescribable state of sexual excitement. After having cut them up, he reinterred the bodies. In July, 1848, he accidentally came across the body of a girl of sixteen. Then, for the first time, he experienced a desire to carry out coitus on a. cadaver. "I covered it with kisses and pressed it wildly to my heart. All that one could enjoy with a living woman is nothing in comparison with the pleasure I experienced. After I had enjoyed it for about a quarter of an hour, I cut the body up, as usual, and tore out the entrails. Then I buried the cadaver again." Only after this, as B. declares, had he felt the impulse to use the bodies sexually before cutting them up, and thereafter he had done it in three instances. The actual motive for exlnnning the bodies, however, was then, as before, to cut them up ; and the enjoyment in so doing was greater than in using the bodies sexually. The latter act had always been nothing more than an episode of the principal one, and had never quieted his desires ; for which reason he had later on always mutilated the body. The medico-legal examiners gave an opinion of " mono- mania ". Court-martial sentence to one year's imprison- ment. {Michea, "Union med.," 1849; Limicr, "Annal. med.-psycho.," 1849, p. 153 ; Tardieu, " Attentats aux moeurs," 1878, p. 114; Legraiid, "La folic devant les tribun.," p. 524.) SEXUAL INCLINATION TOWARD THE OPPOSITE SEX. 95 (c) Injury to Women (Stabbing, Flagellation, etc.). Following lust-murder and violation of corpses, come cases closely allied to the former, in which injury of the victim of lust and sight of the victim's hiood are a dehght and pleasure for degenerate men. The notorious Marquis de Sade/ after whom this combination of lust and crueltv has been named, was such a monster. Coitus only excited him when he could prick the object of his desire until the blood came. His greatest pleasure was to injure naked prostitutes and then dress their wounds. The case of a captain belongs here, mentioned by Brierre de Boismont, who always compelled the object of his affection to place leeches ad pitd'enda before coitus, which was very frequent. Finally this woman became very anaemic and, as a result of this, insane. The following case, from my own practice, very clearly shows the connection between lust and cruelty, with desire to shed and see blood : — Case 23. Mr. X., aged twenty-five; father syphilitic, died of paretic dementia ; mother hysterical and neur- asthenic. He is a weak individual, constitutionally 1 Taxil (op. cit.) gives more detailed accounts of this sexual monster, which must have been a case of habitual satyriasis, accompanied by perverse sexual instinct. Sade was so cynical that he actually sought to idealise his cruel lasciviousness and to be the apostle of a theory based upon it. He got so bad (among other things he made an invited company of ladies and gentlemen erotic by causing to be served to them chocolate bonbons which contained cantharides) that he was committed to the insane asylum at Charenton. During the revolution of 1790 he escaped. Then he wrote obscene novels filled with lust, cruelty and the most lascivious scenes. When Bonaparte became Consul, Sade made him a present of his novels, magnificently bound. The Consul had the works destroyed and the author committed to Charenton again, where he died at the age of sixty-four. Sade was inexhaustible in his lascivious publi- cations, which were markedly intended for advertisement. Fortunately it is difficult to-day to obtain copies. Extant are : " Histoire de Justine," 4 vols. ; " Histoire de Juliette," 6 vols. ; " Philosophic dans le boudoir," London, 1805. Interesting is Sade's biography by /. Janin, 1835. dC) PSYCHOPATHIA SEXUALIS. neuropathic, and presents several anatomical signs of degeneration. When a child, hypochondria and imperative conceptions ; later, constant alternation of exaltation and depression While yet a child of ten the patient felt a peculiar lustful desire to see blood flow from his fingers. Thereafter he dften cut or pricked himself in the fingers, and took great delight in it. Very early, erections were added to this, and also if he saw the blood of others; for example, when he once saw the servant-girl cut her finger it gave him an intense lustful feeling. From this time his vita sexualis became more and more powerful. Without any teaching he began to masturbate, and always during the act there were memory-pictures of bleeding women. It now no longer sufficed him to see his own blood flow ; he longed to see the blood of young females, especially those that were attractive to him. He could scarcely overcome the impulse to violate two cousins and a certain servant. Any young woman, although not attractive, induced this impulse when she excited him by some peculiarity of dress or adornment, especially coral jewellery. At first he succeeded in overcoming these desires ; but in his imagination thoughts of blood were ever present, induc- ing lustful excitement. An inner relation existed between thoughts and feelings. Often there were other cruel fancies. He imagined himself in the role of a tyrant who had the people shot in crowds with grape-shot. He would imagine a scene as it would be, if enemies were to take a city and mutilate, torture, kill, and rape the young women. In times of quiet this patient, who had a mild dis- position and was not morally defective, was ashamed of and horrified by such cruel, lustful fancies, which be- came at once latent, when his sexual excitement was satisfied by masturbation. After a few years the patient became neurasthenic. Then simple imaginary representations of blood and scenes SEXUAL INCLINATION TOWARD THE OPPOSITE SEX. 97 of blood sufficed to induce ejaculation. In order to free himself from his vice and his cruel imagination, he began to indulge in sexual intercourse with females. Coitus was possible, but only when the patient called up the idea that the girl's fingers were bleeding. Without the assist- ance of this idea no erection was possible. The cruel thought of cutting was limited to the woman's hand. At times of greatest sexual excitement, simply the sight of the hand of an attractive woman was sufficient to induce most violent erections. Frightened by the popular stories about the injurious results of onanism, he abstained and fell into a condition of severe general neurasthenia, with hypochondriacal dysthymia and tcedium vitce. Careful and watchful medical treatment cured the patient after a few months. He has remained mentally well for three years; but now, as before, he is very sensual, though very, seldom he is troubled by his earlier ideas of flowing blood. He has given up masturbation altogether, and finds satis- faction in natural sexual indulgence, is virile, and it is no longer necessary for him to call up ideas of blood. The following case, reported by Tarnowsky {op. cit., p. 61), shows that such lustful, cruel impulses may be simply episodical, and occur in certain exceptional states of mind in neurotic individuals : — Case 24. Z., physician ; neuropathic constitution, re- acting badly to alcohol. Under ordinary circumstances capable of normal coitus, but as soon as he has indulged in wine he finds that his increased libido is no longer satisfied by simple coitus. In this condition he is com- pelled to prick the nates puella, or to make stabs with the lancet, to see blood, and feel the entrance of the blade into the living body, in order to have ejaculation and experience complete satiety of his lust. The majoritv of those afflicted with this form of per- 7 98 PSYCHOPATHIA SEXUALIS. version seem insensible to the normal stimulus of woman. In the first case (23), the assistance of the idea of blood was necessary to obtain erection. The following is that of a man who, by masturbation, etc., in early youth, had diminished his power of erection so that the sadistic act look the place of coitus : — Case 25. The girl-stabber of Bozen (reported by Demme, " Buch der Verbrechen," Bd. ii., p. 341). In 18'29, H., aged thirty, soldier, became the subject of legal investigation. At different times, and in different places, he had wounded girls with pocket-knives or penknives, by stabbing them in the abdomen, preferably in the genitals. He gave as a motive for these acts heightened sexual impulse, increasiiig to the intensity of fury, which found satisfaction only in the thought and act of stabbing persons of the female sex. This impulse would pursue him for days at a time. He would then pass into a confused mental state, which would clear away only when the impulse had been satis- fied by the deed. In the act of stabbing he experienced the same satisfaction as that produced by completed coitus. This was increased by the sight of blood dripping from the knife. In his tenth year the sexual instinct became powerfully manifest. At first he yielded to mas- turbation, and felt physically and mentally weakened by it. Before he became a girl-stabber, he had satisfied his sexual lust in violation of immature girls, by causing them to practise masturbation on him, and by sodomy. Gradu- ally the thought came to him how pleasurable it would be to stab a young and pretty girl in the genitals, and take dehght in the sight of the blood running from the knife. Among his effects were found copies of the objects of phallic cult and obscene pictures painted by himself of Mary's conception, and of the '' thought of God in- jected" into the lap of the Virgin. He was considered a peculiar, very irritable man, shy of people, fond of women, moody and glum. Of shanje and regret for his deeds no SEXUAL INCLINATION TOWARD THE OPPOSITE SEX. 99 traces were ever found. He was apparently a person^ wlu) had become impotent through early sexual e.xcesses, and was thus predisposed, by the continuance of intense libido sex^ialis and heredity, to perversion of sexual life. Case 26. In the " sixties " the inhabitants of Leipzig were frightened by a man who was accustomed to attack young girls on the street, stabbing them in the upper-arm with a dagger. Finally arrested, he was recognised as a sadist, who at the instant of stabbing had an ejaculation, and with whom the wounding of the girls was an equi- valent for coitus. (Wharton, "A Treatise on Mental Un- soundness," § 623. Philadelphia, ISTd.f Impotence exists likewise in the next three cases. It may be psychical, however, since the principal tone of the vita sexualis lies in sadistic inclination and the normal elements are distorted : — Case 27. The girl-czotter of A^tgshurg (reported by Demme " Buch der Verbrechen," vii., p. 281). Bartle, wine-merchant. He was subject to lively sexual excite- ment at the age of fourteen, though decidedly opposed to its satisfaction by coitus, his aversion going so far as disgust for the female sex. At that time he already had the idea to cut girls, and thus satisfy his sexual desire. He refrained from it, however, because of lack of oppor- tunity and courage. He disdained masturbation, but now and then had pollutions with erotic dreams of girls who had been cut. At the age of nineteen he first cut a girl. 1 Cf. KraubS, " Psychologie des Verbrechens," 1884, p. 188 ; Dr. Hofer, " Annalen der Staatsarzneikunde," 6 Jahrgang, Heft 2 ; " Schmidt's Jahr- biicher," Bd. 59, p. 94. ^According to newspaper reports, in December, 1890, several similar attacks were made iu Mainz. A young fellow between fourteen and six- teen years of age pressed against women and girls and stabbed them in the legs with a sharp-pointed instrument. He was arrested, and seemed to be insane. Further details of the case arc not kuowu. 100 PSYCHOPATHIA SEXUALIS. During the act he had a seminal emission and experienced intense pleasure. From that time the impulse grew con- stantly more powerful. He chose only young and pretty girls, and, as a rule, asked them before the deed whether they were still single. The ejaculation or sexual satis- faction occurred only when he was sure that he had actually wounded the girls. After such an act he always felt tired and bad, and was also troubled with qualms of conscience. Up to his thirty-second year he pursued this process of cutting, but was always careful not to wound the girls dangerously. From that time until his thirty- sixth year he was able to control his impulse. Then he sought to satisfy himself by simply pressing the girls on the arm or neck, but this gave rise to erections only and not to ejaculation. Then he sought to attain his object by pricking the girls with the knife left in its sheath, but this did not suffice. Finally, he stabbed with the open knife, and had complete success, for he thought that a girl when stabbed bled more and suffered more pain than when merely cut. In his thirty-seventh year he was detected and arrested. In his lodgings were found a collection of daggers, sword-canes, and knives. He said that the mere sight of these weapons, and still more the grasping of them, gave him an intense feeling of sexual pleasure, with violent excitement. According to his own confession, he had injured in all fifty girls. His external appearance was rather pleasing. He lived in very good circumstances, but was peculiar and shy. Case 28. J. H., aged twenty-six, in 1883 came for consultation concerning severe neurasthenia and hypo- chondria. Patient confesses that he has practised onanism since his fourteenth year, infrequently up to his eighteenth year, but since that time he has been unable to resist the impulse. Up to that time he had no opportunity to approach females, for he had been anxiously cared, for and never left alone on account of his invalidism. He SEXUAL INCLINATION TOWARD THE OPPOSITE SEX. 101 had had no real desire for this unknown pleasure, but he accidentally learned what it was when one of his mother's maids cut her hand severely on a pane of glass, which she had broken while washing windows. While helping to stop the bleeding he could not keep from sucking up the blood that flowed from the wound, and in this act he experienced extreme erotic excitement, with complete orgasm and ejaculation. From that time on, he sought, in every possible way to see and, where practicable, to taste the fresh blood of females. That of young girls was preferred by him. He spared no pains or expense to obtain this pleasure. At first he availed himself of a young servant, who allowed her finger to be pricked with a needle or lancet at his request. When his mother discovered this, she dis- charged the girl. Then he was driven to prostitutes as a substitute, with success frequently enough, though with some difficulty. In the intervals he practised onanism and manustupration per feminam, which, however, never afforded him complete satisfaction, but, on the contrary, caused listlessness and self-reproach. On account of his nervous difficulties he visited many sanatoria, and was twice a voluntary patient in institutions. He used hydrotherapy, electricity, and strengthening cures, without particular success. For a time it was possible, by means of cold sitz-baths, monobromate of camphor, and bromides, to diminish his sexual excitability and onanistic impulse. However, when the patient felt himself free again, he would immediately fall into his old passions, and spare no pains or money in order to satisfy his sexual desire in the abnormal manner described. Of special interest for the scientific proof of sadism is a case related by Moll {vide case 29, ninth edition of this work (German)) and recently published by Moll himself in his book on " Lil^ido Sexualis," p. 500. It discloses clearly one of the hidden roots of sadism 102 PSTCHOrATHIA SEXUALTS. — the impulse to complete subjugation of the woman, which here became consciously entertained. This is the more remarkable since it occurred in an individual de- cidedly timid, and in other respects modest and even apprehensive. The case also shows clearly that powerful libido which even impels the individual to overcome all obstacles, may be present, while at the same time coitus is not desired, because the principal intensity of feehn.i;- is, ab origine, connected with the cruel part of the sadistic (lustful and cruel) circle of ideas. This case also contains weak elements of masochism {v. infra). Cases are by no means infrequent in which men with perverse inclinations induce prostitutes, by paying them high prices, to allow themselves to be whipped and even wounded by them. Works on prostitution contain re- ports of them {vide Cofjignon, "La Corruption a Paris," etc.). (d) Defilement of Women. The perverse sadistic impulse, to injure women and put contempt and humiliation upon them, is also expressed in the desire to defile them with disgusting or, at least foul things. The following case, published by Arndt (" Viertol- jahrsschr. f. ger. Medicin," N. F. xvii., H. 1), belongs here : — Case 29. A., medical student at Greifswald, accusatus qnod itcTum iteruviqtie j^'^i^'^^^'i-s honcstis parentibus natis in publico genitalia sua e brads depcndentia j^ld'ne nudata qvrs antea summo amidulo {overcoat) tecta erant, ostendcrat. Non- nunquam 2yucllas fugientes secutus casque ad se attractas urina oblivit. Hac luce clara facta sunt ; nunquam aliquid Jicec faciens locutus est. A. is twenty-three years old, well built, neat in dress, and polite in manners. Indication of cranium progenciim ; chronic pneumonia of the apex of the light lung; empliy- SEXUAL INCLINATION TOWARD THE OPPOSITE SEX. 103 sema. Pulse, 60 ; in excitement not more than 70 to 80. Genitals normal. Complaints of occasional disturbances of digestion, and hardness of the abdomen, vertigo, ex- cessive excitement of sexual desires, which early led to onanism. The sexual desire has never been directed toward a natural method of satisfaction. Complaints of occasional attacks of depression, or thoughts of depreca- tion of self, aiid of perverse impulses, for which he could find no motive, such as lau^^hingat serious things, throwing his money in the water, and running about in the pouring rain. The father of the culprit is of a nervous tempera- ment, the mother subject to nervous headaches. A brother was subject to epileptic convulsions. From his youth the culprit presented a nervous tem- perament, was inchned to convulsions and attacks of syncope, and when severely scolded would fall into a state of momentary stiffness. In 1869 he studied medicine in Berlin. In 1870 he went to the war as a hospital as- sistant. His letters at this time betray peculiar torpidity and softness. On his return home, in 1871, his emo- tional irritability was noticed at once by those about him. Thereafter frequent complaints of bodily ailments ; un- pleasantness resulting from a love affair. In November, 1871, he pursued his studies dihgently in Greifswald. He was considered very gentlemanly. In confinement he is quiet, calm, and sometimes self-absorbed. His acts he attributes to painful sexual excitement, which of late had become excessive. He declared that he had been fully conscious of his perverse acts, and after committing them had always been ashamed of them. He had not ex- perienced actual sexual satisfaction in their commission. He obtained no correct insight into his position. He considered himself a kind of martyr — fallen a victim to an evil power. Presumption of irresponsibility, as a result of absence of free will. The impulse to defile occurs also, paradoxically, in the 104 . PSYCHOPATHIA SEXUALIS. aged, when there is a reappearance of sexual instinct, which, under such circumstances, is so often expressed in perverse acts. Thus Tarnowsky reports (p. 76) the following case : — Case 30. I knew such a patient, who had a woman dressed in a decollete hall-dress he down on a low sofa in a brightly lighted room. Ij^ise aptcd januam alius cubiculi obscurati constitit adsjyiciendo aliquantulum feminam, excitatus in earn insiluit et excrementa in sinus ejus deposuit. Hac faciens ejaculationem quandam se sentire confessus est. An officer of Vienna informs me that men, by means of larc^e sums of money, induce prostitutes to suffer ut illi viri in ora earum spuerent et fceces et urinas in ora explerent} The following case by Dr. Pascal (" Igiene dell' amore ") seems also to belong here : — Case 31. A man had an inamorata. His relation with her was that he had her allow him to blacken her hands with coal or soot, and then she had to sit before a mirror in such a way that he could see her hands in it. -While conversing with her, which was often for a long time, he looked constantly at her mirrored hands, and finally, after a time, he would take his leave, fully satisfied. The following case, communicated by a physician, may be of interest in relation to this subject :— An officer was known in a brothel in K. only by the name of " Oil ". " Oil " induced erection and ejaculation only by having puell. puhl. nudam step into a tub filled with oil, while he rubbed the oil all over her body. 1 Leo Taxil (" La Corruption," Paris, Noiret, p. 223) makes the same statements. There are also men who demand mtroductio lingua mere- tricis in anum. SEXUAL INCLINATIOK" TOWARD THE OPPOSITE SEX. 105 These acts lead to the presumption that certain cases of injury of females {e.g., sprinkhng with sulphuric acid, ink, etc.) depend upon a perverse sexual impulse ; at least, here it is a kind of injury, and those injured are always females, and the perpetrators males. At any rate in the future, in crimes of this kind, pains should be taken to examine into the vita sexualis of the culprits. The case of Bachmann, given below, Case 99, throws a clear light on the sexual nature of such crimes ; for, in this case, the sexual motive in the deed is proven. (e) Other Kinds of Assault on Females — Symbolic Sadism. The foregoing groups do not exhaust the forms in which the sadistic impulse toward women is expressed. If the impulse is not overmastering, or if there is yet sufficient moral resistance, it may happen that the per- verse inclination is satisfied by an act that is apparently quite senseless and silly, but which has nevertheless a symbolic meaning for the perpetrator. This seems to be the meaning of the two following cases : — Case 32. (Dr. Pascal, " Igiene dell' amore ".) A man was accustomed to go, on a certain day once a month, to an inamorata and cut her "fringe". This gave him the greatest pleasure. He made no other demands on the girl. Case 33. A man in Vienna regularly visits several prostitutes only to lather their faces and then to remove the lather with a razor, as if he were shaving them. He never hurts the girls, but becomes sexually excited and ejaculates during the procedure.^ ^ Leo Taxil (op. cit., p. 224) relates that in Parisian brothels instru- ments are kept ready which look like knouts, but which are merely tubes filled with air, such as clowns use in circuses. Sadistic men use them to create for themselves the illusion that they are whipping women. 106 PSYCHOrATHIA SEXUALIS. (f) Sadism with Other Objects — Whi2)ping of Boys. The sadistic acts with females just now described are also practised on other living, sensitive objects, — children and animals. There may be a full consciousness that the impulse is really directed towards women, and that only faute de mieux the nearest attainable objects (pupils) are abused. But the condition of the perpetrator may be such that the impulse to cruel acts enters con- sciousness accompanied only by lustful excitement, while its real object (which alone can explain the lustful colour- ine: of such acts) remains latent. The first alternative suffices as an explanation of the cases which Dr. Albert describes (Friedreich's " Blatter f. ger. Med.," p. 77, 1859), — cases in which lustful teachers whipped their pupils on the naked buttocks without cause. We must think of the second alternative, the sadistic im- pulse with unconsciousness of its object, when boys are immediately excited sexually at the sight of pimishment of their companions, and are thus determined in their later vita sextiolis, as in the following cases : — Case 34. K., aged twenty-five, merchant, appHed to me in the fall of 1889 for advice concerning an anomaly of his vita sexualis, which made him fear invalidism and impossibility of future happiness in marriage. Patient came of a nervous family. As a child he was delicate, weak, and nervous. Healthy except for measles ; later on he became more robust. At the age of eight, while at school, he saw the teacher punish the boys by taking their heads between his thighs and spanking them with a ferule. This sight caused the patient lustful excitement. "Without any idea of the danger and enormity of onanism," he satisfied himself with it, and from that time often masturbated, always calling up the memory -picture of a boy being punished. SEXUAL INCLINATION TOWARD THE OPPOSITE SEX. 107 Thus it continued until his twentieth year. Then he learned the significance of onanism, was terribly fright- ened, and tried to overcome his impulse to masturbate ; but he fell into the practice of psychical onanism, which he regarded as innocuous and morally defensible, and for which he made use of the memory-pictures of boys being whipped, previously mentioned. Patient now became neurasthenic, suffered with pol- lutions, and tried to cure himself by visiting brothels; but he could not induce erection. Then he sought to obtain normal sexual feelings by means of social mter- course with ladies; but he recognised that he was entirely insensible to the charms of the fair sex. The patient is an intelligent man, normally developed, and of aesthetic taste. There is no mclination to persons of his own sex. My advice consisted of means to combat the neurasthenia and pollutions ; interdiction of psychical and manual onanism; avoidance of all sexual excitants; and, possibly, hypnotic treatment to ultimately induce a return of the vita sexualis to its normal condition. Case 35. Abortive sadism. N., student, came under observation in December, 1890. He had practised mas- turbation from early youth. According to his statements, he became sexually excited when he saw his father whip the children, and, later, when he saw his companions whipped by the teacher. When a spectator of such scenes, he always experienced lustful feelings. He could not say exactly when this first occurred, but it iriay have been at about the age of six. He could not tell exactly when he began to masturbate, but he stated with certainty that his sexual instinct was first awakened by the punishment of others, and thus he unconsciously came to practise onanism. The patient remembered clearly that from the age of four to the age of eight he was frequciitly spanked, and that this caused him pain, never lustful pleasure. 108 PSTCHOPATHIA SEXUALIS. Since he did not always have opportunity to see others whipped, he began to imagine how others were punished. This excited his lust, and he would then masturbate. Whenever he could, he managed to see others punished at school. Now and then he also felt desire to whip others. At the age of twelve he induced a comrade to allow him to whip him. He found great sexual pleasure in it. "When, however, his companion beat him in return he experienced nothing but pain. The impulse to beat others was never very strong. The patient experienced more satisfaction in filling his imagination with scenes of whipping. He never indulged in any other sadistic acts, and never had any desire to see blood, etc. Up to his fifteenth year his sexual indulgence consisted of onanism, coupled with such fancies. After that (dancing lessons, association with girls) the early fancies disappeared almost entirely and were accompanied by but weak lustful feelings ; so that the patient gave them up entirely. In their place came thoughts of coitus in a natural way, without anything sadistic. The patient indulged in coitus for the first time " on account of his health". He was potent, and the act gratified him. He then tried to abstain from onanism, but was not successful, though he often indulged in coitus, and with more pleasure than he had in onanism. He wished to be freed from onanism as something vicious. He had coitus once a month, but masturbated once or twice everj^ night. He was sexually normal, excepting the onanism. There was no neurasthenia; genitals normal. Case 36. P., aged 15, of high social position, came of a hysterical mother whose brother and father died in an asylum. Two children of the family died in early child- hood of convulsions. The patient is talented, virtuous, and quiet ; but at times he is very disobedient, stubborn, and of violent temper. He has epilepsy, and practises SEXUAL INCLINATION TOWAED THE OPPOSITE SEX. 109 onanism. One day it was learned that P., with money, induced a conn-ade of fourteen, B., to allow hiinself to be pinched in the arms, genitals, and thighs. When B. cried, P. became excited and struck at B. with his right hand, while with his left he made manipulations in the left pocket of his trousers. P. confessed that to maltreat his friend, of whom he was very fond, gave him peculiar dehght ; and that ejaculation while hurting his friend gave him much more pleasure than when he masturbated alone (v. Gyurkovechky, "Pathol, und Therapie der mannl. Impotenz.," p. 80, 1889). That in all these cases of sadistic abuse of boys there can be no thought of a combination of sadism and con- trary sexual mstinct, as often occurs {v. infra) in indi- viduals of contrary sexuality, is shown — aside from the absence of all positive signs of it — by a study of the next group, where, in association with the object of injury, — animals, — the instinct for women is seen to appear repeatedly. (g) Sadistic Acts tvith Animals. In numerous cases, sadistically perverse men, afraid of criminal acts with human beings, or who care only for the sight of the suffering of a sensitive being, make use of the sight of dying animals, or torture animals, to stimulate or excite their lust. The case of a man in Vienna, which is reported by Hofmann in his "Text-Book of Legal Medicine," is note- worthy in relation to this. According to the evidence of several prostitutes, before the sexual act he was accus- tomed to excite himself by torturing and killing chickens and pigeons and other birds, and, therefore, was called " Hendlherr " (chickenmister). For the elucidation of such cases the observation of Lombroso is of value, according to whom two men had 110 PSTCHOPATHIA SEXUALIS. ejaculation when they killed chickens or pigeons, or wrung their necks. The same author, in his " Uomo dehnquente," p. 201, speaks of a poet of some reputation, who became power- fully excited sexually whenever he saw calves slaughtered, and also at the sight of bloody meat Mantegazza {op. cit. p. 114) relates that among degene- rate Chinese the practice prevails to sodomise geese and at the moment of ejaculation to cut off their heads. Mantegazza (" Fisiologia del piacere," fifth ed., pp. 394, 395) mentions the case of a man who once saw chickens killed, and from that time had a desire to wallow in their warm, steaming entrails, because he experienced a feeling of lust while doing it. Thus, in these and similar cases, the vita sexualis is so constituted ab origine that the sight of blood, death, etc., excites lustful feeling. It is so in the following case : — Case 37. C. L., aged forty-two, engineer, married, father of two children ; from a neuropathic family ; father irascible, a drinker ; mother hysterical, subject to eclamptic attacks. The patient remembers that in childhood he took particular pleasure in witnessing the slaughtering of domestic animals, especially swine. He thus experienced lustful pleasure and ejaculation. Later he visited slaughter- houses, in order to delight in the sight of flowing blood and the death throes of the animals. When he could find opportunity, he killed the animals himself, which always afforded him a vicarious feeling of sexual pleasure. At the time of full maturity he first attained to a knowledge of his abnormality. The patient was not exactly opposed in inclination to women, but close contact with them seemed to him repugnant. On the advice of a physician, at twenty-five he married a woman who pleased him, in the hope of freeing himself of his abnor- mal condition. Although he was very partial to his wife, SEXUAL INCLINATION TOWAED THE OPPOSITE SEX. Ill it was only seldom, and after great trouble and exertion of his imagination, that he could perform coitus with her; nevertheless, he begat two children. In 1866 he was in the war in Bohemia. His letters written at that time to his wife, were composed in an exalted, enthusiastic tone. He was missed after the battle of Koniggratz, If, in this case, the capability of normal coitus was much impaired by the predominance of perverse ideas, in the following it seems to have been entirely repressed : — Case 38. (Dr. Pascal, " Igiene dell' amore.") A gentle- man visited prostitutes, had them purchase a living fowl or rabbit, and made them torture the animal. He par- ticularly revelled in the sight of cutting off the heads and tearing out the eyes and entrails. If he found a girl who would consent, and go about it right cruelly, he was de- lighted, and paid her and went his way without asking anything more or touching her. The last two sections show that the suffering of any living being may become a source of perverse sexual en- joyment to sadistically constituted persons, and that there may be sadism with almost any [living] object. How- ever, it would be erroneous and an exaggeration to try to explain by sadistic perversion all the remarkable and sur- prising acts of cruelty that occur, and to assume sadism as the motive underlying all the horrors recorded in history or found in certain psychological manifestations among the peoples of the present time. Cruelty arises from various sources and is natural to primitive man. Compassion, in contrast with it, is a secondary manifestation and acquired late. The instinct to fight and destroy, so important an endowment in pre- historic conditions, is long afterwards operative ; and, in the ideas engendered by civilisation, like that of " the criniinal," it finds new objects, so long as its original 112 PSYCHOPATHIA SEXUALIS. object — " the enemy " — still exists. That not simply the death, but also torture of the conquered is demanded, is in part explained by the sense of power, which satisfies itself in this way, and in part by the insatiableness of the impulse of vengeance. Thus all horrors and historical enormities may be explained without recourse to sadism (which may often enough have been the motive, but should not be assumed as such, since it is relatively a rare perversion). At the same time, there is still another powerful psychical element to be taken into consideration, which explains the attraction which is still exerted by execu- tions, etc. ; viz., the pleasure which is produced by intense and unusual impressions and rare sights, in contrast to which, in coarse and blunted beings, pity is silent. But undoubtedly there are individuals for whom, in spite or even by reason of their lively compassion, all that is connected with death and suffering has a mysterious attraction who, with inward opposition, and yet follow- ing a dark impulse, occupy themselves with such things, or at least with pictures and notices of them. Still, this is not sadism, as long as no sexual element enters into consciousness ; and yet it is possible that, in unconscious life, slender threads connect such manifestations with the hidden depths of sadism. (h) Sadism in Woman. That sadism — a perversion, though often met with in men — is less frequent in women, may be easily explained. In the first place, sadism, in which the need of subju- gation of the opposite sex forms a constituent element, in accordance with its nature represents a pathological intensification of the mascuhne sexual character ; in the second place, the obstacles which oppose the expression of this monstrous impulse are, of course, much greater for woman than for man. Yet sadism occurs in women, and BEXUAL INCLINATION TOWARD THE OPPOSITE SEX. 113 it can only be explained by the primary constituent ele- ment — the general hyper-excitation of the motor sphere. Only two cases have thus far been scientifically studied. Case 39. A married man presented himself with numerous scars of cuts on his arms. He told their origin as follows : When he wished to approach his wife, who was young and somewhat "nervous," he first had to make a cut in his arm. Then she would suck the wound and during the act become violently excited sexually. This case recalls the widespread legend of the vam- pires, the origin of which may perhaps be referred to such sadistic facts.^ In a second case of feminine sadism, for which I am indebted to Dr. Moll, of Berlin, by the side of the perverse impulse, as so frequently happens, there is anaesthesia in the normal activities of sexual life ; and there are also traces of masochism (v. infra). Case 40. Mrs. H., of H., aged twenty-six, comes of a family in which nervous or mental diseases are said not to have been observed ; but the patient herself presents signs of hysteria and neurasthenia. Although married eight years and the mother of a child, Mrs. H. never had desire to perform coitus. Very strictly educated as a young girl, until her marriage she remained almost innocent of any knowledge of sexual matters. She has menstruated regularly since her fifteenth year. Essential abnormality of the genitals is not apparent. To the patient coitus is not only not a pleasure, but even an unpleasant act, and repugnance to it has constantly increased. The patient ^ The legend is especially spread throughout the Balkan peninsula^ Among the modern Greeks it has its origin in the myth of the lainia and marniolykes — blood-sucking women. Goethe made use of this in his " Bride of Corinth ". The verses referring to vampirism, " suck thy heart's blood," etc., can be thoroughly understood only when conapared with their ancient sources. 8 114 PSYCHOPATHIA SEXUALIS. cannot understand how any one can call such an act the greatest delight of love, which to her is something far sublimer and unconnected with sensual impulse. At the same time it should be mentioned that the patient really loves her husband. In kissing him, too, she experiences a decided pleasure, which she cannot exactly describe. But she cannot conceive how the genitals can have anything to do with love. In other respects Mrs. H. is a decidedly intelligent woman of feminine character. Si oscula dat conjugi, magnam voluptatem percipit in mordendo eum. Gratissimam ei esset conjugem mordere eo modo ut sanguis fluat. Contenta esset, si loco coitus morderetur a conjuge ipssoque eum mordere licerut. Tamen earn poeniteret, si morsu magnum dolorem faccret (Dr. Moll). In history there are examples of famous women who, to some extent, had sadistic instincts. These Messalinas are particularly characterised by their thirst for power, lust, and cruelty. Among them are Valeria Messalina herself, and Catherine de' Medici, the instigator of the Massacre of St. Bartholomew, whose greatest pleasure was to have the ladies of her court whipped before her eyes, etc.^ (Confer above, pp. 111-11'2.) 1 The gifted Henry von Kleist, who was beyond doubt mentally abnor- mal, gives a masterly portrayal of complete feminine sadism in his " Peuthesilea ". In scene xxii., Kleist describes his heroine pursuing Achilles in the fire of love, and when he is betrayed into her hands, she tears him with lustful, murderous fury into pieces, and sets her dogs on him: " She strikes, tearing the armour from his body, her teeth in his white breast — she and her dogs, the rivals, Oxus and Sphynx — they on the right side, she on the left ; and as I approached blood dripped from her hands and mouth." And later, when Penthesilea becomes satiated : " Did I kiss him to death ? No. Did I not kiss him ? Torn in pieces ? Then it was a mistake ; kissing rhymes with biting [in German, Kiisse, Bisse], and one who loves with the whole heart might easily mistake the one for the other." In recent litei-at.ure we find the matter frequently treated, but particularly in Sitcli,cr-Masoch's novels, which are hereafter to be alluded to, and in Ernest von WiLlenbriich's " Brunhilde," Rachilde's "La Marquise de Sade," etc. MASOCHISM. 115 2. The Association of Passively Endured Cruelty and Violence witii Lust — IVlasochism,^ Masochism is the opposite of sadism. While the latter is the desire to cause pain and use force, the former is the wish to suffer pain and be subjected to force. By masochism I understand a pecuhar perversion of the psychical vita sexualis in which the mdividual affected, in sexual feehng and thought, is controlled by the idea of being completely and unconditionally subject to the will of a person of the opposite sex ; of being treated by this person as by a master, humiliated and abused- This idea is coloured by lustful feeling; the masocbist lives in fancies, in which he creates situations of this kind and often attempts to realise them. By this perversion his sexual instinct is often made more or less insensible to the normal charms of the opposite sex — incapable of a normal vita sextialis — psychically impotent. But this psychical impotence does not in any way depend upon a horror sexus alterius, but upon the fact that this perverse instinct finds an adequate satisfaction differing from the normal — in woman, to be sure, but not in coitus. But cases also occur in which with the perverse im- pulse there is still some sensibility to normal stimuli, and intercourse under normal conditions takes place. In other cases the impotence is not purely psychical, but physical, i.e., spinal ; for this perversion, like almost all other per- versions of the sexual instinct, is developed only on the basis of a psychopathic and, for the most part, hereditarily tainted individuality ; and as a rule such individuals are given to excesses, particularly masturbation, to which the difficulty of attaining what their fancy creates drives them again and again. 1 So named from the writer, Sachar-Masoch, whose romances and novels have as their particular ohject the description of this perversion. Those novels caused the author of this book to make observations iu this field and introduce the term Masochism, analogous to the expression Daltonism, from Dalton, the discoverer of colour-blindness. 116 PSYCHOPATHIA SEXUALIS. The number of cases of undoubted masochism thus far observed is very large. Whether masochism occurs associated v^ith normal sexual instincts, or exclusively controls the individual ; whether, and to what extent, the individual subject to this perversion strives to realise his pecuhar fancies or not; whether he has thus more or less diminished his virilitv or not, — depends upon the degree of intensity of the perversion in the single case, upon the strength of the opposing ethical and aesthetic motives and the relative power of the physical and mental organisation of the affected individual. From the psychopathic point of view, the essential and common element in all these cases is the fact that the sexual instiiict is directed to ideas oj subjugation and abtise by the opposite sex. Whatever has been said with reference to the im- pulsive character (indistinctness of motive) the resulting acts and with reference to the original (congenital) nature of the perversion in sadism, is also true in masochism. In masochism there is a gradation of the acts from the most repulsive and monstrous to the silliest, regulated by the degree of intensity of the perverse instinct and the power of the remnants of moral and aesthetic counter- motives. The extreme consequences of masochism, how- ever, are checked by the instnict of self-preservation, and therefore murder and serious injury, which may be com- mitted in sadistic excitement, have here in reality, so far as known, no passive equivalent. Bat the perverse de- sires of masochistic individuals may in imagination attain these extreme consequences {v. infra, case 50). Moreover, the acts to which masochists resort are in some cases performed in connection with coitus, i.e., as preparatory measures ; in others, as substitutes for coitus "when this is impossible. This, too, depends only upon the condition of sexual power, which has been diminished for the most part physically and mentally by the activity of the sexual ideas in the perverse direction, and not upon the nature of the act itself. MASOCHISM. 117 (a) The Desire for Abuse and Humiliation as a Means of Sexual Satisfaction. The following detailed autobiography of a masochist gives an exhaustive description of a typical case of this remarkable perversion : — Case 41 . "I come of a neuropathic family, in which, with all kinds of peculiarities of character and manner of life, there are several abnormalities of a sexual nature. My imagination has always been very lively, and was very early directed to sexual matters. As far as I can remember, I was much given to onanism long before puberty. Even at that time my thoughts were, for hours at a time, directed to intercourse with females. But the relations in which I placed myself with the op- posite sex were very peculiar. I fancied that I was a prisoner and absolutely in a woman's power, and that this woman used her power to hurt and abuse me in every way possible. In this, whipping and blows played an important part in my fancy, and there were many other acts and situations which all expressed the condi- tion of vassalage and subjection. I saw myself constantly kneeling before my ideal, trod upon, laden with chains, and imprisoned. Severe punishments of all kinds were inflicted on me to test my obedience and please my mis- tress. The more severely I was humiliated and abused the more I indulged in these thoughts. (At the same time I developed a great preference for velvet and fur, which I liked to touch and smooth, and which likewise excited me sexually.) " I remember well that when a child I received many actual whippings at the hands of females. They never caused me any other feeling than pain and shame ; never have I thought to connect such realities with my fancies. A threat to punish me severely and correct me agitated me painfully ; but in my fancy I assumed a desire on the part of my " mistress " to enjoy my suffering and humili- 118 PSYCHOrATHIA SEXUALIS. ation, which entranced me. I have never brought into relation with my fancies the directions and commands of the females who took care of me. I was early able to discover the truth about the relation of the sexes ; but this knowledge made no impression on me. The idea of sensual pleasure remained connected with the fancies with which it was originally associated. I also had the desire to touch females, to embrace and kiss them, but I looked for the greatest delight only in being maltreated by them, and in situations in which they would cause me to feel their power. I soon came to realise that I differed from other men, and preferred to be alone and absorbed in my dreams. In my boyhood, real girls and women had but little interest for me ; for I saw no possibility of having them act in the way I desired. On lonely paths in the forest I whipped myself with branches that had fallen from the trees, and allowed my imagination to play in the wonted way. revelled in the sight of pictures of commandiag women, particularly if, like queens, they wore furs. I read everything relating to my cherished ideas. ' Rosseau's Confessions,' which then fell into my hands, were a great discovery. ' found a condition de- scribed that resembled mine in every essential. I was still more astonished at the similarity of my ideas to those I found in the writings of Sacher-Masoch. I de- voured them all with avidity, though the blood-curdling scenes often outstripped my imagination, and then excited my aversion. Later, in order to supply new food for my fancy, I began to write descriptions of erotic scenes to my taste, and to make drawings of situations which, up to this time, I had drawn only in imagination. In this, reality was wholly an indifferent matter to me. In the presence of a woman I was devoid of every sensual feel- ing ; at most, at the sight of a feminine foot a fleeting wish would arise to be trodden upon by it. "This indifference, however, was only in relation to pure sensuality. In late boyhood and early youth 1 was MASOCHISM. 119 suljjoct to an enthusiastic partiality for young girls of my acquaintance, with all the extravagances common to this youthful enthusiasm. But it never occurred to me to connect the vi^orld of my sensual thoughts with these pure ideals. I never had to overcome such a thought ; it never occurred to me. This is the more remarkable, since my lustful fancies seemed very strange to me, and unattainable in reality, but in now^ise vile or obnoxious. This, too, was a kind of poetry with me ; but it was divided into two worlds — on the one hand was my heart, or, rather, my aesthetically excited fancy ; on the other, my sensually inflamed imagination. While my "elevated " feeling al- ways had a certain young girl for its object, at other times I saw myself at the feet of a mature woman, who treated me as previously described. I never placed any lady of my acquaintance in this role. In dreams the two spheres of my erotic ideas recurred alternately, but never combined. Only the images of the sensual sphere induced pollutions. " In my nineteenth year I allowed myself, with outward reluctance but with inward desire, to be taken by friends to visit prostitutes. But there I experienced nothing but repugnance and aversion, and left as soon as possible, without having felt the faintest trace of sensual excite- ment. Later, on my own initiative, I repeated the attempt, in order to convince myself as to whether I was impotent or not ; for I was much troubled by my un- expected failure in the first instance. The result was always the same — I felt no excitement at all, and had not the slightest erection. In the first place, it was not pos- sible for me to regard a real woman as an object of sensual gratification ; and, furthermore, I could not i enounce the conditions and situations which were the principal things in sexualihus for me, and about which nothing could induce me to say a word. Imissio penis — the act to be under- taken by me — seemed to me absolutely senseless and unclean. Again, in the second place, there was also my repugnance for common women and fear of infection. 120 PSTCHOPATHIA SEXUALIS. " In the meantime, in secret, my sexual life went on in the old fashion. Whenever my old fancies came to mind, violent erection occurred, and I provoked ejaculations almost daily. I began to suffer with all kinds of nervous troubles, and now regarded myself as impotent, in spite of powerful erections and intense desire when I was alone. Nevertheless, from time to time I continued my experi- ments with prostitutes. In time I overcame my timidity, and in part my aversion to contact with common women. " After I had, with advancing years, overcome to some extent my shyness and my inchnation to indulge in dreams, in my sexual thought there was an approach to the normal, as I began to direct my interest to real persons. I was even successful in directing sensual thoughts to women of my acquaintance, without carrying over any of my peculiar ideas from the other sphere. Thus I had some affairs with respectable girls. Embracing and kiss- ing occurred ; desire was excited, but not the power — at least, it was too weak to allow me to think that under normal circumstances I should be virile. Of course, the attention I gave to the excitation of my sexual power was not calculated to favour this. Thus, always greatly ashamed, I broke off the relations. " My fancy no longer satisfied me. I went more fre- quently with prostitutes, and after failures in coitus made them to perform manustupration on me. I always anti- cipated to realise by this act a more intense pleasure than my fancies could convey, but met with disappoint- ment. Whilst the woman undressed my eyes followed her garments ; but although even these never had a strong attraction for me, nevertheless, they excited me more than the naked woman ever did. The real object of my interest was the woman well attired. Velvet and furs were the chief attractions, but also every other article of female attire and especially the figure well outlined by lacing and prominent hips. The nude woman only offered an object of sesthetic interest. I was much enchanted by women's MASOCHISM, 121 boots, especially those with high heels, because they associated the idea of being trodden upon by them or suggested my doing homage by kissing the foot. " At last I overcame the last vestige of my shyness, and one day, to realise my dreams, had myself w^hipped, trod upon, etc., by a prostitute. The result was a great dis- appointment. What was done to me I felt to be rough, repugnant, and silly. The blows caused me nothing but pain ; the situation, repugnance and shame. Nevertheless, I induced an ejaculation mechanically, with which, by the help of my imagination, T transformed the real situa- tion into that for which I longed. This — the really de- sired situation — differed from the actual, essentially, in that I created in imagination a woman who abused me with the same pleasure that I experienced in her maltreatment of me. " All my sexual fancies were built upon the assumption of a woman of tyrannical and cruel disposition, to whom I wished to be subject. The act expressing the relation was a secondary matter to me. After the first attempt at an impossible realisation, it was perfectly clear to me whither my longings really drifted. To be sure, in my lustful dreams, I had often passed beyond all ideas of abuse, and conceived a commanding woman, with an imperious mien, a word of command, a kiss on the foot, etc. ; but now I fully reahsed what it was that attracted me, and that flagellation was only the strongest means of express- ing the principle, and in itself secondary, without value, even painful and repulsive. "In spite of this disappointment, after the first step, I did not abandon my efforts to realise my erotic ideas. I was confident that, when once accustomed to the new reality, my fancy would find food in it for more intense activity. For' my purpose I sought the most suitable women, and instructed them carefully in a complicated comedy. In this I occasionally found that the way had been paved for me by predecessors of like disposition. The 122 PSTCHOPATHIA SEXUALIS. value of these comedies, lor the effect of my fancy on my sensuality, remained problematical. What these acts and scenes did for me, in the way of intensifying the subsidiary circumstances of the desired situation, caused a diminu- tion of the intensity of the principal element, which my unaided fancy without the consciousness of planned, coarse deception, could more easily bring up before me. My physical sensations, under the various punishments, were changeable. The more perfect the self-deception, the nlore perfectly the pain was felt as pleasure. " Or, more correctly, the punishment was then con- ceived as a symbolic act. From this arose the illusion of the desired situation, which was then accompanied by an intense psychical feeling of pleasure. Thus the perception of the painful quality of the punishment was overcome. The. j)rocess in the moral punishments — the humiliations to which I subjected myself — w-as similar, but simpler ; because it was confined to the mental sphere. These were also attended with pleasurable feeling when the self-deception succeeded. It was seldom, however, that it succeeded well, and never perfectly ; there always re- mained a disturbing element in consciousness. Therefore, in the intervals, I returned to solitary onanism. Moreover, in the other case, the conclusion of the act was usually an ejaculation provoked by onanism ; often an ejaculation without the aid of mechanical means. " Thus I went on for many years, with diminishing power, but with slightly diminished desire, and with the power of my peculiar sexual idea over me unchanged. And at present the condition of my vita sexualis is the same. Coitus, which I have never performed, still seems to me a strange and unclean act. I learned about it from descriptions of sexual dissipations. My own sexual ideas seem natural, and do not in the least offend my sensitive taste. Their realisation, as previously mentioned, for various reasons leaves me unsatisfied. I am pleased with pretty girls and women of respectability, but for a long MASOCHISM. 123 time T have ceased to approach them. I have never attained, not even partially, a direct actual realisation of my sexual fancy. As often as I have come into close relation with females, I have felt the woman's will to be beneath mine, never vice versd. I have never met a woman manifestin;:,^ a desire of mastery in sexual thinf^s. Women who wish to rule in the houseliold, and exercise petticoat sovereignty, are entirely different from my erotic ideals, "My whole personality presents many abnormalities besides the perversion of my vita sexualis ; my neuropathic condition is expressed in many mental and physical symptoms. Moreover, I think I recognise in myself an original abnormality of character in the nature of a re- semblance to the feminine type ; at least, I regard as of this nature my great weakness of will, and my great lack of courage in the presence of men and animals, which is in contrast with my coolness in the face of peril. My external appearance is entirely masculine." The author of this autobiography sends a further communication : — " I always sought to find out whether the pecuHar ideas that ruled me sexually were entertained by other men. Ever since the first stories about it accidcntly reached my ears, I have sought everywhere to learn of it. As it is really a process of inner consciousness, it is, of course, not easy to identify it, and it cannot always be done with certainty ; but I assume the existence of masochism where I find perverse sexual acts that cannot be explained except by this dominating idea. I look upon this anomaly as wide-spread. " I have heard many stories about it from prostitutes here in Berfin, and in Vienna; and I thus learned how numerous my fellow-sufferers are. I am always careful not to describe my own experiences, or ask whether tliey 124 PSYCHOPATHIA SEXUALIS. know of such ; but I allow these persons to relate thei, experiences just as they choose. " Simple flagellation is so common that almost every prostitute is familiar with it ; but cases of real masochism are very frequent. The men, subject to this perversion, submit themselves to the most refined cruelties. In this they always act the same farce with the instructed prosti- titutes — humiliating subjection of the man, treading upon him, commands, threats, and scoldings that have been committed to memory ; then flagellation, blows on various portions of the body, and all kinds of punishment, pricking with needles, etc. The scenes often end with coitus, but more frequently with ejaculation without it. Twice pros- titutes have shown me heavy iron chains with handcuffs, which their patrons had made for their own use, and the dried peas on which they kneeled, the seat studded with needles on which they sat at command, and many other similar things. Often the perverted man wishes the woman to tie his penis so tightly as to cause pain ; to prick it with needles, make cuts in it with a knife, or beat it with a stick. Even the act of hanging is indulged in, it being cut short at just the right moment. Others have themselves scratched with a knife or dagger, but in the act the woman must threaten him with death. In all these things the symbolism of subjection is the most important factor. The woman is usually called ' mistress ' ; the man, * slave '. "All these comedies with prostitutes, which to the normal man appear as simple madness, are to the ma- sochist only meagre substitutes. Whether there is such a thing as a realisation of these masochistic dreams in love relations or not, I do not know. If it occur, it is certainly very rare, for this taste in women (sadism in women, as described by Sacher-Masoch) is very difficult to find ; be- sides, the expression of sexual abnormalities finds greater obstacles in the modesty of women, etc., than in men. I mj'self have never noticed the shghtest indications of any- MASOCHISM. 125 thing of this kind, and have never been able to attempt an actual realisation of my fancies. Once a man con- fidingly told me of his masochistic perversion, and said he had found his ideal." The two following cases are similar to the foregoing : — Case 42. Mr. Z., aged tv/enty-nine, technologist, came for consultation because of fear of tabes. Father was nervous and died tabetic. Father's sister was insane. Several relatives are very nervous and peculiar. On closer examination the patient was found to have sexual, spinal and cerebral asthenia. He presented no symptoms of tabes dorsalis. Questions concerning abuse of the sexual organs brought out a confession of masturbation practised since youth. In the course of the examination the following interesting psycho-sexual anomalies were discovered : At the age of five the vita sexualis began with the impulse to whip himself, as well as with the desire to see others whipped. In this he never thought of individuals as of the one sex or the other. Faute de mieiix he practised flagellation on himself, and, in time, this induced ejacula- tion. Long before this he had begun to satisfy himself with masturbation, and always during the act revelled in imaginary scenes of whipping. After growing up he twice visited brothels to have himself flogged by prostitutes. For this purpose he chose the prettiest girl he could find ; but he was disappointed, and did not even have an erec- tion, to say nothing of ejaculation. He recognised that the flagellation was subsidiary, and that the idea of subjection to the woman's will was the important thing. He realised this on the second trial. When he had the " thought of subjection " he was perfectly successful. In time, by strannng his imagination with masochistic idea,s, he performed coitus without flagellation ; but he found little satisfaction in it, so that he performed sexual in- tercourse in a masochistic way. He found pleasure in 126 PSYCHOPATHIA SEXUALIS. masochistic scenes, in the sense of his original desire for flagellation, only when he was flagellated ad podicem, or, at least, only when he called up such a situation in imagination. At times of great excitability it was even sufficient if he told stories of such scenes to a pretty girl. He would thus have an orgasm, and usually ejaculation. A very efl'ectual fetichistic idea was early associated with this. He noticed that he was attracted and satisfied only by women wearing high heels and short jackets ("Hungarian fashion"). He did not know how he arrived at this fetichistic idea. Boys' legs with high heels also pleased him ; but this charm was purely aesthetic, without any sensual colouring ; and he said he had never noticed anything homosexual in himself. The patient referred his fetichism to his partiality for calves (legs). He was charmed by ladies' calves only when elegant shoes were on the feet. Nude legs — feminine nudity in general — did not in the least affect him sexually. A subordin^ite fetichistic idea for the patient was the human ear. It was a lustful pleasure for him to caress the handsome ears of people. With men this pleasure was slight, but with women it gave him great enjoyment. He also had a weakness for cats. He thought them simply beautiful, and their movements were very attractive to him. The sight of a cat could raise him from a feeling of the deepest depression. Cats seemed to him sacred ; he saw something divine in them ! He did not know the reason for this idiosyncrasy. Of late he also frequently had sadistic ideas about punishing boys. In these imaginary flagellations both men and women played a part, but particularly the latter, and then his enjoyment was much more intense. The patient found that, besides what he recognised and felt as masochism, there was something else which he preferred to designate " pageism ". While his masochistic fancies and acts were entirely of a coarse, sensual nature, his " pageism " consisted of the MASOCHISM. 127 idea of being a page to a beautiful girl. His conception was perfectly chaste, but piquant ; his relation to her that of a slave, but absolutely pure — a mere platonic sub- mission. This reveUing in the idea of serving such a " beautiful creature " as a page was coloured by a pleasur- able feeling, but this was in no way sexual. He experienced in it an exquisite feeling of moral satisfaction, in contrast with sensually coloured masochism, and therefore he could l)ut regard it as something of a different nature. At first sight there was nothing remarkable in the patient's appearance ; but his pelvis is abnormally broad, the ilia are flat, and the pelvis, as a whole, tilted and decidedly feminine. Eyes, neuropathic. He also men- tioned that he often had itching and lustful irritation at the anus, and that there (" erogenous " area) ope digiti, he could satisfy himself. The patient was troubled about his future. Help would be possible for him if he could but excite in himself an interest in women, but his will and imagination were too weak for that. What the patient designated as "pageism" does not differ in any way from masochism, as may be seen when it IS compared with the following cases of symbolic masochism and others ; and, further, upon the considera- tion that in this perversion coitus is avoided as an inadequate act, and from the fact that in such cases there is often a fantastic exaltation of the perverse ideal : — Case 43. Ideal Masochism. Mr. X., technologist, twenty- six years old. Mother of nervous disposition ; suffers from neuralgia. In the father's family a case of spinal disease and one of psychosis. A brother suffers from nervous- ness. Mr. X. had only slight infantile affections , he learned easily at school, and developed normally He is of manly appearance, but rather weakly and under medium size. The descent of the right testicle ia im- 128 PSYCHOPATHIA SEXUALIS. perfect, but may be noticed in the inguinal canal ; penis is normally formed, but rather small. At the age of five he felt sexual excitement whilst swinging on the cross-bar with legs crossed, and stretched out at full length. He repeated the exercise several times, but forgot about the sensation until he grew up to maturer age. He then tried to induce this pleasurable feeling by repeating the exercise, but without success. At the age of seven he took part in a general fight between the pupils of the school which he attended, after which the victors rode on the backs of the vanquished. This impressed X. considerably. He thought the position of the prostrate boys a pleas- ant one, wanted to put himself in their place, imagining how by repeated efforts he could move the boy on his back near his face so that he might inhale the odour of his genitals. These thoughts, coupled with pleasurable feehngs, often recurred to him afterwards, although they never occasioned real sensations of lust ; in fact, he con- sidered these thoughts sinful and bad, and sought to repulse them. He claims to have had no knowledge at that time of sexual matters. It is remarkable that the patient up to his twentieth year was periodically troubled with eneuresis nocturna. Up to the time of puberty these masochistic fancies to lie under the thighs of others, boys as well as girls, recurred periodically. Now the objects were chiefly girls, but these exclusively when puberty was completed. Little by little these situations gained a different mean- ing, for soon the culminating point was the consciousness to be absolutely subject to the will and whims of a fully developed girl, coupled with corresponding humiliating acts and attitudes. For instance, X. says : — "I am lying on my back on the floor. The mistress stands over my head with one foot on my breast, or she holds my head between her teet so that her genitals are MASOCHISM. 129 directly in a line with my vision. Or she sits a-straddle on my chest or on my face, using my body as a table. If I do not obey her commands promptly she locks me up in a dark W.C. and leaves the house to find pleasure elsewhere. She introduces me to her friends as her slave and turns me over as such to them as a loan. " She makes me perform the lowest menial work, wait upon her when she arises, in the bath et inter mictionem. At times she uses my face for the latter purpose and makes me drink of the voidance." X. claims that he never practically put these ideas into effect for fear of not realising tbe anticipated pleasure. Once only he sneaked into the room of a pretty house- maid ut tcrinam puellcB bib at j but he was too much dis- gusted to carry out the purpose. He states that he fought in vain against these masochistic impulses, considering them of a painful and disgusting nature. They are still prevalent. He points out particularly that the humiliation conn'ected with these imaginary acts is the principal attraction, and that the pleasure derived from causing pain to others is never associated with them. He prefers as "mistress" a slender maiden of about twenty years of age, with a pretty face, and wearing short light dresses. The ordinary intercourse with young women, dancing, or mixed society, never impressed him. With the period of puberty these masochistic ideas were at times accompanied by pollutions, but only weak emotions of lust. At one time the patient resorted to friction of the glafis penis, but he could not induce erection, much less ejaculation, and instead of pleasure he produced disagree- able paralytic feelings. This saved him from masturbation. But after the age of twenty he often experienced lustful emotions with ejaculation when performing gymnastic exercises on the horizontal bar, or when climbing poles 9 130 PSYCHOPATHIA SEXUALIS. or ropes. He never had a desire for sexual intercourse with women or for inverted sexual actions. At the age of twenty-six a friend urged him to coitus, but already on the way to the house " anxiety, restlessness, and decided disgust" crept over him. He became so excited, trembled all over, and broke out into a profuse perspiration, that he could not command an erection. Kepeated attempts proved complete failures, but he was able to control his mental and physical excitement a little better than the first time. Libido was never present. Masochistic imaginations gave no assistance, because his mental faculties at such times were "as if paralysed," and he " could not call up those intense imaginary representations which he found necessary for an erection". Thus he gave up all attempts at coitus, partly because libido was absent, and partly on account of his utter want of confidence in success. Only now and then he satisfied his weak sexual desires by the aid of gymnastic exercises. Occasionally, however, spontaneous or superinduced masochistic fancies (when awake) would cause erection, but never ejaculation. Pollutions occurred at periods of six weeks. The patient is highly intellectual, of refined manners, and a little neurasthenic. He complains that when in society the feeling obtrudes itself constantly that he is being observed. This causes him worry and embarrass- ment, although he is fully aware that all this is naught but imagination. He loves solitude, for fear that others might find out his sexual abnormality. This impotence does not cause him pain, for he has scarcely any desire. Nevertheless he would consider the cure of his vita sextialis a great boon, since so much depends upon it in social hfe, and he would be more self- possessed and manher when among others. His present existence he considers a misery, and his life a burden. MASOCHISM. 131 Case 44. X.,man of letters, aged twenty-eight, tainted. Sexually hyperajsthetic from childhood. At the age of six he had dreams of being whipped ad nates by a wonmn. Upon awaking, intense lustful excitement ; tlius he came to practise onanism. When eight years old he once asked the cook to whip him. From his tenth year, neuras- thenia. Until his twenty-fifth year he had dreams of flagellation or similar fancies when awake, and indulged in onanism. Three years ago he had an impulse to have himself whipped by a p^iella. The patient was dis- appointed, for neither erection nor ejaculation occurred. At twenty-seven, another effort, with the thought to enforce erection and ejaculation. This was finally made possible by the following artifice: While coitus was attempted the puella had to tell him how she flogged mercilessly other impotent men, and threaten him with the same. Besides this, it was necessary for him to fancy that he was bound, entirely in the woman's power, help- less, and most painfully beaten by her. Occasionally, in order to become potent, it was necessary to have himself actually bound. Thus coitu& was possible. Pollutions were accompanied by lustful feeling only when he (infre- quently) dreamed that he was abused, or that he looked on while one puella whipped the other. He never had a real lustful pleasure in coitus. The only things in women that interest him are the hands. Powerful women with big fists are his preference. At the same time, his desire for flagellation is only ideal ; for with his great cutaneous sensitiveness at the most a few strokes are sufficient. Blows from men were repugnant to him. He wishes to marry. From the impossibility of asking a decent woman to perform flagellation and the doubt about being potent without flagellation spring his embarrassment and desire to recover. In three of the foregoing cases for the most part passive flagellation serves him that is subject to this perversion of 132 PSYCHOPATHIA SEXUALIS. masochism as an expression of the desired situation of subjection to the woman. The same means is needed by a large number of masochists. But passive flagellation is a process which, as is known, has a tendency to induce erection reflexly by irritation of the nerves of the buttocks.^ This effect of flagellation is used by weakened debauchees to help their diminished power; and this perversity — not perversion — is very common. It is, therefore, necessary to ascertain in what relation the passive flagellation of the masochists stands to those dissipated individuals who are not psychically perverse, but physically weakened. It is not difficult to show that masochism is some- thing essentially different from flagellation, and more comprehensive. For the masochist the principal thing is subjection to the woman ; the punishment is only the expression of this relation — the most intense effect of it he can bring upon himself. For him the act has only a symbohc value, and is a means to the end of mental satis- faction of his peculiar desires. On the other hand, the individual that is weakened and not subject to masochism and who has himself flagellated, desires only a mechanical irritation of his spinal centre. Whether in a given case it is simple (reflex) flagella- tion or masochism is made clear by the individual's state- ments, and often by the secondary circumstances. The determination depends upon the following facts : — In the first place, the impulse to passive flagellation exists in the masochist ah origine. The desire is felt before there has been any experience of the reflex effect, often first in dreams, as, for example, in case 46, v. infra. Secondly, with the masochist, as a rule, flagellation is only one of many and various punishments which come into his mind as fancies and are often realised. In these other punishments and the frequent acts expressing purely sym- bolic humiliations which occur by the side of flagellation, there can, of coarse, be no thought of a reflex physical 1 Cf. supra, Introduction, p. 35. MASOCHISM. 183 irritative effect. Thirdly, it is significant that, in the masochist when the desired flagellation is carried out, it need have no aphrodisiac effect at all. Very often, indeed, there is a more or less defined disappointment ; in fact, always, if the masochist is not successful in his desire to create by means of the prearranged programme the illu- sion of the desired situation (to be in the woman's power), so that the woman ordered to carry out the act seems to be nothing more than the executive agent of his own will. In reference to this important point, compare the three foregoing cases and case 48. Between masochism and simple (reflex) flagellation, there is a relation somewhat analagous to that existing between contrary sexual instinct and acquired pederasty. It does not lessen the value of this opinion that, in the masochist, the flagellation may also have the known reflex effect ; or that a whipping received in childhood may have aroused lust for the first time, and thus simultaneously excited the latent masochistically constituted vita sexualis. In this event, the case must be characterised by the con- ditions mentioned above under the heads of ''secondly" and " thirdly," in order to be masochistic. If the details of the origin of the case are not known, other circum- stances, such as those mentioned above under " secondly " would make it clearly masochistic. This is illustrated in the following two cases : — Case 45. A patient of Tamoivsky' s had a person in his confidence rent a house during his attacks, and instruct its perso7mel (three prostitutes) in what was to be done with him. Whenever he came there he was undressed, manustuprated, and flagellated as ordered. He pretended to offer resistance, and begged for mercy; then, as ordered, he was allowed to eat and sleep. But in spite of protest he was kept there, and beaten if he did not sub- mit. Thus the affair would go on for some days. When the attack was over he was dismissed, and he returned to 134 PSYCHOPATHIA SEXUALIS. his wife and children, who had no suspicion of his disease. The attacks occurred once or twice a year (Taniowshy , op. cit.). Case 46. X., aged thirty-four, greatly predisposed, suffers with antipathic sexual instinct. For various rea- sons he had no opportunity to satisfy himself with men, in spite of great sexual desire. Occasionally he dreamed that a woman whipped him, and then had a pollution. Through this dream he came to have prostitutes beat him as a substitute for love with men. Occasionally he would obtain a prostitute, undress himself completely (while she was not to take off her chemise), and have her tread upon him, whip and beat him. Qua re summa libidine affectus j^cdem femincz lambit quod solum eum lihidino- siim facer e potest : turn ejaculationem assequitur. Then dis- gust at the morally debasing situation occurred, and he retired as quickly as possible. Cases occur, however, in which passive flagellation alone constitutes the entire content of the masochistic fancies, without other ideas of humiliation, etc., and without well-defined consciousness of the real nature of this expression of submission. Such cases are difficult to differentiate from those of simple reflex flagellation. A knowledge of the primary origin of the desire, before any experience of reflex stimuli {v. supra, under ''first"), is the only thing that renders the differential diagnosis certain, if weighed with the circumstance that genuine masochists are perverse from early youth, and that the realisation of their desires is scarcely ever accomplished or proves a disappointment {v. sitjjra, under '" thirdly ") ; for the whole thing chiefly belongs to the realm of imagination. The following is a case of typical masochism in which the whole circle of ideas peculiar to this perversion appears completely developed. This case, in which there is a detailed personal description of the whole psychical MASOCHISM. 135 state, is different from case 41 only in that there is here no thought of a reahsation of the perverse fancies, and that, notwithstanding the perversion of the vita sexualis, normal stimuli are so far effectual that sexual intercourse is really possible under normal conditions. Case 47. "I am thirty-five years old, mentally and physically normal. Among all my relatives, in the direct as well as in the lateral line, I know of no case of mental disorder. My father, who at my birth was thirty years old, as far as I know had a preference for voluptuous, large women. " Eveji in my early childhood I loved to revel in ideas about the absolute mastery of one man over others. The thought of slavery had something exciting in it for me, ahke whether from the standpoint of master or servant. That one man could possess, sell or whip another, caused me intense excitement ; and in reading ' Uncle Tom's Cabin ' (which I read at about the beginning of puberty) I had erections. Particularly exciting for me was the thought of a man being hitched up to a waggon in which another man sat with a whip, driving and whipping him. Until my twentieth year these ideas were purely objective and sexless — i.e., the one in subjugation in my fancy was another (not myself), and the master was not necessarily a woman. These ideas were, therefore, without effect on my sexual desires — i.e., on the way in which they took practi- cal shape. Although these ideas caused erections, yet I have never masturbated in my life, and from my nine- teenth year I had coitus without the help of these ideas and without any relation to them. I always had a great preference for elderly, voluptuous, large women, though I did not scorn younger ones. " After my twenty-first year myideas became objective, and it became an essential thing that the ' mistress ' should be a woman over forty years old, tall and power- ful. From this tirne I was always in my fancies the subject : 136 PSYCHOPATHIA SEXUALIS. the 'mistress' was a rough woman, who made use of me in every way, also sexually ; who harnessed me before a carriage and made me take her for a drive, whom I must follow like a dog, at whose feet I must lie naked and be punished — i.e., whipped — by her. This was the constant element in my ideas, around which all others were grouped. In these fancies I always found endless pleasurable comfort which caused erection, but never ejaculation. As a result of the induced sexual excitement, I would immediately seek a woman, preferably one corre- sponding exteriorly with my ideal, and have coitus with her without any actual aid of my fancies, and some- times also without any thought of them during the act. I had, however, also inclination toward women of a different kind, and had coitus with them without being impelled to it by my fancy, " Notwithstanding all this, my life was not exceedingly abnormal sexually ; yet these ideas were certain to occur periodically, and they have remained essentially un- changed. With growing sexual desire, the intervals constantly grew shorter. At the present time the attacks come every two or three weeks. If I previously were to have coitus, the occurrence of the fancies would, perhaps, be postponed. I have never attempted to realise my very definite and characteristic ideas — i.e., to connect them with the world without me — but I have contented myself with reveUing in the thoughts, because I was convinced that my ideal would not allow even an approach to realisation. The thought of a comedy with paid pros- titutes always seemed so silly and purposeless, for a person hired by me could never take the place in my imagi))ation of a 'cruel mistress'. I doubt whether there are sadis- tically constituted . women like Sacher-Masoch's heroines. But, if there were such women, and I had the fortune (!) to find" one, still, in a world of reality, intercourse with her would ever seem only a farce to me. Indeed, I can say that, were I to become the slave of a Messalina, I believe MASOCHISM. 137 that owing to the other necessary renunciations my desired manner of hfe would soon pall on me, and in my lucid intervals I should make every effort to obtain my freedom at all hazards. "Yet I have found a way in which to induce, in a certain sense, a realisation. After my sexual desire has been intensely excited by revelling in my fancy, I go to a prostitute and there call up before my mind's eye with great intensity some scene of the kind mentioned, in which I play the principal role After thinking of such a situation for about half an hour, with a constantly re- sulting erection, I perform coitus with increased lustful pleasure and strong ejaculation. After the latter, the vision fades away. Ashamed, I depart as quickly as possible, and try not to think of the affair. Then for about two weeks I have no more such ideas ; indeed, after a particularly satisfactory coitus, it may happen that until the next attack I have not even any sympathy whatever with masochistic ideas. But the next attack is sure to come sooner or later. I must, however, state that I also have coitus without being prepared by such ideas, especi- ally, too, with women that are acquainted with me and my position, and in whose presence I abhor such fancies. Under the latter circumstances, hoiuever, I am not ahoays potent, while, with masochistic ideas, my virility is perfect. It does not seem superfluous to add that otherwise in my thought and feeling I am very aesthetic, and despise anything like maltreatment of a human being. Finally, I will not leave unmentioned the fact that the form of address is of importance. In my fancies it is essential that the ' nu's- tress ' address me in the second person {Du), while I must address her in the third {Sie). This circumstance of being thus familiarly addressed {Du) by a person so m- cHned, as the expression of absolute mastery, has from my youth given me lustful pleasure, and does to-day. " I had the fortune to find a wife who is in everything, but especially sexually, attractive to mc; though, as I 138 PSYCHOPATHIA SEXUALIS. scarcely need say, she in no way resembles my masochistic ideals. She is gentle, but voluptuous, for without the latter characteristic I cannot conceive such a thing as sexual charm. The first few months of married life were normal sexually ; the masochistic attacks did not occur, and I had almost lost all thought of masochism Then came the first confinement and the necessary abstinence. Punctually, then, with the occurrence of libido came the masochistic fancies again, which, in spite of my great love for my wife, necessitated coitus with another, with the accompaniment of masochistic ideas. It is here worthy of note that coitus maritalis, which was later resumed, did not prove sufficient to banish the masochistic ideas, as masochistic coitus always does. As for the essential element in masochism, I am of the opinion that the ideas — i.e., the mental element — are the end and aim. " If the realisation of the masochistic ideas {i.e., passive flagellation, etc,") be the desired end, then it is in opposi- tion to the fact that the majority of masochists never attempt realisation ; or when this is attempted great disappointment occurs, or at any rate the desired satis- tion is not obtained. " Finally, I should mention that, according to my experience, the number of masochists, especially in large cities, seems to be quite large. The only sources of such information are — since men do not reveal these things — statements by prostitutes, and since they agree on the essential points, certain facts may be assumed as proved. " Thus there is the fact that every experienced prosti- tute keeps some suitable instrument (usually a whip) for flagellation, but it must be remembered that there are men who have themselves whipped simply to increase their sexual pleasure. These, in contrast with masochists, regard flagellation as a means to an end. " On the other hand, almost all prostitutes agree that there are many men who hke to play 'slave' — i.e., like to be so called, and have themselves scolded and trod upon MASOCHISM. 139 and beaten. As has been said, the number of masochists is larger than has yet been dreamed. " A.S you can imagine, your chapter on this subject has made a deep impression on me. I should like to have faith in a cure, in a logical cure, so to speak, in accordance with the motto : ' Tout comprendre c'est tout guerir '. " Of course the word cure is to be taken with some limitation, and there must be a distinction made between general feelings and concrete ideas. The former can never be removed ; they come like a streak of lightning, are there, and one does not know whence or how. " But the practice of masochism in imagination by means of concrete associated ideas can be avoided, or at least restricted. " Now the thing is changed. I say to myself : What ! you busy your mind with things which not only the assthetic sense of others, but also your own, disapproves? You regard that as beautiful and desirable which, in your own judgment, is at once ugly, coarse, silly, and impossible ? You long for a situation which in reality you can never obtain ? This opposing idea has an immediate inhibitory and undeceiving effect, and breaks the point of the fancy. In fact, since reading your book (early this year) I have actually not revelled in my fancy once, though the masochistic tendencies have recurred at regular intervals. " I must also confess that, in spite of its marked patho- logical character, masochism is not only incapable of destroying my pleasure in life, but it does not in the least affect my outward life. When not in a masochistic state, as far as feeling and action are concerned, I am a perfectly normal man. During the activity of the masochistic tendencies there is, of course, a great revolution in my feeling, but my outward manner of life suCfers no change ; I have a calling that makes it necessary for me to move much in public, and I pursue it in the masochistic con- dition as well as ever." 140 PSYCHOPATHIA SEXUALIS. The author of the foregoing lines also sends me the following notes : — I. "Masochism, according to my experience, is under all circumstances congenital, and never acquired by the individual. I know positively that I teas never sjMnked ; that my masochistic ideas were manifested from my earliest youth, and that, as long as I have been capable of think^ ing, I have had such thoughts. If the origin of them had been the result of a particular event, especially of a beating, I should certainly not have forgotten it. It is characteristic that the ideas were present before there was any libido. At that time the ideas were absolutely sexless. I remember that when a boy it affected (not to say excited) me intensely when an older boy addressed me in the second person {Du) while I spoke to him in the third {Sie). I would keep up a conversation with him and have this exchange of address {Du and Sie) take place as often as possible. Later, when I had become more mature sexually, such things affected me only when they occurred with a woman, and one relatively older than myself. II. " Physically and mentally I am in all respects mas- culine. I have a superabundant growth of beard, and my whole body is very hairy. In my relations to the female sex that are not masochistic the dominating position of the man is an indispensable condition, and any attempt to change it would meet with my energetic opposition. I am energetic, if not over-courageous ; but the want of courage is not manifest when my pride is injured. I am not sensitive to events in nature (thunder storms, storms at sea, etc.).-^ " Again, my masochistic tendencies have nothing femi- nine or effeminate about them (?). To be sure, in these, 1 This difference of courage in the face of events in nature, on the one hand, and in the face of conflict with will-power, on the other, is certainly remarkable (c/. case 41, p. 117), oven though it is the only indication of eSeminacy apparent in this case. MASOCHISM. 141 the inclination to be sought and desired by the woman is dominant ; but the general relation desired with her is not that in which a woman stands to a man, but that of the slave to the master, the domestic animal to its owner. If one regards the ultimate aim of masochism without prejudice, it must be acknowledged that its ideal is the position of a dog or horse. Both are owned by masters and punished by them, and the masters are responsible to no one. Just this unlimited power of life and death, as exercised over slaves and domestic animals, is the aim and end of all masochistic ideas. III. " The foundation of all masochistic ideas is libido, and as this ebbs and flows, so do the masochistic fancies. On the other hand, as soon as the ideas are present, they greatly intensify the libido. I am not by nature exces- sively sensual. However, when the masochistic ideas occur I am impelled to coitus at any cost (for the most part I am driven to the lowest women) ; and if these impulses are not soon obeyed, libido soon becomes almost satyriasis. One is almost justified in looking upon this as a circulus vitiostcs. " Libido occurs either in the course of time or as the result of especial excitement (also of a kind that is not masochistic — e.g., kissing). In spite of its manner of origin, this libido, by virtue of the masochistic ideas it engenders, is soon transformed into a masochistic and impure libido. " Moreover, there is no doubt that external accidental impressions, particularly loitering in the streets of a large city, greatly intensify the desire. The sight of beautiful and imposing female forms, in nature as well as in art, is exciting. For those subject to masochism — at least during the attacks — the whole external world be- comes masochistic. The box on the ear administered by the teacher to the pupil and the crack of the driver's whip make deep impressions on the masochist, while they leave him indifferent or annoy him when he is not in the maso- chistic state. 142 PSYCHOPATHIA SEXUALIS. IV. " In reading Sacher-Masoch it struck me that in masochists now and then there was also an undercurrent of sadistic feeling. I have now and then discovered in myself sporadic feelings of sadism. I must remark, how- ever, that the sadistic feelings are not so marked as the masochistic. Apart from the fact that they appear but seldom, and then only in a manner as accessories, these sadistic fancies never leave the sphere of abstract feeling, and, above all, never take the form of concrete, connected ideas. The effect on libido, however, is the same with both." If this case is remarkable on account of the complete development of the psychical state which constitutes masochism, the following is noteworthy because of the great extravagance of the acts resulting from perversion. The case is also particularly suited to make clear the reason for the subjection and humiliation at the hands of the woman, and the peculiar sexual colouring of the resulting situations : — Case 48. Mr. Z., official, aged fifty ; tall, muscular, healthy. He is said to come of healthy parentage, but his father was thirty years older than his mother. A sister, two years older than Z., suffers with delusions of persecution. There is nothing remarkable in Z.'s external appearance. Skeleton entirely masculine ; abundant beard, but no hair on trunk. He characterises himself as a man of sanguine temperament, who cannot refuse others any- thing ; though irascible and quick-tempered, he is quick to regret outbursts. Z. says that he has never masturbated. From his youth there have been nightly pollutions, in which girls play a part, but the sexual act never. For example, he dreams that a pleasing woman lies heavily on him, or that as he lies sleeping on the grass she playfully walks up his back. Z. had always been averse to coitus with women. MASOCHISM. 143 This act seemed bestial to him. Nevertheless, he was drawn to women. It was only in the society of beautiful women and girls that he felt well and in his place. He was very gallant, without being forward. A voluptuous woman of beautiful form, and particu- larly with a pretty foot, when seated, had the power to throw him into intense excitement. He was impelled to offer himself as a chair, in order " to support such grand beauty ". A kick, a box on the ear from her, would be heaven to him. He had a horror at the thought of coitus with her. He felt the need to serve woman. He thought how much ladies liked to ride. He revelled in the thought how fine it would be to be wearied by the burden of a beautiful woman in order to give her pleasure. He painted the situation in all colours ; thought of the beautiful foot armed with spurs, the beautiful calves, the soft, full thighs. Every beautiful mature woman, every pretty female foot, always excited his imagination ; but he never betrayed the peculiar feelings that seemed to him abnor- mal, and was able to control himself. But he felt no need to fight against them ; on the contrary, it would have grieved him to be compelled to give up the feelings that had become so dear to him. At the age of thirty-two Z. happened to make the acquaintance of an attractive woman, aged twenty-seven, who had been separated from her husband, and whom he found in need. He took her and worked for her with- out any selfish motive, for months. One evening she impatiently demanded sexual satisfaction from him, and almost used violence. Coitus was successful. Z. took the woman, hved with her, and indulged in coitus moder- ately, but coitus was more a burden than a pleasure ; erections became weak, and he could no longer satisfy the woman. She finally declared that she would not have intercourse with him, because he only excited without satisfying her. Though he loved the woman very much, he could not give up his peculiar fancies. After this he 144 PSYCHOPATHIA SEXUALIS. lived with her only in friendly relations, and deeply re- gretted that he could not serve her in the way she desired. Fear of how she would receive his propositions and a feeling of shame kept him from confessing. He found a substitute in his dreams. Thus, for example, he dreamed that he was a proud, fiery steed, ridden by a beautiful lady. He felt her weight, the bit he had to obey, the pressure of the thighs on his flanks ; he heard her beautiful, joyous voice. The exertion threw him into a perspiration, the touch of the spurs did the rest, and always induced pollution with great lustful pleasure. Under the influence of such dreams, seven years ago Z. overcame his reluctance, in order to experience such things in reality. He was successful in creating suitable opportunity. He speaks of it as follows: "I knew how to arrange it so that on an occasion she would of her own will seat herself on my back. Then I endeavoured to make this situation as pleasant as possible, and easily arranged it so that on the next occasion she said spon- taneously, ' Come, give me a little ride ! ' Being of tall stature, both hands braced on a chair, I made my back horizontal, and she mounted astride, after the manner of a man. I then did the best I could to imitate the move- ments of a horse, and loved to have her treat me like a horse, without consideration. She could beat, prick, scold, or caress me, just as she felt inclined. I could carry on my back persons weighing from sixty to eighty kilos, for half or three-quarters of an hour, without inter- ruption. At the end of this time I usually asked for a rest. During this the intercourse between the mistress and me was perfectly harmless, and without any relation to what had preceded. After about a quarter of an hour I was rested and placed myself again at the disposal of the mistress. When time and circumstances allowed it, I did this three or four times in succession. It sometimes happened that I practised it both in the morning and afternoon After it I never felt weary or had uncomfort- MASOCHISM. 145 able feelings, but on such days I had very Httle appetite. When possible, I liked best to bare my trunk, that I might feel the riding- whip more sharply. The mistress had to be decent. I liked her best in pretty shoes and stockings, with short closed drawers reaching to the knee ; with the upper portion of her person completely dressed, and with hat and gloves." Mr. Z. further says that he has not performed coitus in seven years, but he thinks he is potent. The riding was a perfect substitute for that "bestial act," even when ejaculation was not induced. For eight months Z. had determined to give up his masochistic play, and had kept his determination. But he thought that if a woman only moderately pretty were to address him directly and say, " Come, I want to ride you," he would not be strong enough to withstand the tempta- tion. Z. wishes to know whether his abnormahty is curable, whether he is unworthy as a vicious man, or an invalid deserving pity.^ Even in the foregoing series of cases, with other things, the act of being walked upon has played a role as a means of expressing the masochistic situations of humiliation and pain. The exclusive and most extensive use of this means for perverse excitation and satisfaction, which has caused me to arrange a special group, because it forms the tran- sition to another kind of perversion (vide infra (&), p. 159) is shown in the following classical case of masochism, reported by Hamvwnd (op. cit., p. 28) from an observation by Dr. Cox ^ of Colorado : — Case 49. X., a model husl)and, very moral, the father of several children, has times — i.e., attacks— in which he A similar case is related in the eighth edition (German) of this book. Cf. there case 51. 2 " Transactions of the Colorado State Medical Society," quoted in the " Alienist and Neurologist," April, 1883, p. 345. 10 146 PSYCHOPATHIA SEXUALIS. visits brothels, chooses two or three of the largest girls, and shuts himself up with them. He bares the upper portion of his body, hes down on the floor, crosses his hands on his abdomen,' closes his eyes, and then has the girls walk over his naked breast, neck and face, urging them at every step to press hard on his flesh with the heels of their shoes. Sometimes he wants a heavier girl, or some other act still more cruel than this procedure. After two or three hours he has enough. He pays the girls with wine and money, rubs his blue bruises, dresses himself, pays his bill, and goes back to his busi- ness, only to give himself the same strange pleasure again after a few weeks. Occasionally it happens that he has one of the girls stand on his breast, and the others then turn her around until his skin is torn and bleeding from the turning of the heels of her shoes. Frequently one of the girls has to stand on him in such a way that one shoe is over the eyes, with its heel pressing on one eye, while the other shoe rests across his neck. In this position he endures the pressure of a person weighing about 150 pounds for four or five minutes. The author speaks of dozens of similar cases that are knoivn to him. Hammond presumes, with reason, that this man had become impotent for intercourse with women ; that in this strange procedure he found an equivalent for coitus ; and that, when the heels drew blood, he had pleasant sexual feehngs, accompanied by ejaculations. The cases of masochism thus far described, and the numerous analogous cases mentioned by those who report them, form a counterpart to the previously described Group "c" of sadism. Just as in sadism men excite and satisfy themselves by maltreating women, so in maso- chism the same effect is sought in the passive reception of similar abuse.^ But Group "a" of the sadists — that 1 Instructive instances are given by Seydel, " Vierteljahrsschr. f. Ger. Med.," 1893, Heft 2, pp. 275, 276. MASOCHISM. 147 of lust-murder — strange as it may seem, is not without its counterpart in masochism. In its extreme consequences, masochism must lead to the desire to be killed by a person of the opposite sex, in the same way that sadism has its acme in active lust-murder. But the instinct of self- preservation opposes such a result, so that the extreme is not actually carried out. When, however, the whole structure of masochistic ideas is purely psychical, in the imagination of such individuals even the extreme may be reached, as the following case shows : — Case 50. A middle-aged man, married, and the father of a family, who has always led a normal vita sexualis, but who says he comes of a very nervous family, makes the following communication : In his early youth he was powerfully excited sexually at the sight of a woman slaughtering an animal with a knife. From that time, for many years, he had revelled in the lustfully coloured idea of being stabbed and cut, and even killed, by women with knives. Later on, after the beginning of normal sexual intercourse, these ideas lost completely their per- verse stimulus for him. This case should be compared with the statements made on page 123, according to which men find sexual pleasure in being lightly pricked with knives in the hands of women, who at the same time threaten them with death. Such fancies, perhaps, give the key to an understand- ing of the following strange case, for which I am indebted to a communication from Dr. Korber, of Rankau, in Silesia : — Case 51 . "A lady makes me the following communica- tion : While still a young and innocent girl, she was married to a man of about thirty years On their wed- ding night he forced a bowl with soap into her hands, 148 PSYCHOPATHIA SEXUALIS. and without any expression of endearment wanted her to lather his chin and neck (as if for shaving). The inex- perienced young wife did it, and was not a httle astonished during the first weeks of married life to learn its secrets in absolutely no other form. Her husband always told her that it gave him the greatest delight to have his face lathered by her. Later, after she had sought the advice of friends, she induced her husband to perform coitus, and had three children in the course of time (by him, she states with every assurance). The husband is industrious and reliable, but a moody man, with short temper; by occupation a merchant." It may be inferred that this man conceived the act of being shaved {i.e., the lathering as a preparatory measure) as a rudimentary, symbolic realisation of ideas of injury or death, or of fancies about knives, like those the man pre- viously mentioned had had in his youth, and by means of which he had been sexually excited and satisfied. The perfect sadistic counterpart to this case, looked upon in the same light, is offered by observation 32, which is a case of symbolic sadism. At any rate, there is a whole group of masochists who satisfy themselves with the symbolic representations of situations corresponding with their perversion ; a group which corresponds with Group " e " of " symbolic " sadists just as the previously mentioned cases of masochism corre- spond with the groups "c" and "a" of sadism. Thus, just as the perverse longings of the masochist may on the one hand advance to "passive lust-murder" (to be sure, only in imagination), so, on the other hand, they may be satisfied with simple symbolic representations of the desired situations, which otherwise are expressed in acts of cruelty, (this, of course, taken objectively, goes much farther than the idea of being murdered, but in fact not so far, owing to the determining subjective conditions). MASOCHISM. 149 With case 51 other similar cases may be here de- scribed, in which the acts desired and planned by the masochist have a purely symbolic character, and to a certain extent serve to define the desired situation. Case 52. {Pascal, " Igiene dell' amore ".) Every three months a man of about forty-five years would visit a cer- tain prostitute and pay her ten francs for the followinf^ act. The puella had to undress him, tie his hands and feet, bandage his eyes, and draw the curtains of the windows. Then she would make her guest sit down on a sofa, and leave him there alone in a helpless position. After half an hour she had to come back and unbind him. Then the man would pay her and leave perfectly satisfied, to repeat his visit in about three months. In the dark this man seems to have extended this situation of being helpless in the hands of a woman by the aid of imagination. The following case, in which again a complicated comedy in the sense of masochistic desires is played, is still more peculiar : — Case 53. {Dr. Pascal, ibid.) A gentleman in Paris was accustomed to call on certain evenings at a house where a woman, the owner, acceded to his peculiar desire. He entered the salon in full dress, and she, likewise in evening toilette, had to receive him with a very haughty manner. He addressed her as " Marquise," and she had to call him " dear Count ". Then he spoke of his good fortune in finding her alone, of his love for her, and of a lover's interview. At this the lady had to feel insulted. The pseudo-count grew bolder and bolder, and asked the pseudo-marquise for a kiss on her shoulder. There is an angry scene ; the bell is rung ; a servant, prepared for the occasion, appears, and throws the count out of the house. He departs well satisfied, and pays the actors in the farce handsomely. 150 PSYCHOPATHIA SEXUALIS. A distinction must be made here between " symbolic " and " ideal " masochism. In the latter the psychical perversion remains entirely within the spheres of imagina- tion and fancy, and no attempt at reahsation is made. (Cf. cases 47 and 50.) Two other cases of ideal masochism are quoted here. The first is that of an individual men- tally and physically tainted, bearing degenerative signs, in whom mental and physical impotence occurred early : — Case 54. Mr. Z., aged twenty-two, single, was brought to me by his father for medical advice, because he was very nervous and plainly sexually abnormal. Mother and maternal grandmother were insane. His father begat him at a time when he was suffering severely from nervousness. Patient is said to have been a very lively and talented child. At the age of seven he was noticed to practise masturbation. After his ninth year he became inattentive, forgetful, and did not progress in his studies, constantly requiring help and protection. AVith difficulty he got through the Gymnasium, and during his time of freedom had attracted attention by his indolence, absent-minded- ness, and various foolish acts. Consultation was occasioned by an occurrence in the street, in which Z. had forced himself on a young girl in a very impetuous manner, and in great excitement had tried to have a conversation with her. The patient gave as a reason that by conversing with a respectable girl he wished to excite himself so that he could be potent in coitus with a prostitute ! His father characterises him as a man of perfectly good disposition, moral but lazy, dissatisfied with himself, often in despair about his want of success in Hfe, indolent, and interested in nothing but music, for which he possesses great talent. The patient's exterior — his plagiocephalic head, his large, prominent ears, the deficient innervation of the MASOCHISM. 151 right facialis about the mouth, the neuropathic expression of the eyes — indicate a degenerate, neuropathic individual. Z. is tall, of powerful frame, and in all respects of masculine appearance. Pelvis mascuhne, testicles weW developed, penis remarkably large, mons veneris w^ith abundant hair. The right testicle hangs much lower than the left, the cremasteric reflex is weak on both sides. The patient is intellectually below the average. He feels his deficiency, complains of his indolence, and asks to have his will strengthened. His awkward, embarrassed manner, timid glances, and relaxed attitude point to mas- turbation. The patient confesses that from his seventh year until a year and a half ago he practised it, years at a time, from eight to ten times daily. Until a few years ago, when he became neurasthenic (cephalic pressure, loss of mental power, spinal irritation, etc.), he says he always found great sensuous pleasure in it. Since then this had been lost, and the desire to masturbate had disappeared. He had constantly grown more bashful and indolent, less energetic, and more cowardly and apprehensive. He had lost interest in everything, and did his business only from a sense of duty, feeling very low-spirited. He had never thought of coitus, and from his standpoint as an onanist, he could not understand how others could find pleasure in it. Investigations in the direction of inverted sexual in- stinct gave a negative result. He says he never was drawn toward persons of his own sex ; he rather thinks he has now and then had a weak inclination for females. He asserts that he came to masturbate independently. In his thirteenth year he first noticed ejaculations as a result of masturbatic manipulations. It was only after long persuasion that Z. consented to entirely unveil his vita sexualis. As his statements which follow show, he may be classified as a case of ideal maso- chism, with rudimentary sadism. The patient distinctlv remembers that at the age of six, without any cause, he 152 PSTCHOPATHIA SEXUALIS. had "ideas of violence ". He was compelled to imagine that a servant girl spread his legs apart and showed his genitals to another ; that she tried to throw him into cold or hot water in order to cause him pain. These " ideas of violence " were attended with lustful feeling, and became the cause of masturbatic manipulations. Later the patient called them up voluntarily, in order to incite himself to masturbation. They also played a part in his dreams ; but they never induced pollution, apparently because the patient masturbated excessively during the day. In time, to these masochistic " ideas of violence " others of a sadistic nature were added. At first they were scenes in which boys forcibly practised onanism on one another, or cut off the genitals. He often imagined him- self such a boy, now in an active, now in a passive role. Later he busied himself with mental pictures of girls and women exhibiting themselves to one another. He revelled in the thought, for example, of a servant girl spreading another girl's legs apart and pulling the genital hair ; or in the thought of boys treating girls cruelly, and pricking and pinching their genitals. Such ideas also always induced sexual excitement,but he never experienced any impulse to carry them out actively or to have them performed on himself passively. It satisfied him to use them for masturbation. Since a year and a half ago, with diminishing sexual imagination and libido these ideas and impulses had become infrequent, but their content remained unchanged. The masochis- tic "ideas of violence" predominated over the sadistic. Now, when he sees a lady, he has the thought that she has sexual ideas Hke his own. In this way, in part, he explains his embarrassment in social intercourse. Owing to the fact that he had heard that he would get rid of his burdensome sexual ideas if he were to accustom himself to natural sexual indulgence, during the last year and a half he has twice attempted coitus, though he only ex- perienced repugnance, and was not confident of success. MASOCHISM. 153 On both occasions the attempt was a fiasco. The second time he made the attempt he felt such aversion that he pushed the girl away and fled. The second case is the following observation placed at my disposal by a colleague. Even though it be aphor- istic, it seems particularly suited to throw a clear light on the distinctive element of masochism — the consciousness of subjection, in its peculiar psycho-sexual effect : — Case 55. Z., aged twenty-seven, artist, powerfully built, of pleasing appearance, is said to be free from hereditary taint. Healthy in youth, since his twenty-third year he has been nervous and inclined to be hypochondriacal. Although he brags of sexual indulgence he is not very virile. In spite of associations with females, his relations with them are limited to innocent attentions. At the same time, his covetousness for women who are cold toward him is remarkable. Since his twenty -fifth year he has noticed that females, no matter how ugly, always excite him sexually whenever he discovers any- thing domineering in their character. An angry word from the lips of such a woman is sufficient to give him the most violent erections. Thus, one day he sat in a cafe and heard the (ugly) female cashier scold the waiters in a loud voice. This threw him into the most intense sexual excitement, which soon induced ejaculation. Z. requires the women with whom he is to have sexual intercourse to repulse and annoy him in various ways. He thinks that only a woman like the heroines of Sacher-Masoch's romances could charm him. Cases like this, in which the whole perversion of the vita sexiialis is confined to the sphere of imagination — to the inner world of thought and instinct — and only acci- dentally comes to the knowledge of others, do not seem to be infrequent. Their practical significance, like that of 154 PSYCHOPATIIIA SEXUALIS. masochism in general (which has not the great forensic importance of sadism), is confined to the psychical im- potence to which such individuals, as a rule, become subject ; and to the intense impulse to solitary indulgence, with adequate imaginary ideas, and all its consequences. That masochism is a perversion of uncommonly fre- quent occurrence is sufficiently shown by the relatively large number of cases that have thus far been studied scientifically, as well as by the agreement of the various statements reported. The works concerning prostitution in large cities also contain numerous statements concerning this matter.^ It is interesting and worthy of mention that one of the most celebrated of men was subject to this perversion and describes it in his autobiography (though some- what erroneously). From " Jean Jacques Eousseau's Confessions " it is evident that he was affected with masochism. Rousseau, with reference to whose life and malady Mobius {" J. J. Eousseau's Krankheitsgeschichte," Leipzig, 1890) and Chatclain (" La folie de J. J. Eousseau," Neu- cliatel, 1891) may be consulted, tells in his " Confessions" (part i., book i.) how Miss Lambercier, aged thirty, greatly impressed him when he was eight years old, and lived with 1 Leo Taxil {op. cit., p. 228) describes masochistic scenes in Parisian brothels. The man affected witli this perversion is there also called " slave ". Coffignon (" La corruption a Paris ") has a chapter in his book entitled " Les Passionels " which contains contributions to this subject. The strongest proof of the frequency of masochism lies in the fact that it openly appears in newspaper advertisements. For instance, the following advertisement appeared in the " Hannoversches' Tageblatt."' 4th December, 1895 : — " Sacher-Masoch. 109,404. Ladies interested in the works, and who embody the female characters, of this author are requested to send their address, under No. E. 537, to the offices of this paper. Strictest discretion." A similar advertisement appeared in the same number. MASOCHISM. 155 lier brother as his pupil. Her solicitude when he could not immediately answer a question, and her threats to punish him if he did not learn well, made the deepest impression on him. When one day he had blows at her hands, with the feeling of pain and shame he also experi- enced sensuous pleasure, that incited a great desire to be whipped by her again. It was only for fear of disturbing the lady that Rousseau failed to make other opportunities to experience this lustful, sensual feeling. One day, how- ever, he unintentionally gave cause for a whipping a,t Miss Lambercier's hands. This was the last ; for Miss Lam- bercier must have noticed something of the peculiar effect of the punishment, she did not allow the eight -year-old boy to sleep in her room any more. From this time Rousseau felt a desire to have himself punished by ladies pleasing to him, a la Lambercier, but he asserts that until his youth he knew nothing of the relation of the sexes to each other. As is known, Rousseau was first introduced to the real mysteries of love in his thirtieth year, and lost his innocence through Madame de Warrens. Till then he had had only feelings and impulses attracting him to woman in the nature of passive flagellation, and other masochistic ideas. Rousseau describes in extenso how he suffered, with his great sexual desires, by reason of his peculiar sensuousness, which had undoubtedly been awakened by his whippings, for he revelled in desire, and could not disclose his long- ings. It would be erroneous, however, to suppose that Rousseau was concerned merely with flagellation. Fla- gellation only awakened ideas of a masochistic nature. At least in these ideas lies the psychological nucleus of his interesting study of self. The essential element with Rousseau was the feeling of subjection to the woman. This is clearly shown by the " Confessions," in which he expressly emphasises that " Etre aux genoux d'une maitresse imperieuse, obeir a ses ordres, avoir des pardons 156 PSYCHOPATPIIA SEXUALIS. a lui demander, etaient pour moi de tres douces jouis- sances ".^ This passage proves that the consciousness of subjec- tion to and humihation by the woman was the most important element. To be sure, Bousseau was himself in error in supposing that this impulse to be humiliated by a woman had arisen by association of ideas from the idea of flagellation : — " N'osant jamais declarer mon gout, je I'amusais du moins par des rapports qui m'en conservaient I'idee". It is only in connection with the numerous cases of masochism, the existence of which has now been estab- lished, and among which there are so many that are in no wise connected with flagellation, showing the primary and purely psj^chical character of this instinct of subjection — it is only in connection with these cases that a complete insight into Bousseau's case is obtained and the error de- tected into which he necessarily fell in the analysis of his own condition. Binet (" Eevue Anthropologique," xxiv., p. 256), who an- alyses Rousseau's case in detail, justly calls attention to its masochistic significance when he says : " Ce qu'aime Rousseau dans les femmes, ce n'est pas seulement le sourcil fronce, la main levee, le regard severe, I'attitude imperieuse, c'est aussi I'etat emotionnel, dont ces faits sont la traduction exterieure ; il aime la femme fiere, dedaigneuse, I'ecrasant a ses pieds du poids de sa royale colere ". The solution of this enigmatical psychological fact Binet finds in his assumption that it is an instance of fetichism, only with the difference that the object of the fetichism — i.e., the object of individual attraction (fetich) ^ " To be at the feet of an imperious mistress, to obey her orders, to bo compelled to sue her for pardon, — these things are my most intense de- light." MASOCHISM, 157 ■ — is not a portion of the body like a hand or foot, but a mental peculiarity. This enthusiasm he calls " amour spirihcaliste," in contrast with '' amour plastique," as mani- fested in ordinary fetichism. This deduction is acute, but it is only a term by which to designate a fact, not a solution of it. Whether an explanation is possible, will later occupy our attention. There were also elements of masochism (and sadism) in the French writer C. P. Baudelaire, who died insane. Baudelaire came of an insane and eccentric family. From his youth he was psychically abnormal. His vita sexualis was decidedly abnormal. He had love-affairs with ugly, repulsive women — negresses, dwarfs, giantesses. About a very beautiful woman he expressed the wish to see her hung up by her hands and to kiss her feet. This enthusiasm for the naked foot also appears in one of his fiercely feverish poems as the equivalent of sexual indulg- ence. He said women were animals who had to be shut up, beaten and fed well. The man displaying these masochistic and sadistic inclinations died of paretic de- mentia. {Lomhroso, "The Man of Genius".) In scientific literature, the conditions constituting masochism have not received attention until recently. Tarnoivsky, however ("Die kraiikhaften Erscheinungen des Geschlechtssinns," BerHn, 1886), relates that he has known happily married, intellectual men, who from time to time felt an irresistible impulse to subject themselves to the coarsest, cynical treatment — to scoldings or blows from passive or active pederasts or prostitutes. It is worthy of remark that, as Tarnowsky observes, in certain cases blows, even when they draw blood, do not bring the desired result (virility, or at least ejaculation during flagellation) by those given to passive flagellation. " The individual must then be undressed by force, his hands tied, fastened to a bench, etc., during which he shams opposi- 158 PSYCriOPATHIA SEXUALIS. tion, scolds, and pretends to resist. Only under such circumstances do the blows induce excitement leading to ejaculation." 0. Zimmirmans work, " Die Wonne des Leids," Leip- zig, 1885, also contributes much to this subject,^ taken from history and literature. More recently this matter has attracted fuller attention. A. Moll, in his work, " Die Contrare Sexualempfin- dung," pp. 133 and 151 et seq., Berlin, 1891, quotes a number of cases of complete masochism in individuals of inverted sexuality, and among them that of a man suffer- ing with sexual perversion, who sent written instructions, containing twenty paragraphs, to a man engaged for this purpose, who was to treat and abuse him like a slave. In June, 1891, Mr. Dimitri von Stefanowshy , Deputy Government Attorney in Jaroslaw, Eussia, informed me that, about three years before, he had given his attention to the perversion of the vita sexualis designated "maso- chism" by me, and called "passivism" by him; that a year and a half previously he had prepared a paper on the subject for Professor von Kowaleivsky for the Russian "Archives of Psychiatry" ; and that in November, 1888, he had read a paper on this subject, considered in its legal and psychological aspects, before the Legal Society of Moscow (printed in the " Juridischer Boten," the organ of the society, in Nos. 6 to 8).^ V. Schrenck-Notzing devotes in his work " Therapeutic Suggestions in Psychopathia Sexualis,'" (Stuttgart, 1892), 1 However, the domain of masochism must be sharply differentiated from the principal subject of that work, which is, that love contains an element of sufEerhig. Unrequited love has always been described as " sweet, but sorrowful," and yyocis speak of " blissful pain " or " painful bliss ". This must not be confounded, as Z. does, with the manifestations of masochism, any more than should be the characterisation of an un- yielding lover as "cruel". It is remarkable, however, that Hamcrling (" Amor und Psyche," iv. Gesang) uses perfect masochistic pictures, flagellation, etc., to express this feeling. ^C/. his recent paper on " Passivisimus " in the " Archives d'Anthro- pologie Criminulle," 1892, vii., p. 294. MASOCHISM. 159 several paragraphs to masochism and sadism and quotes several observations of his own.^ (b) Latent Masochism — Foot- and Shoe-Fetichists. Following the group of masochists is the very numer- ous class of foot- and shoe-fetichists. This group forms the transition to the manifestations of another independent perversion, i.e., fetichism itself; but it stands in closer relationship to masochism than to the latter, for which reason it is placed here. By fetichists {v. infra, 3) I understand individuals whose sexual interest is concentrated exclusively on cer- tain parts of the female body, or on certain portions of female attire. One of the most frequent forms of this fetichism is that in which the female foot or shoe is the fetich, and becomes the exclusive object of sexual feeling and desire. It is highly probable, and shown by a correct classification of the observed cases, that the majority — and perhaps all — of the cases of shoe fetichism, rest upon a basis of more or less conscious masochistic desire for self-humihation. In Hammond' s case (case 49) the satisfaction of a maso- chist was found in being trod upon. In cases 41 and 47 1 In later fiction, the psycho sexual perversion which forms the subject of this study has been treated by Sacher-Masoch, whose writings, already frequently alluded to, afford typical pictures of the perverse mental life of men of this kind. Many affected with this perversion refer directly to the writings of Sacher-Masoch, as is seen from the foregoing cases, as typical descriptions of their own psychical condition. In " Nana," Zola has a masochistic scene, and likewise in " Eugene Rougon ". The latest "decadent" literature of France and Germany is also largely concerned with the themes of sadism and masochism. Ac- cording to voii Stefanowsky's statement, the modern Russian novel fre- quently treats the subject ; but the statements of the writer of travels, Johann Georg Foister (1754-1794) show that this subject also played a role in Russian folk-lore. Stefanowsky finds the type of passivism in an English tragedy by Otway, " Venice Preserved," and refers also to Dr. Luiz, " Les FcUatores, Moeurs de la decadence," Paris, 1888 (Union des bibliophiles). 160 PSTCHOPATHIA SEXUALIS. they also had themselves trod upon ; in case 48, equus eroticus, the person loved a woman's foot, etc. In the majority of cases of masochism the act of being trod upon with feet plays a part ^ as an easily accessible means of expressing the relation of subjection. Of the numerous established cases of shoe-fetichism, the following one, reported by Dr. A. Moll, of Berlin, which corresponds in many respects with Hammond's case, but which is described in greater detail and is more carefully observed, seems especially suited to show the connection between masochism and shoe-fetichism : — Case 56. 0. L., aged thirty-one, book-keeper in a city of Wiirtemberg ; comes of a tainted family. The patient is a large, powerful man, of ruddy appear- ance. In general he is of a quiet temperament, but may become very violent on occasion ; he says himself that he is quarrelsome and dogmatic. L. is of a kindly disposition and generous ; easily made to weep. At school he passed for a talented pupil, with good powers of comprehen- sion. The patient at times has congestion of the head, but is otherwise healthy, except that he is much depressed and melancholic as a result of his sexual per- version, here to be described. But little can be learned of any hereditary taint. The following facts concerning the development of his sexual life are gathered from the patient's own state- ments : — In very early youth — in fact, when he was eight or nine years old — L. had the desire to lick his teacher's boots like a dog. L. thinks it possible that this thought was excited by once seeing a dog actually do this, but he can- not state it with certainty ; and it seems much more likely to the patient that the first ideas of this kind came in a waking state, not in dreams. 1 The desire to be trod upon also occurs in religious enthusiasts (c/. Turgenjew, " Sonderbare Geschichteu "). MASOCHISM. 161 From his tenth to his fourteenth year he constantly sought to touch the shoes of his fellow-pupils, and also those of little girls ; but for this purpose he always chose boys who had toealihy and prominent parents. One of these, the son of a rich landed proprietor, had riding-boots ; in the boy's absence L. took these in his hands, struck him- self with them and pressed them against his face. L. did the same thing with the elegant boots of an officer of dragoons. With arriving puberty the desire was transferred ex- clusively to the boots of females. Thus, while skating, the patient's attention was entirely occupied with putting on and taking off skates for ladies ; but he always chose only such women as were rich and prominent socially, wearing elegant boots. In the street and everywhere L. constantly looked for elegant boots. His love for them went so far that he often put in his purse, and even in his mouth, the sand and mud that bore their imprints. As a boy of fourteen L. visited brothels, and he often visited a cafe chantant solely to excite himself with the sight of ele- gant boots (low shoes were less attractive). In his school books and on the walls of closets L. drew boots. In the theatre he saw nothing but the shoes of the ladies. For hours at a time, in the street and on board steamboats, L. would run after ladies wearing elegant boots; and he thought with delight of how he might get a chance to touch the boots. This peculiar love for boots remains un- changed. The thought to have himself trod zcpon by ladies in their boots or to kiss the boots gives L. the most intense sensual delight. Before the windows of shoe shops he will stand and stand, merely to look at the boots. He is particularly excited by their elegance. The patient prefers high-buttoned or laced boots with high heels ; but less elegant boots, even with low heels, also excite him if their wearer is a wealthy, distinguished, and proud lady. At the age of twenty L. attempted coitus; but "in 11 162 PSYCHOPATHIA SFXUALIS. spite of the greatest efforts," as he beheves, he was not successful. During the attempt the patient had no thought of shoes ; on the contrary, he had first sought to excite himself sexually with shoes, and he asserts that too great excitement was to blame for his want of success in coitus. Up to this time, being thirty-one years old, he has attempted coitus only four or five times, and always in vain. On one occasion the patient, already much to be pitied on account of his disease, had the misfortune to contract syphilis. In reply to the question as to what he regarded as the most lustful act, the patient said : "It is my greatest delight to lie naked on the floor and have myself trod upon by girls wearing elegant boots ; but, of course, this is possible only in brothels ". Moreover, according to the patient's statements, these sexual perversions of men are well known m many houses of prostitution — a proof that they are nut so very infrequent. The prostitutes call these men " boot lovers ". But the patient has only very infrequently had the lustful act actually performed, notwithstanding the fact that it is most beautiful and pleasant to him. The patient has no thoughts that impel to intercourse ; at least not in the sense of immissio penis in vaginam — an act that affords him no pleasure whatever. Indeed, he has gradually developed a fear of coitus, which may be sufficiently explained by his numerous unsuccessful at- tempts ; for the patient says himself that his inability to ccjmplete coitus embarrassed him exceedingly. The patient has never practised real onanism. With the exception of a few occasions on which the patient satisfied his sexual desire by onanism with boots or in a similar way, he is innocent of such satisfaction ; for, in the excite- ment with boots, there is scarcely ever anything more than erection ; at most, only a slight discharge of fluid takes place slowly which the patient takes to be semen. Simply a shoe, worn by no one, excites him when he sees it, but not nearly as intensely as when it is worn by MASOCHISM. 163 a woman. New shoes that have not been worn excite him much less than those that have been used ; but they must be free from wear and look as new as possible. Shoes of this kind excite him the most. As has been said, ladies' boots excite him when they are not on the feet. Under such circumstances, in fancy L. creates a lady for them ; he presses them to his hps and on his penis. He would "die with delight" if a proud, respect- able lady were to tread upon him with her shoes. Aside from the previously mentioned characteristics of the women (pride, wealth, social prominence), which, in connection with the elegance of the boots, constitute an especial stimulus, the patient is by no means indifferent to the physical charms of the female sex. He is enthusi- astic about beautiful women without thinking of boots, but this love is not directed to sexual satisfaction. The bodily charms play a part even in connection with the boots ; a homely old woman, even wearing the most ele- gant boots, cannot affect the patient. The rest of the attire and other circumstances also play an essential ruh, as is shown by the fact that elegant boots worn by proud, distinguished women especially excite the patient. A common servant girl in her working dress, even in the most elegant shoes, would not excite him. Men's shoes and boots no longer affect the patient, and he never in the slightest degree feels himself attracted to men sexually. Yet the patient has erections very easily. When he takes a child in his lap, when he pats a dog or horse for some time, when he travels on the cars, or when he rides, — ■ erections occur. In the latter case he thinks it is due to the shaking. He has erections every morning, and he can induce erection in a very short time by thinking of the act with boots that is so pleasing to him. Pollutions for- merly occurred frequently at night — about every three or four weeks ; now they are more infrequent, occurring once about every three months. In his erotic dreams the patient is almost always 164 PSYCMOPATHIA SEXUALIS. sexually excited by the same thoughts that excite him in the waking state. For some time he thinks he has felt ejaculation during erection; but he draws this conclusion only from feeling a little moisture at the end of the penis. Literature touching upon the sphere of the patient s sexual ideas especially excite him. Thus, in reading " Venus in Furs," by Sacher-Masoch, he is so excited ut S2)cr7na stillaret. ' Moreover, with L., this kind of ejacu- lation while reading is a decided satisfaction of his sexual desire. My question, whether blows received from a woman's hand would also excite him, the patient thinks he would have to answer in the affirmative. The patient has never made any such trial, but jplayful taps had, at any rate, always been very pleasing to him. It would afford the patient a particularly intense pleasure if he were to be kicked by a woman, even without shoes, and with bare feet. He does not think that the blows, as such, would cause the excitement. But rather the thought of being maltreated by a woman ; the sanie effect might be obtained by scolding or actual blows. Besides, blows and cross words had an exciting effect only when they came from a proud and distinguished lady. In general it is the feeling of humiliation and slavish subjection that gives the patient lustful pleasure. " Were a lady," the patient tells me, " to command me to wait for her, even in severe cold weather, I should, nevertheless, feel sensual pleasure." To the question whether boots in general produced this feeling of humiliation, the patient answers : " I think that this passion for self-humiliation has been concentrated especially on ladies' boots, for it is symbolic of one's being ' unworthy to loosen the latchet of another's shoe ' ; and, besides, a subject kneels ". Women's stockings also have an exciting effect on the patient, but only to a slight extent, and perhaps only through awakening an idea of boots. The patient's pas- sion for ladies' boots had coi:stantly increased, but of late MASOCHISM. 165 years he thought he had noticed a diminution of it. He seldom visits pubhc women, and is also more capable of self-restraint. Yet this passion still rules him absolutely, and every other pleasure is spoiled by it, A pretty female boot could draw his eye away from the most beautiful landscape. At the present time he often goes about at night in the corridors of hotels, seeking elegant ladies' shoes, which he kisses and presses against his face and neck, but principally against his penis. The patient, who is very well-to-do, a short time ago went voluntarily to Italy, only with the thought of be- coming the servant of a rich and distinguished lady unacquainted with him ; but the plan failed. The patient, who came only for consultation, has not yet been treated medically. The foregoing history reaches almost to the present time, and m the interval he has sent me communications by letter concerning his condition. It does not require an extensive commentary. It seems to me to be one of the best cases to illustrate the relationship between shoe- fetichism and masochism as set forth by von Krafft-Ehing} The principal charm for the patient, as he, without leading questions, always emphasises, is his subjection to a woman, who in pride and position must be as far above him as possible {Moll, " Untersuchungen iiber Libido Sexualis, Bd. i., 2 Theil, Beob. 36, p. 320). Such cases are numerous in which, within a fully 1 However, against the theory that foot- and shoe-fetichism is a manifestation of (latent) masochism, Dr. Moll {op. cit., p. 136) raises the objection that it is still unexplained why the fetichist so often prefers boots with high heels, to boots and shoes of a particular kind — buttoned or laced. To this objection it may be remarked that in the first place the high heels characterise the shoes as feminine, and in the second place, that in spite of the sexual character of his inclination, the fetichist de- mands all kinds of aeithetic qualities in his fetich (c/. case 88) ; also the interesting theories advanced by Restif de la Bretonnc [himself foot- fetichist], and quoted in Moll's work, np. ciL, pp. 493 and 499, footnote. 166 PSTCHOPATHIA SEXUALIS. developed circle of masochistic ideas, the foot and the shoe or boot of a woman, conceived as a means of humili- ation, have become the objects of especial sexual interest. Through numerous deforces that are easily discriminated they form the demonstrable transition to other cases in which the masochistic inclinations retreat more and more to the background, and little by little pass beyond the threshold of consciousness, while the interest in women's shoes, apparently absolutely inexplicable, alone remains in consciousness. Frequent cases of shoe-lovers, which, like all cases of fetichism, posses^ forensic interest (theft of shoes), occupy a position midway between masochism and fetichism. The majority or all may be looked upon as instances of latent masochism (the motive remaining unconscious) in which the female foot or shoe, as the maso- chist's fetich, has acquired an independent significance. Next come two cases in which the female shoe pos- sesses a subordinate interest, but in which unmistakable masochistic desires play an important part (c/. case 41) : — Case 57. Mr. X., aged twenty-five, parents healthy, never sick before, places the following autobiography at my disposal : " I began to practise onanism at the age of ten, without ever having any lustful thoughts during the act. Yet at that time — I am sure of this — the sight and touch of girls' elegant boots had a pecuhar charm for me ; my greatest desire was also to wear such shoes, a wish that was occasionally fulfilled at masquerades. But I was also troubled l)y a very different thought : my ideal was to sec myself in a position of humiliation; I would gladly have been a slave, and whipped ; in short, I wished to receive the treatment that one finds described in many stories of slavery. I do not know whether the reading of such stories gave rise to my wish, or whether it arose spon- taneously. " Puberty began at the age of thirteen ; with the occurrence of ejaculation lustful pleasure increased, and I MASOCHISM. 167 masturbated more frequently, often two or three times a day. From my twelfth to my sixteenth year, during the act of onanism, I always had the idea that I was forced to wear girls' boots. The sight of an elegant boot, on the foot of a girl at all pretty, intoxicated me ; I inhaled the odour of the leather with avidity. In order to smell leather during the act of onanism, I bought a pair of leathern cuffs, which I smelled while I masturbated. My enthusiasm for ladies' leathern shoes remains the same to-day ; only, since my seventeenth year, it has been coupled with the wish to become a servant, to blacken shoes for distingidshed ladies, to put on and take off their shoes for them, etc. " My dreams at night are made up of shoe-scenes : either I stand before the show-window of a shoe-shop regarding the elegant ladies' shoes, — particularly buttoned shoes, — or I He at a lady's feet and smell and hck her shoes. For about a year I have given up onanism and go ad jmellas ; coitus takes place by means of intense thought of ladies' buttoned shoes ; or, if necessary, I take the shoe of ihepuella to bed with me. I have never suffered from my former onanism. I learn easily, have a good memory, and h.ave never had headache in my life. This much concerning myself. "A few words about my brother: I am thoroughly convinced that he is also a shoe-fetichist. Of the many facts that demonstrate this to me, it is only necessary to mention that it is a great pleasure for him to have a cer- tain cousin (a very beautiful girl) tread upon him. As for the rest, I might undertake to tell whether a man who stands before a shoe-shop and regards the shoes on exhibi- tion is a " foot-lover " or not. This anomaly is uncom- monly frequent. When in the circle of my acquaintance I turn the conversation to tlie question of what woman's charm is, I very frequently hear it said that it is much more in attire than in nuditv ; but every one is careful not to reveal his especial fetich I think an uncle of mine is also a shoe-fetichist." 168 PSYCHOPATHIA SEXUALIS. Case 58. Z., twenty-eight years, official, comes from neuropathic mother. Father died early ; as to his family and health no information is obtainable. Z. was from early childhood nervous and impressionable ; began early to masturbate on his own accord ; with puberty he became neurasthenic, avoided onanism for a while, but was troubled with pollutions very frequently; recovered somewhat at a hydropathic institute ; experienced strong libido towards woman, but never succeeded in coitus partly on account of diffidence in his power, partly from fear of infection. This upset him very much, especially as he relapsed faute de mieux into his secret habit. Z., during a searching consultation about his vita sexualis, proves to be fetichist as well as masochist, and reveals interesting relations between these two anomalies. He asserts that since his ninth year he has had a weakness for women's shoes. This, he claims, was caused by seeing at that time a lady mounting a horse whilst an attendant held the stirrup for her. This sight excited him very much, it constantly recurred to his imagination, ever increasing his lustful feelings. Later on his sensations during pollution were connected with women in high boots. Laced boots with high heels charm him most especially when this idea is associated with the lustful thought that a woman trod upon him with her heel, and that he, whilst kneeling, kissed a woman's shoes. The only interesting thing about a woman is her shoe. Im- pressions of odour do not play any part in this. The shoe as such is insufficient ; it must be worn by woman. Whenever he sees a woman with laced boots he becomes excited and masturbates. He believes that he could not command virile power with any woman unless her feet were clad with laced boots. Faute do miciix he made a drawing of such a boot, and whilst masturbating revels in gazing at it. The following case is not only instructive because of MASOCHISM. 1G9 the relations shown therein to exist between shoe-fetich- ism and masochism, but is also of interest on account of the cure of the vita sexualis brought about by the patient himself. Case 59. Mr. M., thirty- three years of age, of good family, which on the maternal side for generations has shown manifestations of psychical degeneration, extend- ing even to cases of moral insanity. The mother was neuropathic and characterologically abnormal. Himself strong, well built, but neuropathic ; began as a small boy to practise onanism spontaneously. When twelve years of age peculiar dreams of being tortured, whipped and kicked by men and women, especially by the latter. When about fourteen a weakness for women's boots came over him. They caused sexual excitement ; he was forced to kiss and press them to him ; this produced erection and orgasm, followed by masturbation. But these acts were also accompanied by masochistic ideas of being kicked and tortured. He recognised that his vita sexiialis was abnormal, and at the age of seventeen he sought a cure in coitus. He found himself quite impotent. At eighteen another attempt proved a failure ; he continued masturbation assisted by shoe-fetichism and masochistic fancies. At the age of nineteen he heard by accident a man speak of flagellation by a girl as a means to bring about virility. He now felt that he had found his remedy, and hastened to carry out the advice just received, but was completely disappointed. The whole situation disgusted him so thoroughly that no erection resulted. He made no more similar attempts, and satisfied him- self in the accustomed manner. When he was twenty- seven he met by accident a sympathetic and tjalante girl, became intimate, and complained to her about his impo- tence. She laughed at him, and said that at his age and with his constitution this was impossible. 170 PSYCHOFATHIA SEXUALIS. He gained self-confidence, but only after fourteen days of the greatest intimacy and with the aid of shoe-fetichism and masochistic fancies he obtained power. This lasted several months. His condition improved, he could do without the secret aids, and his abnormal fancies became latent. Then for three years, on account of psychical impotence with other women, he yielded again to mastur- bation and his former fetichism. With his thirtieth year he entered again upon sympathetic relations with another girl ; but as he felt himself incapable of coitus without the aid of masochistic situations, he instructed her to treat him as her slave. She played her part well, made him kiss her feet, whipped him with a switch, and trod upon him. But it was all in vain. He only felt pain and utter confusion, and soon had these assaults discontinued. Ideal masochistic situations, however, aided him at times to accomplish coitus. But he found little satisfaction under these circum- stances. Then he came across my book on " Psychopathia Sexualis," and found out the real condition of his anomaly. He wrote to his former acquaintance and entered again upon intimate relations with her, but told her definitely that the former absurd scenes of " slavery " must not be enacted again, and that under no circumstances, even though he request it himself, must she enter upon his masochistic ideas. In order to free himself of shoe-fetichism he adopted the following plan. He bought a lady's elegant boot and made daily these suggestions to himself whilst kissing the boot repeatedly: "Why should I have erections when kissing this boot, which is after all only a piece of ordinary leather?" This practice Httle by Httle stripped the object of its fetichistic charm. The erections disappeared, and finally the boot impressed him only as a boot. Intimate intercourse with the sympathetic per- son ran parallel with this suggestive self-treatment, and although at first he could not produce virility without the MASOCHISM. 171 assistance of masochistic ideas, these latter gradually disappeared. He was so pleased with his cure that he came to thank me for the valuable help he had found in the perusal of my book, which had shown him the right way to remedy his defect. Since then he has written that he is completely cured, that he meets with no difficulties in his sexual intercourse, although from time to time masochistic representations faintly reappear, without, however, leaving any impression on his mind. Case 60. Keported by Mantcgazza in his "Anthropo- logical Studies," 1886, p. 110. X., American, of good family, mentally and morally well constituted ; from the beginning of puberty capable of being excited sexually only by a woman's shoe. Her body and naked or stockinged foot made no impression on him; but the foot, when covered with the shoe, or a shoe alone, in- duced erection and even ejaculation. Sight alone was sufficient for him in the case of elegant shoes — i.e., shoes of black leather, buttoning up the side and having very high heels. His sexual desire was powerfully excited by touching, kissing, or putting such shoes on his own feet. His enjoyment was increased by driving nails through the soles so that their points would penetrate his feet while walking. 'This caused him terrible pain, but he had real lustful feeling at the same time. His greatest enjoyment was to kneel down before the elegantly clad feet of ladies and have them step on him. If the wearer be an ugly woman, the shoes would not affect him, and his fancy would cool. If the patient had empty shoes only at his disposal, his fancy would create a beautiful woman wear- ing them, and ejaculation would result. His nightly dreams were of the shoes of beautiful women. He con- sidered the exposure of ladies' shoes in show-windows immoral; while talk about the nature of woman seemed 172 PSYCHOPATHIA SEXUALIS. to him harmless, but in bad taste. X. attempted coitus several times without success, ejaculation never occurred. In the following case the masochistic as well as the sadistic element is in evidence (c/. " Torture of x\nimals," p. 109, under " Sadism") : — Case 61. A young, powerful man, aged twenty-six. Nothing in the opposite sex excites his sensual feehng except elegant shoes on the feet of a buxom woman, especially when they are made of black leather and have high heels. The shoes without the wearer are sufficient. It gives him the greatest pleasure to see, touch and kiss them. The feminine foot, when bare or covered with a stocking, has no effect on him. Since childhood he has had a weakness for ladies' fine shoes. X. is potent ; during the sexual act the female must be elegantly dressed and, above all, have on pretty shoes. At the height of sexual excitement cruel thoughts about the shoes arise. He is forced to think with delight of the death agonies of the animal from which the leather was taken. Sometimes he is imp3lled to take chickens and other animals with him to Phryiie, in order to have her tread on them with her pretty shoes for his pleasure. He calls this "sacrificing to the feet of Venus". At other times he has the woman walk on him with her shoes on, the harder the better. Until the previous year it was sufficient — since he did not take the slightest sensual pleasure in women — to caress ladies' shoes that pleased him, thus attaining ejaculation and complete satisfaction {Lombroso, "Arch, di psichiatria," ix., fascic. iii.). The next case reminds one of case 60, on account of the interest in the nails of the shoes (as capable of inflicting pain) ; and of 61, on account of the shght acconipanying sadistic element : — MASOCHISM. 173 Case 62. X., aged thirty-four, married; of neuro- pathic parentage ; suffered severely from convulsions as a child; remarkably precocious, but one-sided in develop- ment (could read at age of three) ; nervous from childhood. At the age of seven he manifested an inclination to finger shoes, especially the nails of women's shoes. The mere sight, but still more the touching, of the shoe-nails and counting them, gave him indescribable pleasure. At night he gave himself up to imagining how his cousins had their measures taken for shoes ; how he nailed horse-shoes on to one of them or cut her feet off. In time the shoe-scenes came upon him during the day, and involuntarily induced erection and ejaculation. Fre- quently he took the shoes of female occupants of the house ; and if he touched them with his penis he had an ejaculation. For a long time, when a student, it was possible for him to control his ideas and incHnations ; but there came a time when he was compelled to listen to female footsteps on the pavement, which, like the sight of the nails being driven into ladies' shoes, or the sight of shoes in the windows of the boot-shops, always swayed him with feelings of lustful pleasure. He married, and during the first months of his married life was free from these desires. Gradually he became hysteropathic and neurasthenic. At this stage he began to have hysterical attacks when the shoemaker spoke to him of nails in ladies' shoes or of driving nails in the same. The reaction was still greater if he chanced to see a pretty lady with shoes well beset with nails. In order to induce ejaculation it was only necessary for him to cut soles out of pasteboard and beset them with nails ; or he would buy ladies' shoes, have them beset with nails in the shop, and at home scrape them on the ground, and finally touch them with the end of his penis. Moreover, lustful shoe-visions occurred spontaneously, in which he satisfied himself by masturba- tion. 174 PSYCHOPATHIA SEXUALIS. X. is otherwise intelligent, skilful in his calling, but powerless in combating his perverse inclinations. He presents phimosis ; penis short, expanded at the root, and incapable of complete erection. One day the patient allowed himself to masturbate when excited by the sight of ladies' shoes beset with nails in front of the window, of a shoe- shop, and this lecame a criminal {Blanche " Archiv. de Neurologie," 1882, No. 22). Keference may be made here to a case of inverted sexuality, to be described later, in which the prmcipal sexual interest was in the boots of male servants. The desire was to be trod upon by them, etc. Case 63. (Dr. Pascal, " Igiene dell' amore ".) X., merchant ; from time to time (but particularly in bad weather) had the following desire : He would accost some prostitute and ask her to go to a shoe-shop with him, where he would buy her the handsomest pair of shoes made of patent leather, under the condition that she would put them on immediately. When this had taken place, she had to go about in the street, walking in manure and mud as much as possible, in order to soil the shoes. Then X. would lead the person to a hotel, and, almost before they had reached a room, he would cast himself upon her feet, feehng an extraordinary plea- sure in licking them with his lips. When he had cleansed the shoes in this manner, he paid her and went his way From these cases it may be plainly seen that the shoe is the fetich of the masochist,^ and apparently because of the relation of the dressed female foot to the idea of being trod upon and other acts of humilation. When, therefore, in other cases of shoe-fetichism, the female shoe appears 1 Cf. the observation of the author in the " Centralblatt f. d. Krank- heiten der Harn-und Sexualorgane," vi., 7, referring to a masochist troubled with shoe-fetichism which excludes all doubts in this respect. MASOCHISM. ^ 175 alone as the excitant of sexual desire, one is justified in presuming that masochistic motives have remained latent. The idea of being trod upon, etc., remains in the depths of unconscious life, and the idea of the shoe alone, the means for such acts, rises into consciousness. Cases which would otherwise remain wholly inexplicable are thus sufficiently explained. Here one has to do with latent masochism which may always be assumed as the unconscious motive, when not infrequently the origin of the fetichism can be proved to arise from an association of ideas with some particular event, as in cases 93 and 94. Such cases of desire for ladies' shoes, without conscious motive and without demonstrable origin, are really in- numerable.^ Three cases are here given as examples : — Case 64. Minister, aged fifty. From time to time he goes to houses of prostitution under the pretext of renting a room. He enters it with a girl. Then he lustfully regards her shoes, takes one off, osculatur et mordet caligam lihidine captus. Ad genitalia denique caligam premit, cjacula semen semineque ejaculato axillas pectusque terit ; then he comes out of his sexual ecstasy. He begs the woman to allow him to keep the shoe for a few days, and always, at the appointed time, returns it with thanks (Cantaranot, " La Psichiatria, v., p. 205). Case 65. Z., Student, aged twenty-three ; comes of a tainted family. Sister was insane; brother suffered with hysteria virilis. The patient, peculiar from childhood, has frequent attacks of hypochondriacal depression, tadiumvitcB, and feels that he is being shghted. In a consultation on account of mental trouble, I find him a very perverse 1 There is apparently a connection between foot-fetichism and the fact that certain persons of this liind, whom coitus does not satisfy, or who are unable to perform it, find a substitute for it in tritus membri inter l^edes mulieria. 176 PSTCHOPATHIA SEXUALIS. hereditarily predisposed man, with neurasthenic and hypo- chondriacal symptoms. A suspicion of masturbation is confirmed. Patient makes interesting disclosures concern- ing his vita sexualis. . At the age of ten he was powerfully attracted by the foot of one of his comrades. At twelve he became an enthusiast for ladies' feet. It gave him a delightful sensation to revel in the sight of them. At fourteen he began to masturbate, thinking, at the same time, of the beautiful foot of a lady. At this time he revelled in the sight of the feet of his three-year-old sister. The feet of other females that attracted him induced sexual excitement. Only women's feet — no other part of them — interested him. The thought of sexual intercourse with women excited his disgust. He had never attempted coitus. After his twelfth year he had no interest in the feet of male individuals. The style of covering of the female foot is indifferent to him ; it is only necessary that the person seem to be sympathetic. The thought of enjoying the feet of prostitutes was disgusting to him. For years he had been in love with his sister's feet. If he could but obtain her shoes, the sight of them power- fully excited his sensuality. Kissing or embracing his sister did not have this effect. His greatest delight was to embrace and kiss the foot of a sympathetic woman, when ejaculation would result with a lively pleasurable sensation. Often he was impelled to touch his genitals with one of his sister's shoes ; but he had been able, thus far, to master this impulse, especially for the reason that for two years (owing to progressive irritable weakness of the genitals) the simple sight of the foot had induced ejaculation. From his relatives it is ascertained that the patient has a silly admiration for the feet of his sister ; so that she avoids him and seeks to hide her feet from him. The patient looked upon his perverse sexual impulse as pathological, and was painfully affected by the fact that his vile fancy had for its object his sister's foot. He avoided opportunity as much as he could, and sought to MASOCHISM. 177 help the matter by masturbation when, as in dreams accompanied by pollution, ladies' feet filled his imaj^ina- tion. However, when the impulse became too powerful he could not avoid gaining a partial sight of his sister's foot. Immediately after ejaculation he would become angry with himself at having been weak again. His partiality for his sister's foot had cost him many a sleep- less night. He often wondered that he could still love his sister. Although it seemed right to him that she should conceal her feet from him, yet he was often irritated because the concealment caused him to have pollutions. The patient gives assurances, confirmed by his relatives, of being moral in other respects. Case 66. S., New York, is accused of being a street- thief. Numerous cases of insanity in his ancestry ; father, brother and sister mentally abnormal. At seven years, violent cerebral concussion twice. At thirteen, struck by a beam. At fourteen S. had violent attacks of head- ache. Accompanying these attacks, or immediately after them, peculiar impulse to take the shoes of female members of the family — as a rule, only one at a time — and hide them in some out-of-the way corner. Taken to task, he would lie, or declare that he had no recollection of the affair. The passion for shoes was unconquerable, and made its appearance every three or four months. On one occasion he attempted to take a shoe from the foot of one of the servants, and on another he stole his sister's shoe from her bedroom. In the spring two ladies had their shoes torn from their feet in the open street. In August, S. left his home early in the morning to go to his work as a printer. A moment afterwards he tore the shoe from a girl's foot in the open street, fled to his place of work, and there was arrested as a street-thief. He declared that he did not know much of his act ; that it had come upon him like a stroke of lightning, at the sight of the shoe, that he must possess himself of it, but 12 178 PSYCHOPATHIA SBXUALIS. for what purpose he did not know. He had acted while in a state of unconsciousness. The shoe, as he correctly indicated, was found in his coat. In confinement he was so much excited mentally that an outbreak of insanity was feared. Discharged, he stole his wife's shoes while she was asleep. His moral character and habits of life were blameless. He was an intelligent workman ; but irregularity of employment, that soon followed, made him confused and incapable of work. Pardoned {Nichols, " Am. Journal of Insanity," 1859; Beck, " Med. Jurisprudence," vol. i., p. 732, 1860). Dr. Pascal (oj). cit.) has some similar cases, and many others have been mentioned to me by colleagues and patients. (c) Disgusting Acts for the Purpose of Self- Humiliation and Sexual Gratification — Latent Masochism — Koprolaipiia. Whilst in the manifestations thus far described the a3sthetic sentiment is at least, so far as appearances go, saved, and the lustful situation is kept within the confines of a symbolic or ideal character, there are many cases in which the desire for sexual gratification by self-humifia- tion before woman finds expression in acts which defile the moral and assthetic feelings of the normal man. Impressions obtained through the senses of smell and taste, which in the normal man produce only feelings of nausea and disgust, are made the basis of the most vivitl emotions of lust, producing in the perverse subject mighty impulses to orgasm and even ejaculation. An analogy with the excesses of rehgious enthusiasm can be even traced. The religious enthusiast, Antoinette Bouvignon de la Porte, used to mix with her food excreta in order to mortify herself {Zimmermann, op. cit, p. 124). The beatified Marie Alacoque ficked up with her tongue t]-ie excrements of sick people to " mortify" herself, and MASOCHISM. 179 sucked their festering toes. The analogy with sadism is also of interest in this connection because here also mani- festations in the sense of vampyrism and anthropophagy arising from disgusting appetites of the organs of taste and olfaction produce lustful feelings (c/. case 59, Bichel, Menesclou, L Beob. 18, 19, 20, 22). This impulse to dis- gusting acts might well be named koprolagnia. Its relations to Masochism (as a subordinate form) have been indicated in case 43. The subsequent observation will render them clearer. In some cases it would appear as if the masochistic element were unknown to the perverse subject and the instinct for nauseating acts alone were present (latent masochism). A striking instance of masochistic kopro- lagnia (combined with perverse sexuality) may be found in case 114 of the eighth edition of this work. The subject of this case revels not only in the thought of being the slave of the beloved, referring for this purposp to Sacher- Masoch's " Venus in Furs," sed etiam sibi fingit amatum poscere ut crepidas sudore diffluentes olfaciat ejimque ^tercore vescatur. Deinde narrat, quia non habeat, qua confimjat et exoplet, eoricm loco suas crepidas sudore infectas olfacere suoque stercurc vesci, inter qua facta pene erecto se voluptate pertur- bari scmenque ejaculari. Case 67. Masochism — Koprolagnia. — Z., fifty-two years of age ; high position ; father phthisical ; family claimed to be untainted ; always nervous, only child, deposes to have had peculiar emotions since he was seven, when by chance "he saw the servants take off their boots and stockings preparatory to scrubbing the floors of the house. Once he begged one of the maids to show him her toes and feet before she washed them. When he began going to school and reading books, he felt forcibly drawn to litera- ture which contained descriptions of refined cruelty and tortures, especially when they were executed at the de- mands of women. He simply devoured novels dealing 180 PSYCHOPATHIA SEXUALIS. with slavery and bondage, and whilst reading them, he became so excited that he began masturbation. What excited him most was to imagine that he was the slave of a pretty young lady of his acquaintance who allowed him after a long walk, pedes lamherc,^ pracipue platitas et spatia inter digitos. He thought of the young lady as particularly cruel and enjoying tortures and whippings meted out to him. These fancies were accompanied by masturbation. At the age of fifteen whilst revelling in such fictions, he let a poodle dog hck his feet. One day he noticed how a pretty servant girl in his own house let a poodle dog hck her toes whilst she was reading. This caused in him erection and ejaculation. He per- suaded the girl to let this happen frequently whilst he looked on. After a while he took the place of the poodle and ejaculated every time. From his fifteenth to his eighteenth year he was at a boarding-school and had no opportunity to practise such evil habits. He was satisfied to excite himself every few weeks with the perusal of literature treating on cruelties committed by women, imagining all the time that he was licking the feet of such women. This produced ejaculation accompanied by the highest lustful excitement. The female organs had never any attraction for him, and he never felt sexually drawn towards men. When he had attained puberty he solicited girls and had coitus with them, but always sucked their feet before the act. He would do this also, inter actum, and aske 1 the girls to tell him with what cruelties they would afflict him in case he did not lick their toes quite clean. Z. affirms that he very often succeeded in this, and that the whole action was .always pleasing to the girls. He was especially attracted by the feet of well-bred women that were deformed by narrow boots and had not ^This disgusting impulse is also referred to in case 68 of ttio eighth edition of this work. It seems to occur especially with koprolaguists and fetichists. MASOCHISM. 181 been washed for several days, but he could stomach only " slight, natural deposits, such as one may find upon the feet of clean well-bred ladies, also discolorations from the stockings, whilst sweating feet excited him only in imagin- ation, but in reahty disgusted him". "Cruel tortures" also existed for him only in imagination as a means to excitement ; he abhorred them and never craved for them in reality. Nevertheless they played a pre-eminent part in his fancy, and he never neglected to mstruct the women with whom he kept in masochistic touch how they were to write him threatening letters. From the collection of such letters placed at my disposal by Z. one is given here because ii; clearly illustrates the line of thought and sentiment : — " Lambitor sudoris pedum mulierum ! I take the utmost dehght m conjuring up the moment when you will Uck my toes, especially after a long walk. A facsimile of my foot I shall send you soon. It will intoxicate me like nectar when you will lick up my s2idor pedum. And if you will not do it voluntarily, I shall force you to it ; I shall treat you as my meanest slave. You shall witness how another favoritus s^idorem pedum mihi lamhit, whilst you shall whine like a dog under the lashes of my servants. I shall declare you outlawed. I shall find the most exquisite pleasure in seeing you in pain, breathing your last under the most cruel tortures, licking my toes in extreme agony. . . . You challenge my cruelty— very well, I shall crush you under my foot like a worm. . . . You ask me for a stocking ? I shall wear it longer than usual. But I demand that you kiss it and lick it; that you soak the foot of it in water and then drink the latter. If you do not carry out my pleasure absolutely, I shall cliastise you with my riding-whip. I demand uncon- ditional obedience. If you do not obey, I shall have you whipped with the knout, I shall make you walk over a floor well-spiked with sharp nails, I shall have you bastinaded and cast to the lions in the cage. It will 182 PSYCHOPATHIA SEXUALIS. give me the utmost delight to see how the wild beasts enjoy your flesh." In spite of such ridiculous tirades, ordered by himself, Z. looks upon them as a means to satisfy his perverse sexuality. These sexual monstrosities, which to him are only a congenital anomaly, he does not consider unnatural, although he admits them to be disgusting to the normally constituted man. Otherwise he appears to be a decent sort of a man with rather refined manners, but his other- wise meagre aesthetic sentiments are overbalanced by sensuality which gratifies his perverse desires. Z. gave me an insight into his correspondence with the Hterary champion of masochism, Sacher-Masoch. One of these letters, dated 1888, shows as a heading the picture of a luxuriant woman, with imperial bearing, only half covered with furs and holding a riding-whip as if ready to strike. Sacher-Masoch contends that " the passion to play the slave " is widespread, especially among the Germans and Eussians. In this letter, the history of a noble Eussian is related who loved to be tied and whipped by several beautiful women. One day he found his ideal in a pretty young French woman and took her to his home. According to Sacher-Masoch, a Danish woman yielded her favour to no man until he acted the part of slave to her for a considerable time. Amantcs coagere solebat, ut vedcs suos ct j)ocliccm lambeant. She had her adorers put in chains and whipped until they obeyed her lamhmdo -pedes. Once she had the "slave" fastened to her bed- posts and thus made him witness her granting the highest favour to another. After the latter left her she had the fettered " slave " whipped by her servants until he yielded lamherc podicem domina. If these assertions were true which, of course, cannot be accepted from the poet without definite proof, they would constitute remarkable proofs of sadismus fcminarum. At any rate they are psychologically interesting instances MASOCHISM. 183 of thonc^hts and sentiments specific to masochism (my own observations, " Centralblatt fiir Krankheiten der Harn- mid Sexualorgane," vi., 7). Case 68. Z., aged twenty-four ; Eussian civil servant ; mother nem'opathic, father psychopathic. Z. is intelhgent, of refined manners, physically normal, of pleasing appear- ance and aesthetic tastes ; never had a severe illness. Claims to have been of a nervous disposition from infancy ; has like his mother neuropathic eyes and latterly suffers from cerebral asthenic troubles. Perversio vita sexualis causes him much worry, bordering on despair, deprives him of self-esteem and tempts him to suicide. What oppresses him is the unnatural desire recurring every four weeks for mictio mulieris in os suum. As cause he gives the following facts, interesting on account of their genetic importance. When six years of age he put his hand by accident sub podiccm jyucllcB who sat next to him in school. This caused him pleasure and he repeatedly did so. The memory of these pleasant situations strongly aroused his fancy. Puerum decern annorum serva educatrix libidine mota ad corpus stium appressit et digiUtm ejus in vaginam introduxit. Qimm postoa fortnitu digito ?iasum tetigit, odorc ejus valde dclectatus fuit. This immoral act developed into a lustful fancy which made him believe vincUis inter femora imdieris cumhere, coactus, ut dormiat sub ejus podice et ut bibat ejus urinam. With the thirteenth year these fictions disappeared. At fifteen first coitus, at sixteen second, quite normal and without fanciful representations. Deficiente pccunia et magna libidine perturbatus mas- tubartionc earn satiabat. At seventeen perverse ideas recurred. They became more powerful and he struggled against them in vain. At eighteen he yielded to the impulse. Quum mulier 184 PSYCHOPATHIA SEXUALIS. qttcedam in os ei minxit, maxivia voluptate affectus est. He then had coitus with the vile woman. Since then, he felt the necessity to repeat the disgusting act every four weeks. After indulging in this perverse action he was ashamed of himself and disgust overcame him. Ejaculations ac- companied the act but seldom, but it produced erections and orgasm and whenever ejaculation missed, he gratified himself with coitus. During the intervals between these excessive impulses he was quite free from perverse tlioughts and desires as well as from ideal masochism and fetichistic relations. Libido during these intervals is but slight and easily gratified in the normal fashion without the assistance of perverse fiction. He often travelled miles from his country seat to the city to satisfy his cravings when these spells came over him. Again and again the patient — refined as he was and disgusted with his own perversity — sought to resist the morbid impulse, but in vain ; restlessness, anxiety, trem- bling and somnolence made life unbearable, until he found final release from the psychical tension in the gratifi- cation of his morbid cravings at any price. He attained this easily, but was at once overcome with self-reproach and contempt for himself bordering even on tadium vitcs. These mental struggles have enervated the patient and he complains of debility of memory, absent-mindedness, mental impotence, and cerebral pressure. His last hope is that medical science may succeed in freeing him from this monstrous affliction and in re-estabhshing his moral self. Other cases of Gantarano's (loc cit.) belong here {niictio even defacatio puellcB ad linguam viri ante actum) consump- tion of confects smelling like faeces, in order to become potent ; and also the following case, likewise communi- cated to me by a physician : — MASOCHISM. 185 " A Eussian prince, who was very decrepit, was ac- customed to have his mistress tm-n her back to him and defecate on his breast ; this being the only way in which he could excite the remnant of libido." Another supported a mistress in unusually brilhant style, with the condition that she ate marchpane exclu- sively. Ut libidinosus fiat et ejaculare. possit excrementa femincs ore excijjit. A Brazilian physician tells me of several cases of defcecatio fcmincB in os viri that have come to his knowledge. Such cases occur everywhere, and are not at all infrequent. All kinds of secretions — saliva, nasal mucus, and even aural cerumen — are used in this way and swallowed with pleasure .; and oscula ad nates and even ad anum are indulged in. Dr. Moll {op. cit., p. 135) reports the same thing of a man affected with contrary sexuality. The perverse desire to practise cunnilingus, which is very wide-spread, probably has its root frequently in masochistic impulses. In the " Centralblatt fiir die Krankheiten der Harn- und Sexualorgane," vi., 7, p. 355, I have given such a case of masochism combined with . shoe- and foot-fetichism and koprolagnia (desire for sudorem pedem and axillarum fcmmcB for the fcetor ctmni et awi_ going as far even as to cunnilingus et anilingtcs !) caused by indifference to coitus. Evidently the case quoted by Cantarano (" La Psichia- tria," v., p. 207) belongs here also, in which coitus is preceded by morsus et succio of the woman's toes which have not been washed for some time. Also a case quoted by me in the eighth edition of this book, cf. ibid., case 68. Stefanoiosky (" Archives de I'Anthropologie criminelle," 1892, vol. vii.) knows of a Russian merchant qui valde delectatus fuit bibcndo ea qua puella lupanarii jusso sua in vas spuerunt. Neri, " Archiv. delle psicopatie sessuali," p. 108: Workman, aged twenty-seven, heavily tainted, tic in the 186 PSTCHOPATHIA SEXUALIS. face, troubled with phobia (especially agoraphobia) and alcoholism. Sumvia ei fit voluptas, si meretrices in os ejus faces et urinas deponunt. Vinum supra corpus scortorum effusum defi,uens ore ad meretricis cunnum adposito excipit. Valde delectatur, si sang^dncm menstrualem ex vagina effluentem sugere potest. He is fetichist of ladies' gloves and shppers, osculatur calceos sororis, cujzis pedes sudore madent. Libido ejus turn demum maxime satiatur, si a puellis insultatur, immo vero verberatur, ut sanguis exeat. Dum verberatur, genibiis nixus veniam et clementiam puellce expetit, dcinde masturbare incipit. Pelanda (" Archivio di Psichiatria," x., fascicolo 3, 4) relates the following case : — Case 69. W., aged forty-five, predisposed, was given to masturbation at the age of eight. A dccimo sexto anno libidincs suas bibendo recentcm feminarum urinam satiavit. Tanta erat voluptas urinam bibentis ut nee aliquid olfaceret nee saperet, hac faciens. After drinking he always experi- enced disgust and ill-feeling, and made firm resolutions to do it no more in the future. Once he had the same pleasure in drinking the urine of a nine-year-old boy, with whom he once practised /cZZa^w. The patient suffers with epileptic insanity. Still other older cases belong here, which Tardieu (" ]j^tude medico-legale sur les attentats aux mcBurs," p. 206) observed in senile individuals. He describes as " Renifleurs " persons " qui in secretos locos nimirum theatro- rum piorticos convenientes q^co compilures feminoi ad micturiendum festinant, per nares urinali odore cxcitati, illico se inviccm jjolluunt'\ The " Stercoraires " that Taxll (" La prosti- tution contemporaine ") mentions are, in relation to this subject, unique, Eulenburg relates farther monstrous facts belonging to this section. Gf. Ziilzers "Klin. Handbuch der Harn- und Scxualorgane,"' iv., p. 47. MASOCHISM. 187 (d) Masochism in Women. In woman voluntary subjection to the opposite sex is a physiological phenomenon. Owing to her passive role in procreation and long-existent social conditions, ideas of subjection are, in woman, normally connected with the idea of sexual relations. They form, so to speak, the harmonics which determine the tone-quality of feminine feeling. Any one conversant with the history of civilisation knows in what a state of absolute subjection woman was always kept until a relatively high degree of civihsation was reached ; ^ and an attentive observer of life may still easily recognise how the custom of unnumbered genera- tions, in connection with the passive role with which woman has been endowed by Nature, has given her an instinctive inclination to voluntary subordination to man ; he will notice that exaggeration of customary gallantry is very distasteful to women, and that a deviation from it in the direction of masterful behaviour, though loudly reprehended, is often accepted with secret satisfaction.^ Under the veneer of polite society the instinct of feminine servitude is everywhere discernible. Thus it is easy to regard masochism in general as a pathological growth of specific feminine mental ele- ments, — as an abnormal intensification of certain features of the psycho-sexual character of woman, — and to seek its primary origin in that sex {v. infra, p. 199). It may, how- ever, be held to be established that, in woman, an inclina- ' The laws of the early middle ages gave the husband the riglit tc kill the wife ; those of the later middle ages, the right to heat her. The latter right was used freely, even by those of high standing (c/. Sdmltze, "Das hofische Leben zur Zeit dcs Minnesangs," Bd. i., p. 1G3 ct seq.). Yet, by the side of this, the paradoxical chivalry of the middle ages stand; unexplained (v. infra, p. 198). ^ C/. Lady Milford's words in Sc/wW^r's " Kabale und Licl)o": "We women can only choose between ruling and serving; but tlie highest pleasure power affords is but a miserable substitute, if the greater joy ol being tlic slaves of a man we love is denied us I " (Act II., Scene I.). 188 PSTCHOrATTIIA SFXUALIS. tion to subordination to man (which may be regarded as an acquired, purposeful arrangement, a phenomenon of adaptation to social requirements) is to a certain extent a normal manifestation. The reason that, under such circumstances, the " poetry" of the symbolic act of subjection is not reached, lies partly in the fact that man has not the vanity of that weakling who would improve the opportunity by the dis- play of his power (as the ladies of the middle ages did towards the love-serving knights), but prefers to reahse solid advantages. The barbarian has his wife plough for him, and the civilised lover speculates about her dowry ; she willingly endures both. Cases of pathological increase of this instinct of sub- jection, in the sense of feminine masochism, are probably frequent enough, but custom represses their manifesta- tion. Many young women like nothing better than to kneel before their husbands or lovers. Among all Slavs of the lower classes it is said that the wives feel hurt if they are not beaten by their husbands. A Hungarian official informs me that the peasant women of the Somo- gyer Comitate do not think they are loved by their husbands until they have received the first box on the ear as a sign of love. It would probably be difficult for the physician to find cases of feminine masochism.^ Intrinsic and extraneous restraints — modesty and custom — naturally constitute in woman insurmountable obstacles to the expression of perverse sexual instinct. Thus it happens that, up to the present time, but two cases of masochism in woman have been scientifically established. Case 70. Miss X., twenty-one years of age ; her mother ^ Seydel, " Vierteljahresschr. f. ger. Med.," 1893, vol. ii., quotes as an instance of masochism the patient of Dieffenbach, who repeatedly and pur- posely dislocated her arm in order to experience lustful sensations when it was being reduced, anesthetics not being known then. MASOCHISM. 189 was a morphia maniac and died some years ago from nerv- ous disorders. Her uncle (mother's side) is also a mor- phia-eater. A brother of the girl is neurasthenic, another is a masochist (wishes to be beaten with a cane by proud, noble ladies). Miss X. has never had a severe illness, but at times suffers from headaches. She considers herself to be physically sound, but periodically insane, viz., when she is haunted by the fancies which she thus describes : — Since her earhest youth she fancied herself being whipped. She simply revels in these ideas, and has the most intense desire to be severely punished with a rattan cane. This desire, she claims, originated from the fact that at the age of five a friend of her father's took her for fun across his knees, pretending to whip her. Since then she has longed for the opportunity of being caned, but to her great regret her wish has never been realised. At these periods she imagines herself as absolutely helpless and fettered. The mere mention of the words "rattan cane" and " to whip " cause her intense excitement. Only for the last two years she associates these ideas with the male sex. Previously she only thought of a severe school- mistress or simply a hand. Now she wishes to be the slave of a man whom she loves ; she would kiss his feet if he would only whip her. She does not understand that these manifestations are of a sexual nature. A few quotations from her letters are characteristic as bearing upon the masochistic character of this case : — "In former years I seriously contemplated going into a lunatic asylum whenever these ideas worried me. I fell upon this idea whilst reading how the director of an insane asylum pulled a lady by the hair from her bed and beat her with a cane and a riding-whip. I longed to be treated in a similar manner at such an institute, and have therefore unconsciously associated my ideas with the male 190 PSYCHOPATHIA SEXUALIS. sex. I liked, however, best to think of brutal, uneducated female warders beating me mercilessly. " Lying (in fancy) before him, he puts one foot on my neck whilst I kiss the other. I revel in the idea of being whipped by him ; but this changes often, and I fancy quite different scenes in which he beats me. At times I take the blows as so many tokens of love — he is at first extremely kind and tender, and then, in the excess of his love, he beats me. I fancy that to beat me for love's sake gives him the highest pleasure. Often I have dreamed that I was his slave — but, mind you, not his female slave ! For instance, I have imagined that he was Kobinson and I the savage that served him. I often look at the pictures in which Kobinson puts his foot on the neck of the savage. I now find an explanation of these strange fancies : I look upon woman in general as low, far below man ; but I am otherwise extremely proud and quite indomitable, whence it arises that I think as a man (who is by nature proud and superior). This renders my humiliation before the man I love the more intense. I have also fancied myself to be his female slave ; but this does not suffice, for after all every woman can be the slave of her husband. Case 71 ■ Miss v. X., aged thirty-five ; of greatly pre- disposed family. For some years she has been in the initial stage of ixiraiioia joersccutoria. This sprang from cerebro- spinal neurasthenia, the origin of which is found to be sexual hyperexcitation. Since her twenty-fourth year she has been given to masturbation. As a result of dis- appointment in an engagement and intense sexual excite- ment, she began to practise masturbation and psychical onanism. Inclination toward persons of her oion sex never occurred. The patient says : "At the age of six or eight I conceived a desire to be whipped. Since I had never been whipped, and had never been present when others were thus punished, I cannot understand how I came to have this strange desire. I can only think that it is congenital. MASOCHISM. 191 With these ideas of being whipped I had a feehng of actual dehght, and pictured in my fancy how fine it would 1)0 to be whipped by one of my female friends. I never had any thought of being whipped by a man. I revelled in the idea, and never attempted any actual realisation of my fancies, which disappeared after my tenth year. Only when I read " Bousseau's Confessions," at the age of thirty-four, did I understand what my longing for whippings meant, and that my abnormal ideas were like those of Bousseau. On account of its original character and the reference to Bousseau, this case may with certainty be called a case of masochism. The fact that it is a female friend who is conceived in imagination »s whipping her, is explained by the circumstance that the masochistic desire was here present in the mind of a child before the psychical vita sexualis had developed and the instinct for the male had been awakened. Antipathic sexual instinct is here ex- pressly excluded. An Attempt to Explain Masochism. The facts of masochism are certainly among the most interesting in the domain of psychopathology. An attempt at explanation must first seek to distinguish in them the essential from the unessential. The distinguishing charac- teristic in masochism is certainly the unlimited subjection to the will of a person of the opposite sex (in sadism, on the contrary, the unlimited mastery of this person), with the awakening and accompaniment of lustful sexual feel- ings to the degree of orgasm. From the foregoing it is clear that the particular manner in which this relation of subjection or domination is expressed {v. supra), whether merely in symbolic acts, or whether tliere is also a desire to suffer pain at the hands of a person of the opposite sex, is a subordinate matter. 192 PSYCHOPATHIA Sl'IXUALIS. While sadism may be looked upon as a pathological intensification of the masculine sexual character in its psychical peculiarities, masochism rather represents a pathological degeneration of the distinctive psychical peculiarities of woman. But masculine masochism is un- doubtedly frequent ; and it is this that comes most fre- quently under observation and almost exclusively makes up the series of observed cases. The reason for this has been previously stated (p. 188). Two sources of masochism can be distinguished in the sphere of normal phenomena. The first is, that in the state of lustful excitement every impression made by the person giving rise to the sexual stimulus, independently of the nature of its action, is pleasing to the individual excited. It is entirely physiological that playful taps and light blows should be taken for caresses,^ Like the lover's pinch, which hurts and is desired. — Anthony and Cleopatra, v., 2. From here the step is not long to a state where the wish to experience a very intense impression at the hands of the consort leads to a desire for blows, etc., in cases 'of pathological intensification of lust ; for pain is ever a ready means for producing intense bodily impressions. Just as in sadism the sexual emotion leads to a state of exaltation in which the excessive motor excitement im- plicates neighbouring nervous tracts, so in masochism an ecstatic state arises, in which the rising flood of a single emotion ravenously devours and covers with lust every impression coming from the beloved person. The second and, indeed, the most important source of masochism is to be sought in a wide-spread phenomenon, wliicb, though it is extraordinary and abnormal, yet, by no means lies within the domain of sexual perversion. 1 Analogous facts are found in the animal kingdom. Puhnonata Cicv., for instance, possess a small calcareous staff which lies hidden in a special pouch of the body, but is at the time of nesting projected and used as a means of sexual excitement, producing, beyond doubt, pain. MASOCHISM. 193 I here refer to the very prevalent fact that in in- numerable instances, which occur in all varieties, one individual becomes dependent on another of the opposite sex, in a very extraordinary and remarkable manner, — even to the loss of all independent will-power ; a depend- ence which forces the party in subjection to acts and suffering which greatly prejudice personal interest, and often enough lead to offences against both morality and law. This dependence, however, differs from the manifest- ations of normal life only in the intensity of the sexual feelmg that here conies in play, and in the slight degree of will-power necessary for the maintenance of its equili- brium. The difference is one of intensity, not of quality, as in masochistic manifestations. This dependence of one person apon another of the opposite sex — abnormal but not perverse, a phenomenon possessing great interest when regarded from a forensic standpoint — I designate "sexual bondage'' ;^ for the rela- tions and circumstances attending it have in all respects the character of bondage. The will of the ruling indi- vidual dominates that of the person in subjection, just as a master's does his bondsman's.^ This " sexual bondage," as has been said, is certainly an abnormal phenomenon. It begins with the first devia- tion from the normal. The degree of dependence of one ' Cf. the author's article, " Uber geschlechtliche Horigkeit und ^lasochismus," in the " Psychiatrischen Jahrbiicher," Bd. x., p. 169 d t/eq., where this subject is treated in detail, and particularly from the forensic standpoint. -The expressions " slave " and "slavery," though often used meta- phorically under such circumstances, are avoided here because they are the favourite expressions of masochism, from which this " bondage " must be strictly differentiated. The expression " bondage " is not to be construed to mean J. S, MilVs " Bondage of Woman ". What 3Iill designates with this expression are laws and customs, social and historical facts. Here, however, we always speak of facts having peculiar individual motives that even conflict with prevalent customs and laws. Besides it has reference to cither sex. 13 194 PSYCHOPATHIA SEXUALIS. person upon another, or of two upon each other, resulting from individual pecuharity in the intensity of motives that in themselves are normal, constitutes the normal standard established by law and custom. Sexual bondage is not a perverse manifestation, however ; the instinctive activities at work here are the same as those that set in motion — even though it be with less violence— the psychical vita scxualis which moves entirely within normal limits. Fear of losing the companion and the desire to keep him always content, amiable, and inclined to sexual inter- course, are here the motives of the individual in subjection. An extraordinary degree of love— which, particularly in woman, does not always indicate an unusual degree of sensuality — and a weak character are the simple elements of this extraordinary process.^ The motive of the dominant individual is egotism which finds unlimited room for action. The manifestations of sexual bondage are various in form, and the cases are very numerous.^ At every step in life we find men that have fallen into sexual bondage. Among married men, hen-pecked husbands belong to this category, particularly elderly men who marry young wives and try to overcome the disparity of years and physical defects by unconditional submission to the wife's every whim ; and unmarried men of ripe maturity, who seek to 1 Perhaps the most important clement is, that by the habit of sub- mission a kind of mechanical obedience, without consciousness of its motives, which operates with automatic certainty, may be established, having no opposing motives to contend with, because it lies beyond the threshold of consciousness ; and it may be used by the dominant individual like an inanimate instrument. ' Sexual bondage, of course, plays a role in all literatures. Indeed, for the poet, the extraordinary manifestations of the sexual life that are not perverse form a rich and open field. The most celebrated description of masculine " bondage " is that by Abbd Privost, " Manon Lescault ". An excellent description of feminine " bondage " is that of " Leone Leoni," by George Sand. But first of all comes Xleist.'s " Kiithchen von Heilbronn," who himself called it the counterpart of (sadistic) " Penthesilea ". Halm's " Griseldis " and many other similar poems also belong here. MASOCHISM. 195 better their last chance of love by unlimited sacrifice, are also to be enumerated here. Here belong, also, men of any age, who, seized by hot passion for a woman, meet coldness and calculation, and have to capitulate on hard conditions ; men of loving natures who allow themselves to be persuaded to marriage by notorious prostitutes ; men who, to run after adventuresses, leave everything and jeopardise their future ; husbands and fathers who leave wife and child, to lay the income of a family at the feet of a harlot. But, numerous as the examples of masculine "bond- age" are, every observer of life who is at all unprejudiced must allow that they are far from equalling in number and importance the cases of feminine " bondage". This is easily explained. For a man, love is almost always only an episode, and he has many other and important interests ; for a woman, on the other hand, love is the principal thmg in life, and, until the birth of children, always her first mterest. After this it is still often her first thought, but always takes at least the second place. But, what is still more important, man ruled by this impulse easily satisfies it in embraces for which he finds unhmited opportunities. Woman in the upper classes of society, if she have a husband, is bound to him alone ; and even m the lower classes there are still great obstacles to polyandry. Therefore, a woman s husband means for her the whole sex, and his importance to her becomes very great. It must also be considered that the normal relation established by law and custom between husband and wife is far from being one of equality. In itself it expresses a sufficient predominance of woman's dependence. The concessions she makes to her lover, to retain the love which it would be almost impossible for her to replace, only plunge her deeper in bondage ; and this increases the insatiable demands of husbands resolved to use tlieir advantage and traffic in woman's readiness to sacrifice herself. 196 PSYCHOPATIIIA SEXUALIS. Here may be placed the fortune-hunter, who for money allows himself to be enveloped in the easily created illu- sions of a maiden ; the seducer, and the man who com- promises wives, calculating on blackmail ; the gilded army officer and the musician with the lion's mane, who know so well how to stammer " T^hee or death ! " as a means to pay debts and provide a hfe of ease. Here, too, belong the kitchen-soldier, whose love the cook returns with love plus means to satisfy a different appetite; the drinker, who consumes the savings of the mistress he marries ; and the man who with blows compels the prostitute on whom he Hves to earn a certain sum for him daily. These are only a few of the innumerable forms of bondage into which woman is forced by her greater need of love and the diffi- culties of her position. It was necessary to give the subject of " sexual bond- age " here brief consideration, for in it may be clearly discerned the soil from which the main root of masochism springs. The relationship of these two phenomena of psychical sexual life is immediately apparent. Bondage and masochism both consist of the unconditional subjec- tion of the individual affected with this abnormality to a person of the opposite sex, and of domination of the former by the latter.^ The two phenomena, however, must be strictly differentiated ; they are not different in degree, but in quality. Sexual bondage is not a perversion and not patho- logical ; the elements from which it arises — love and weakness of will — are not perverse; it is only tbeir snnul- taneous activity that produces the abnormal result which is so opposed to self-interest, and often to custom and law. The motive, in obedience to which the subordinated 1 Cases may occur in which the sexual bondage is expressed in the same acts that are common in masochism. When rough men whip their wives, and the latter suffer for love, without, however, having a desire for blows, we have a pseudo form of bondage that may simulate masochism. MASOCHISM. 197 individual acts and endures tyranny, is the normal instinct toward woman (or man), the satisfaction of which is the price of bondage. The acts of the person in subjection, by means of which the bondage is expressed, are per- formed at the command of the ruHng individual, to satisfy selfishness, etc. For 'the subordinated individual they have no independent purpose ; they are only the means to an end — to obtain or retain possession of the ruhng individual. Finally, bondage is a result of love for a particular person ; it first appears when this love is awakened. In masochism, which is decidedly abnormal and a perversion, this is all very different. The motive under- lying the acts and suffering of the person in subjection is here the charm afforded by the tyranny in itself. There may, at the same time, be a desire for coitus with the dominant person, but the impulse is directed to the acts which serve to express the tyranny, as the immediate objects of gratification. These acts in which masochism is expressed are, for the individual in subjection, not means to an end, as in bondage, but the end in them- selves. Finally, in masochism the longing for subjection occurs a priori before the occurrence of an inclination to any particular object of love. The connection between bondage and masochism may be- assumed by reason of the correspondence of the two phenomena in the objective condition of dependence, notwithstanding the difference in their motives ; and the transformation of the abnormality into the perversion probably takes place in the following manner : Any one living for a long time in sexual bondage becomes disposed to acquire a slight degree of masochism. Love that willingly bears the tyranny of the loved one then becomes an immediate love of tyranny. When the idea of being tyrannised is for a long time closely associated with the lustful thought of the beloved person, the lustful emotion is finally trans- ferred to the tyranny itself, and the transformation to preversion 198 PSYCHOPATHIA SEXUALIS. is completed. This is the manner in which masochism may be acquired by cultivation.^ Thus a mild degree of masochism may arise from "bondage" — become acquired; but genuine, complete, deep-rooted masochism, with its feverish longing for sub- jection from the time of earliest youth, is congenital. The explanation of the origin of the perversion — infrequent though it be — of fully developed masochism is most probably to be found in the assumption that it arises 1 It is highly interesting, and dependent upon the nature of bondage and masochism, wliiph essentially correspond in external effects, that to illustrate the former certain playful, metaphorical expressions are in gen- eral use ; such as " slavery," " to bear chains," " bound," " to hold the whip over," " to harness to the triumphal car," " to lie at the feet," " hen- pecked," etc., — all things which, liteially carried out, form the objects of the masochist's desire. Such similes are frequently used in daily life and have become trite. They are derived from the language of poetry. Poetry has always recognised, within the general idea of the passion of love, the element of dependence in the lover, who practises self-sacrifice spontaneously or of necessity. The facts of " bondage " have also always presented themselves to the poetical imagination. When the poet chooses such expressions as those mentioned, to picture the dependence of the lover in striking similes, he proceeds exactly on the same lines as does the maxochist, viz., to intensify the idea of his dependence (his ultimate aim), he creates such situations in reality. In ancient poetry, the expression " domina " is used to signify the loved one, with a preference for the simile of " casting in chains " (e.g., Horace, Od. iv., 11). From antiquity through all the centuries to our own times [cf. Grillparzer, " Ottokar," act V. : " To rule is sweet, almost as sweet as to obey ") the poetry of love is filled with similar phrases and similes. The history of the word " mistress " is also interesting. But poetry reacts on life. It is probable that the courtly chivalry of the middle ages arose in this way. In its reverence for women as " mistresses " in society and in individual love- relations ; its transference of the relations of feudalism and vassalage to the relation between the knight and his lady ; its submission to all feminine whims ; its love-tests and vows ; its duty of obedience to every command of the lady — in all this, chivalry appears as a systematic, poeti- cal development of the " bondage " of love. Certain extreme manifesta- tions, like the deeds and sufferings of Ulrich von Lichtendein or Pierre Vidnl in the service of their ladies ; or the practice of the fraternity of the " Galois " in France, whose members sought martyrdom in love and subjected themselves to all kinds of suffering — these clearly have a maso- chistic character, and demonstrate the natural transformation of one phenomenon into the other. MASOCHISM. 199 from the more frequent abnormality of "sexual bondage," through which, now and then, this abnormality is heredi- tarily transferred to a psychopathic individual in such a manner that it becofnes transformed into a perversion. It has been previously shown how a shght displacement of the psy- chical elements under consideration may effect this transi- tion. Whatever effects associating habits may have on possible cases of acquired masochism, the same ejffects are produced by the varying tricks of heredity upon original masochism. No new element is thereby added to " bond- age," but on the contrary the very element is deleted which cements love and dependence, and thereby dis- tinguishes " bondage " from masochism and abnormality from perversion. It is quite natural that only the in- stinctive element is transmitted. This transition from abnormality into perversion, through hereditary transference, takes place very easily where the psychopathic constitution of the descendant presented the other factor of masochism, — i.e., what has been previously called its main root, — the tendency of sexually hypersesthetic natures to assimilate all impres- sions coming from the beloved person with the sexual impression. From these two elements, — from " sexual bondage " on the one hand and from the above-mentioned disposi- tion to sexual ecstasy, which apperceives even maltreat- ment with lustful emotion, on the other, — the roots of which may be traced back to the field of physiological facts, masochism arises from the basis of psychopathic predisposition, in so far as its sexual hypersesthesia inten- sifies first all the physiological accessories of the vita sexualis and, finally, only its abnormal accompaniments, to the pathological degree of perversion.^ 1 If it be conRidcred thab, as shown above, " sexual bondage" is a phe- nomenon observed much more frequently and in a more pronounced degree in the female sex than in the male, the thought arises that masochism (if not always, at least as a rule) is an inheritance of the 200 PSYCHO PATH I A SliXUALIS. At any rate, masochism, as a congenital sexual per- version, constitutes a functional sign of degeneration in (almost exclusively) hereditary taint ; and this clinical deduction is confirmed in m}^ cases of masochism and sadism. It is easy to demonstrate that the peculiar, psychically anomalous direction of the vita sexicalis re- presented in masochism is an original abnormality, and not, so to speak, cultivated in a predisposed individual by passive flagellation, through association of ideas, as Bousseau and Binet contend. This is shown by the numerous cases of masochism — in fact, the majority — in which flagellation never appears, in which the perverse impulse is directed exclusively to purely symbolic acts expressing subjection without any actual infliction of pain. This is demonstrated by the whole series of obser- vations, from case 49, given here. The same result — namely, that passive flagellation is not the nucleus around which all the rest is gathered — is reached when closer study is given to the cases in which passive flagellation plays a role, as in cases 41 and 47. Case 48 is particularly instructive in relation to this ; for in this instance there can be no thought of a sexually stimulating effect by punishment received in youth. More- over, in this case, connection with an early experience is " bondage " of feminine ancestry. Thus it conies into a relation — though distant — with antipathic sexual instinct, as a transference to the male of a perversion really belonging to the female. This conception of maso- chism as a rudimentary inverted sexual instinct, as a partial effemination, here affecting only the secondary sexual character of the vita sexiialis (a theory still more unconditionally expressed in the sixth edition of this work) finds its support in the statements of the subjects of case 42 and case 48 (vide supra), who present other features of effemination, and give as their ideal a relatively old woman who seeks and wins them. It must, however, be emphasised that " bondage " also plays no unim- portant rdle in the masculine vita sexiialis, and that masochism in man may also be explained without any such transference of feminine elements. It must also be remembered here that masochism, as well as its counter- part, sadism, occurs in irregular combination with antipathic sexual instinct. MASOCHISM. 201 not possible ; for the situation constituting the object of principal sexual interest is absolutely incapable of being carried out by a child. Finally, the origin of masochism from purely psychical elements, on confronting it with sadism {v. infra), is con- vincingly demonstrated. That passive flagellation occurs so frequently in masochism is explained simply by the fact that it is the most extreme means of expressing the relation of subjection. I repeat that the decisive points in the differentiation of simple passive flagellation from flagellation dependent upon masochistic desire are, that in the former the act is a means to render coitus, or at least ejaculation, possible ; and that in the latter it is a means of gratification of masochistic desires. As we have already seen, masochists subject themselves to all other kinds of maltreatment and suffering in which there can be no question of reflex excitation of lust. Since such cases are numerous, we must in these acts (as well as in flagellation in masochists, having like significance) seek to ascertain the relation in which pain and lust stand to each other. From the statement of a masochist it is as follows : — . The relation is not of such a nature that what causes physical pain is here simply perceived as physical pleasure ; for the person in a state of masochistic ecstasy feels no pain, either because, by reason of his emotional state (like that of the soldier in battle), the physical effect on his cutaneous nerves is not apperceived, or because (as with religious martyrs and enthusiasts), in the preoccupation of consciousness with lustful emotion, the idea of mal- treatment remains merely a symbol, without its quality of pain. To a certain extent there is overcompensation of physical pain in psychical pleasure, and only the excess remains in consciousness as psychical lust. This also undergoes an increase, since, either through reflex spinal 202 PSYCHOPATHIA SEXUALIS. influence or through a pecuhar colouring in the sensorium of sensory impressions, a kind of hallucination of bodily pleasure takes place, with a vague localisation of the objectively projected sensation. In the self-torture of rehgious enthusiasts (fakirs, howl- ing dervishes, religious flagellants) there is an analogous state, only with a difference in the quality of pleasurable feeling. Here the conception of martyrdom is also apper- ceived without its pain ; for consciousness is filled with the pleasurably coloured idea of serving God, atoning for sins, deserving heaven, etc., through martyrdom. Masochism and Sadism. The perfect counterpart of masochism is sadism. While in the former there is a desire to sufi'er and be subjected to violence, in the latter the wish is to inflict pain and use violence. The parallelism is perfect. All the acts and situations used by the sadist in the active role become the object of the desire of the masochist in the passive role. In both perversions these acts advance from purely symbolic acts to severe maltreatment. Even murder, in which sadism reaches its acme, finds, as is shown by case 50, — of course, only in fancy, — its passive counterpart. Under favouring conditions, both perversions may occur with a normal vita sexualis ; in both, the acts in which they express themselves are preparatory to coitus or substi- tutes for it.^ But the analogy does not exist simply in external 1 Of course, both have to contend with opposing ethical and aesthetic motives in foro interna. After these have been overcome, active sadism immediately comes in conflict with the law. This is not the case with masochism, which accounts for the greater frequency of masochistic acts. But the instinct of self-preservation and fear of pain prevent the realisa- tion of the latter. The practical significance of masochism lies only in its relations to psychical impotence ; while that of sadism lies beyond this, and is principally forensic. MASOCHISM AND SADISM. 203 manifestations ; it also extends to the intrinsic character of both perversions. Both are to be regarded as original psychopathies in mentally abnormal individuals, v^^ho, in particular, are affected with psychical hyperesthesia sexu- alis, and, as a rule, also with other abnormalities ; and for each of these perversions two constituent elements may be demonstrated, which have their roots in psychical facts lying within physiological limits. In masochism, as shown above, these elements lie in the fact (1) that in the state of sexual emotion every impression produced by the con- sort, independently of the manner of its production, is, per se, attended with lustful pleasure, which, when accom- panied by hyperesthesia sexualis, may go so far as to overcompensate all painful sensation ; and in the fact (2) thflt " sexual bondage," dependent on mental factors — in themselves not perverse — may, under pathological condi- tions, become a perverse, pleasurable desire for subjection to the opposite sex, which — even if its inheritance from the female side need not be presupposed — represents a pathological degeneration of the character (really belong- ing to woman) of the instinct of subordination, physiolo- gical in woman. In harmony with this, there are, likewise, two consti- tuent elements explanatory of sadism, the origin of which may also be traced back within physiological limits. These are : the fact (1) that in sexual emotion, to a certain ex- tent as an accompanying psychical excitation, an impulse may arise to influence the object of desire in every possible way and with the greatest possible intensity, which, in individuals sexually hyperaesthetic, may de- generate into a craving to inflict pain ; and the fact (2) that, under pathological conditions, man's active role of winning woman may become an unlimited desire for subjugation. Thus masochism and sadism represent perfect counter- parts. It is also in harmony with this that the individuals affected with these perversions regard the opposite perver- 204 PSTCHOPATHIA SEXUALIS. sion in the other sex as their ideal, as shown by cases 41 and 47, and also by " Bousseaus Confessions ". But the contrast of masochism and sadism may also be used to invalidate the assumption that the former has its origin in the reflex effect of passive flagellation, and that all the rest is the product of association of related ideas, as Binet, in explanation of Eousseaiis case, thinks, and as Rousseau himself believed {vide siipra, p. 154). In the active maltreatment forming the object of the sadist's sexual desire there is, in fact, no irritation of his own sensory nerves by the act of maltreatment, so that there can be no doubt of the purely psychical character of the origin of this perversion. Sadism and masochism, however, are so re- lated to each other, and so correspond in aJl points with each other, that the one allows, by analogy, a conclusion for the other ; and this is alone sufficient to establish the purely psychical character of masochism. According to the above-detailed contrast of all the ele- ments and phenomena of masochism and sadism, and as a rdsume of all observed cases, lust in the infliction of pain and lust in inflicted pain appear but as two different sides of the same psychical process, of which the primary and essential thing is the consciousness of active or passive subjection, in which the combination of cruelty and lustful pleasure has only a secondary psychological significance. Acts of cruelty serve to express this subjection ; first, be- cause they are the most extreme means for the expression of this relation ; and, again, because they represent the most intense effect that one person, either with or without coitus, can exert on another. Sadism and masochism are the results of associations, just the same as all compHcated manifestations of psychi- cal life are associations. For psychic life consists, after the production of the simplest elements of consciousness, simply of associations and disassociations of these ele- ments. The chief point gained by this analysis is that sadism MASOCHISM AND SADISM. 205 and masochism are not merely the results of accidental associations, occasioned by chance or an opportune coinci- dence, but results of associations springing from causes existing under normal circumstances, easily produced under certain conditions — e.g., sexual hypersesthesia. An abnormally intensified sexual instinct spreads in every direction. It reaches into adjacent spheres, and amalga- mates with their contents, thus producing the pathological associations which are the real essence of both these per- versions.^ Of course, this need not always be so, for there are cases of hypersesthesia without perversion. But these cases of pure hyjmrcBsthesia sexualis — at least, those of striking intensity — seem to be of rarer occurrence than those of perversion. ^ Schrcnck-Notzing, who in his explanation of all perversions lays par- ticular stress upon the " occasional momentum," gives preference to the theory of acquired perversiolis over the congenital, and allows the mani- festations of sadism and masocliism (according to his terminology " active and passive algolagnia ") only a subordinate position. Although he ad- mits that many cases can only be explained on the assumption of con- genital predisposition, yet he contends that circumstances or a timely coincidence controlled their acquirement (op. cit. p. 170). His arguments are based upon observations. Quoting two cases of psychopathia sexualis (29 and 37 of the seventh edition) he contends that the accidental sight of a girl bleeding or a boy being whipped coinciding with a strong sexual emotion might be sufficient cause for continued patholo- gical associations. Against this it may, however, be decisively held that in every hyper- sesthetic individual early and strong sexual emotions have often coincided with numerous heterogeneous things, whilst the patJiological associaticnis are always coupled ivilh but few definite (sadistic and masochistic) things. Numerous pupils indulge in sexual emotions or gratifications during lessons in grammar and mathematics in the class-room, as well as elsewhere, without thereby contracting perverse associations. From this clearly follows that the sight of a whipping or similar scenes may provoke pathological associations already present but latent, but that it cannot produce them. Moreover, the aroused sexual instinct is not associated with the numerous indifferent things that are ever pre- sent* but only with such as normally excite disgust. The same argument refers to the opinion of Binet. who also seeks to explain these manifestations by accidental associations {vide infra, p. 211). 206 PSYCHOPATHIA SEXUALIS. The cases in which sadism and masochism occur simultaneously in one individual are interesting, but they present some difficulties of explanation. Such cases are, for instance, No. 49 of the seventh edition, also Nos. 47 and 54 of the present, but especially No. 29 of the ninth edition. From the latter it is evident that it is especially the idea of subjection that, both actively and passively, forms the nucleus of the perverse desires. Traces of the same thing are also to be observed, with more or less clearness, in many other cases. At any rate, one of the two perversions is always markedly predominant. Owing to this marked predominance of one perversion and the later appearance of the other in such cases, it may well be assumed that the predominating perversion is original, and that the other has been acquired in the course of time. The ideas of subjection and maltreat- ment, coloured with lustful pleasure, either in an active or passive sense, have become deeply imbedded in such an individual. Occasionally the imagination is tempted to try the same ideas in an inverted role. There may even be realisation of this inversion. Such attempts in imagination and in acts, are, however, usually soon aban- doned as inadequate for the original inclination. Masochism and sadism also occur in combination with contrary sexual instinct, and, in fact, in association with all forms and degrees of this perversion. The individual of contrary sexuality may be a sadist as well as ma.socbist (c/. cases 46 and 49 of the seventh edition and numer- ous cases m the subsequent series of cases of sexual inversion). Wherever a sexual perversion has developed on the basis of a neuropathic individuality, sexual hyperaesthesia, which may always be assumed to be present, may induce the phenomena of masochism and sadism — now of the one, now of both combined, one arising from the other. Thus masochism and sadism appear as the fundamental forms of psycho-sexual perversion, which may make their FETICHISM. 207 appearance at any point in the domain of sexual aber- ration.' Fetichism. — 3. The Association of Lust with the Idea of Certain Portions of the Female Person, or with Certain Articles of Female Attire. — Fetichism. In the considerations concerning the psychology of the normal sexual life in the introduction to this work (vide pp. 19, 20), it was shown that, within physiological limits, the pronounced preference for a certain portion of the body of persons of the opposite sex, particularly for a certain form of this part, may attain great psycho-sexual import- 1 Every attempt to explain the facts of either sadism or masochism owing to the close connection of the two phenomena demonstrated here, must also be suited to explain the other perversion. An attempt to offer an explanation of sadism, by J. G. Kiernan (Chicago) {vide " Psychological Aspects of the Sexual Appetite," Alienist and Neurologist, St. Louis, April, 1891) meets this requirement, and for this reason may be briefly mentioned here. Kiernan, who has several authorities in Anglo-American literature for his theory, starts from the assumption of several naturalists (Dallinger, Drysdale, Rolph, Cienkoivsky) which conceives the so-called conjugation, a sexual act in certain low forms of animal life, to be canni- balism, a devouring of the partner in the act. He brings into immediate connection with this the well-known facts that at the time of sexual union crabs tear limbs from their bodies and spiders bite off the heads of the males, and other sadistic acts performed by rutting animals with their consorts. From this he passes to lust-murder and other lustful acts of cruelty in man, and assumes that hunger and the sexual appetite arc, in their origin, identical ; that the sexual cannibalism of lower forms of animal life has an influence in higher forms and in man, and that sadism is an atavistic rebound. This explanation of sadism would, of course, also explain masochism ; for if the origin of sexual intercourse is to be sought in cannibalistic processes, then both the survival of one sex and the destruction of the other would fulfil the purpose of nature, and thus the instinctive desire to be the victim would be explained. But it must be stated in objection that the basis of this reasoning is insufficient. The extremely complicated process of conjugation in lower organisms, into which science has really penetrated only during the last few years, is by no means to be regarded as simply a devouring of one individual by another (c/. Weismann, " Die Bedeutung der Sexuellen Fortpflanzung fiir die Seloctionstheorio," p. 51, Jena, 188G). 208 PSYCHOPATHIA SEXUALTS. ance. Indeed, the especial power of attraction possessed by certain forms and peculiarities for many men — in fact, the majority — may be regarded as the real principle of individualisation in love. This preference for certain particular physical char- acteristics in persons of the opposite sex — by the side of which, likewise, a marked preference for certain psychical characteristics may be demonstrated — following Binet (" Du Fetischisme dans I'amour," " Bevue Philosophique," 1887) and Lombroso (Introduction to the Italian edition of the second edition of this work), I have called " fetichism " ; because this enthusiasm for certain portions of the body (or even articles of attire) and the worship of them, in obedience to sexual impulses, frequently call to mind the reverence for relics, holy objects, etc., in religious cults. This physiological fetichism has already been described in detail on page 19, et seq. By the side of this physiological fetichism, however, there is, in the psycho-sexual sphere, an undoubted jjcUho- loijical, erotic fetichism, of which there is already a numerous series of cases presenting phenomena having great clinical and psychiatric interest, and, under certain circumstances also, forensic importance. This pathological fetichism does not confine itself to certain parts of the body alone, but it is even extended to inanimate objects, which, however, are almost always articles of female wearing-apparel, and thus stand in close relation with the female person. This pathological fetichism is connected, through gra- dual transitions, with physiological fetichism, so that (at least in body-fetichism) it is almost impossible to sharply define the beginning of the perversion. Moreover, the whole field of body-fetichism does not really extend beyond the limits of things which normally stimulate the sexual instinct. Here the abnormality consists only in the fact that the whole sexual interest is concentrated on the impres- sion made by a part of the person of the opposite sex, so that all other impressions fade and become more or less indif- FETICHISM. 209 ferent. Therefore, the body-fetichist is not to be regarded as a monstrum j)er excessum, Hke the sadist or masochist, but rather as a monstnim per defectum. What stimulates him is not abnormal, but rather what does not affect him, — the limitation of sexual interest that has taken place in him. Of course, this limited sexual interest, within its narrower limits, is usually expressed with a correspondingly greater and abnormal intensity. It would seem reasonable to assume, as the distinguish- ing mark of pathological fetichism, the necessity for the presence of the fetish as a conditio sine qua non for the possibility of performance of coitus. But when the facts are more carefully studied, it is seen that this limitation is really only indefinite. There are numerous cases in which, even in the absence of the fetich, coitus is possible, but incomplete and forced (often with the help of fancies relating to the fetich), and particularly unsatisfying and exhausting; and, too, closer study of the distinctive sub- jective psychical conditions in these cases shows that there are transitional states, passing, on the one hand, to mere physiological preferences, and, on the other, to psychical impotence, in the absence of the fetich. It is therefore better, perhaps, to seek the pathological criterion of body-fetichism in purely subjective psychical states. The concentration of the sexual interest on a cer- tain portion of the body that has no direct relation to sex (as have the mammae and external genitals) — a peculiarity to be emphasised — often leads body-fetichists to such a condition that they do not regard coitus as the real means of sexual gratification, but rather some form of manipula- tion of that portion of the body that is effectual as a fetich. This perverse instinct of body-fetichists may be taken as the pathological criterion, no matter whether actual coitus is still possible or not. Fetichism of inanimate objects or articles of dress, however, in all cases, may well be regarded as a pathological phe- nomenon, since its object falls without the circle of normal 14 210 PSYCHOPATHIA SEXUALTS. sexual stimuli. But even here, in the. phenomena, there is a certain outward correspondence with processes of the normal psychical vita sexualis ; the inner connection and meaning of pathological fetichism, however, are entirely different. In the ecstatic love of a man mentally normal, a handkerchief or shoe, a glove or letter, the flower " she gave," or a lock of hair, etc., may become the object of worship, but only because they represent a mnemonic symbol of the beloved person — absent or dead — whose whole personality is reproduced by them. The pathologi- cal fetichist has no such relations. The fetich constitutes the entire content of his idea. When he becomes aware of its presence, sexual excitement occurs, and the fetich makes itself felt.^ According to all observations thus far made, patho- logical fetichism seems to arise only on the basis of a psychopathic constitution that is for the most part hereditary, or on the basis of existent mental disease. Thus it happens that it not infrequently appears com- bined with the other (original) sexual perversions that arise on the same basis. Not infrequently fetichism occurs in the most various forms in combination with contrary sexuality, sadism, and masochism. Indeed, certain forms of body-fetichism (hand- and foot-fetichism) probably have a more or less distinct connection with the latter two perversions (v. iyifra). But if fetichism also rests upon a congenital general psychopathic disposition, yet this perversion is not, like those previously considered, essentially of an original nature ; it is not congenitally perfect, as we may well assume sadism and masochism to be. While in the sexual perversions described in the pre- ceding chapters we have met only cases of congenital type, 1 In Zola's " Therese Raquiu, wliere the lover repeatedly kisses his mistress-'s boot, the case is quite different from that of shoo- and boot- fetichists, who, at the sight of every boot worn by a lady, or even alone, are thrown into sexual excitement, even to the extent of ejaculation. FETTCHTSM, 211 here we meet only acquired cases. Aside from the fact that often in fetichism the causative circumstance of its acquirement is traced, yet the physiological conditions are wanting, which in sadism and masochism, by means of sexual hyperaesthesia, are intensified to perversions, and justify the assumption of congenital origin. In fetichism, every case requires an event which affords the ground for the perversion. As has been said, it is, of course, physiological in sexual life to be partial to one or another of woman's charms, and to be enthusiastic about it ; but concentration of the entire sexual interest on such partial impression is here the essential thing ; and for this concentration there must be a particular reason in every individual affected. There- fore, we may accept BineVs conclusion that in the life of every fetichist there may he assumed to have been some evetit which determined the association of kistful feeling with the single impression. This event must be sought for in the time of early youth, and, as a rule, occurs in connection with the first awakening of the vita sexualis. This first awakeninc^ is associated with some partial sexual impression (since it is always a thing standing m some relation to woman), and stamps it for life as the principal object of sexual interest. The circumstances under which the association arises are usually forgotten ; the result of the association alone is retained. The general predisposition to psycho- pathic states and the sexual hyperaesthesia of such indi- viduals are all that is original here.^ ^ Though Binet {op. cit.) declares that every sexual perversion, with- out exception, depends upon such an " accident acting on a predisposed subject " (where, under predisposition, only hyperaesthesia in general is understood), yet such an assumption for other perversions than fetichism is neither necessary nor satisfactory. For example, it is not clear how the sight of another's chastisement could excite sexually even a very excit- able individual, if the physiological relationship of lust and cruelty had not been developed into original sadism in an abnormally excitable indi- vidual. As the sadistic and masochistic associations are preformed in the mind of the subject from homogeneous elements in adjacent spheres, in 212 PSYCHOPATHIA SEXUALIS. Like the other perversions thus far considered, erotic (pathological) fetichism may also express itself in strange, unnatural, and even criminal acts : gratification vi^ith the female person loco indeblto, theft and robbery of objects of fetichism, pollution of such objects, etc. Here, too, it only depends upon the intensity of the perverse impulse and the relative power of opposing ethical motives, whether and to what extent such acts are performed. These perverse acts of fetichists, like those of other sexually perverse individuals, may either alone constitute the entire external vita sexualis, or occur parallel with the normal sexual act. This depends upon the condition of physical and psychical sexual power, and the degree of excitability to normal stimuli that has been retained. Where excitabihty is diminished, not infrequently the sight or touch of the fetich serves as a necessary pre- paratory act. The great practical importance which attaches to the facts of fetichism, in accordance with what has been said, Hes in two factors. In the first place, pathological fetichism is not infrequently a cause of j^sychical ijnpotence} Since the object upon which the sexual interest of the fetichist is concentrated stands, in itself, in no immediate relation to the normal sexual act, it often happens that the same measure is the possibility of fetichistic associations prepared by the idiosyncrasies of the object and thus easier understood. In nearly every instance it is impressions of parts of the female form (including garments) that are in question. Fetichistic association which originated only by mere accident can only be traced in a few special cases. 1 When young husbands who have associated much with prostitutes feel impotent in the face of the chastity of their young wives —a thing of frequent occurence— the condition may be regarded as a kind of (psy- chical) fetichism in a wider sense. One of my patients was never potent with his beautiful and chaste young wife, because he was accustomed to the lascivious methods of prostitutes. When he now and then at- tempted coitus with puellis he was perfectly potent. Hammond (op. cit. pp. 48, 49) reports a very similar interesting case. Of course, in such cases, a bad conscience and hypochondriacal fear of impotence play an important part. FETICHISM. 213 the fetichist diminishes his excitability to normal stimuli by his perversion, or, at least, is ca.pable of coitus only by means of concentration of his fancy upon his fetich. In this perversion, and in the difficulty of its adequate gratification, just as in the other perversions of the sexual instinct, lie conditions favouring psj^cbical and physical onanism, which again reacts deleteriously on the constitu- tion and sexual power. This is especially true in the case of youthful individuals, and particularly in the case of those who, on account of opposing ethical and sesthetic motives, shrink from the realisation of their perverse desires. Secondly, fetichism is of great forensic vnportance. Just as sadism may extend to murder and the infliction of bodily injury, fetichism may lead to theft and even to robbery for the possession of the desired 'articles. Erotic fetichism has for its object either a certain portion of the body of a person of the opposite sex, or a certain article or material of wearing apparel of the opposite sex. (Only cases of pathological fetichism in men have thus far been observed, and therefore only portions of the female person and attire are spoken of here.) In accordance with this, fetichists fall into three groups. (a) The Fetich is a Part of the Female Body. Just as, in physiological fetichism, the eye, the hand, the foot and the hair of woman frequently become fetiches, so, in the pathological domain, the same portions of the body become the sole objects of sexual interest. This exclusive concentration of interest on these parts, by the side of which everything else feminine fades, and all other sexual value of woman may sink to nil, so that, instead of coitus, strange manipulations of the fetich become the object of desire, — this it is that makes these cases patho- logical. 214 PSTCHOPATHIA SEXUALIS. Case 72. (Binet, op. cit.) X., aged thirty-four, teacher in a gymnasium. In childhood he suffered from convul- sions. At the age of ten he began to masturbate, with lustful feelings, which were connected with very strange ideas. He was particularly partial to women's eyes ; but since he wished to imagine some form of coitus, and was absolutely innocent in sexual matters, to avoid too great a separation from the eyes, he evolved the idea of making the nostrils the seat of the female sexual organs. Then his vivid sexual desires were revolved around this idea. He sketched drawings representing correct Greek profiles of female heads, but the nostrils were so large that immissio penis would have been possible. One day, in an omnibus, he saw a girl in whom he thought he recognised his ideal. He followed her to her home and immediately proposed to her. Shown the door, he returned again and again, until arrested. X. never had sexual intercourse. Hand-fetichists are very numerous. The following case is not really pathological. It is given here as a transitional case : — Case 73. B., of neuropathic family, very sensual mentally intact. At the sight of the hand of a beautiful young lady he is always charmed and feels sexual excite- ment to the extent of erection. It is his delight to kiss and press such hands. As long as they are covered with gloves he feels unhappy. By pretexts he tries to get hold of such hands. He is indifferent to the foot. If the beautiful hands are ornamented with rings, his lust is increased. Only the living hand, not its image, causes him this lustful excitement. It is only when he is exhausted sexually by frequent coitus that the hand loses its sexual charm. At first the memory-picture of female hands disturbed him even while at work {Binet, op. cit.). FETICHISM. 215 Binet states that such cases of enthusiasm for the female hand are numerous. Here it may be recalled that, according to case 23, a man may be partial to the female hand as a result of sadistic impulses ; and that, according to case 44, the same thing may be due to masochistic desires. Thus such cases have more than one meanino-. But it does by no means follow that all, or even a majority, of the cases of hand-fetichism allow or require a sadistic or masochistic explanation The following interesting case, that has been studied in detail, shows that, in spite of the fact that at first a sadistic or masochistic element seems to have exercised an influence, at the time of the individual's maturity and the complete development of the perversion, the latter contained nothing of these elements. Of course, it is possible that, in the course of time, they disappeared ; but here the assumption of the origin of the fetichism in an accidental association meets every requirement : — Case 74. A case of hand-fetichism, communicated by Albert Moll. P. L., aged twenty-eight, a merchant in West- phaha. Aside from the fact that the patient's father was remarkably moody and somewhat quick-tempered, nothing of a hereditary nature could be proved in the family. At school the patient was not very dihgent ; he was never able to concentrate his attention on any one subject for any length of time ; on the other hand, from childhood he had a great mclination for music. His temperainent was always nervous. In August, 1890, he came to me complaining of head- ache and abdominal pain, which in every way gave the impression of being neurasthenic. The patient also said he was destitute of energy. Only after accurately directed questions did the patient make the following statements concerning his sexual life. As far as he could remember, the beginnings of sexual excitement occurred in his seventh year. Whenever he saw a boy of his own age urinate and 216 PSYCHOPATHIA SEXUALIS. caught sight of his genitals, he became lustfully excited. L. states with certainty that this excitement was associated with strongly accentuated erections. Led astray by another boy, L. learned to masturbate at the age of seven or eight. *' Being of a very excitable nature," said L., " I practised masturbation very frequently until my eighteenth year, without gaining any clear idea of the evil results or the meaning of the practice." He was particularly fond of practising mutual onanism with some of his school-friends, but it was by no means an indifferent matter who the other boy was ; on the contrary, only a few of his companions could satisfy him in this respect. To the question as to what particularly caused him to prefer this or that boy, L. replied that a white, beautifully formed hand in his school- fellows impelled him to practise mutual onanism with them. L. further remembered that frequently, at the beginning of the gymnastic lesson, he would exercise by himself on a bar standing apart. He did this for the purpose of exciting himself as much as possible ; and he was so successful that, without using his hand and without ejaculation — L. was still too young — he had lustful pleasure. Another early event which L. remembers is interesting. One day his favourite companion, N., who practised mutual onanism with him, proposed that L. should try to get hold of his (N.'s) penis, and he would do all he could to prevent it, L. acquiesced. In this way onanism was directly com- bined with a struggle between both parties, in which N. was always conquered. The struggle always finally ended in N.'s being compelled to allow L. to practise onanism on him. L. assured me that this kind of masturbation had given him, as well as N., especial pleasure. In this way L. continued to practise masturbation very frequently until his eighteenth year. AVarned by a friend, he then began to struggle with all his might against this evil habit. He became more and more successful, and finally, after the first performance of coitus, he stopped the practice of onanism entirely. But this was only accomplished in hia FETICHISM. 217 twenty-second year. It now seems incomprehensible to the patient — and he says he is filled with disgust at the thought — how he could ever have found pleasure in per- forming masturbation with other boys. Now, nothing could induce him to touch another man's genitals, the sight of which is even unpleasant to him. He has lost all inclination for men, and feels attracted by women exclusively. It must be mentioned, however, that, although L. has a decided inclination for the female sex, he presents an abnormal phenomenon. The essential thing in woman that excites him is the sight of her beautiful hands ; L. is by far more impressed when he touches a beautiful female hand than he would be were he to see its possessor in a state of complete nudity. The extent to which L.'s preference for beautiful female hands goes is shown by the following incident : — L. knew a beautiful young lady possessed of every charm, but her hands were quite large and not beautifully formed, and often they were not as clean as L. could wish. For this reason it was not only impossible for L. to con- ceive a deeper interest in the lady, but he was not able even to touch her. L. believes that there is nothing more disgusting to him than dirty finger-nails; this alone would make it impossible for him to touch a woman who in all other respects was most beautiful. L. formerly, as a substitute for coitus, induced the puella to perform genital manipulation with her hand until ejaculation took place. To the question as to what there was about a woman's hand that attracted him in particular, whether he saw in it a symbol of power, and whether it gave him pleasure to be directly humiliated by a woman, the patient answered that only the beautiful form of the hand charmed him ; that it afforded him no gratification to be humiliated by a woman ; and that he had never had any thought to regard the hand as the symbol or instrument of a woman's power. The preference for the hand is still so great that the 218 PSYCHOPATHIA SEXUALIS. patient has greater pleasure when his genitals are touched by it than when he performs coitus in vagiyiam. Yet, the patient prefers to perform the latter, because it seems to him to be natural, while the former seems abnormal. The touch of a beautiful female hand on his body immediately causes him to have erection ; he thinks that kissing and other contacts do not exert nearly so strong an influence. It is only of late years that the patient has performed coitus frequently, but it has always been very diliicult for him to determine to do it. Moreover, in coitus, he did not find the complete satisfaction he sought. However, when he finds himself near a woman whom he would like to possess, sometimes, at mere sight of her, his sexual excite- ment becomes so intense that ejaculation results. L. says expressly that during this process he does not in- tentionally touch or press his genitals ; ejaculation under such circumstances affords him much more pleasure than he experiences in actual coitus.^ To go back, the patient's dreams were never about coitus. When he had pollutions at night, they were almost always associated with other thoughts than those that occur in the normal man. The patient's dreams are of events of his school-days, when, besides the mutual onan- ism described, he had ejaculations whenever he became anxiously excited. "When, for example, the teacher dic- tated an extemporaneous exercise, and L. was unable to follow in translation, ejaculation often occurred.''^ The pollutions that now occur occasionally, at night, are only accompanied by dreams that have the same or a similar 1 Great sexual hypersesthesia. Cf. note on p. 64. 2 This is also sexual hypcraesthesia. Any intense excitement afiects the sexual sphere [Bijiet's " Dynamogcnie gcncrale "). Concerning tliis Dr. Moll communicates the following case : " A similar thing is described by Mr E., aged twenty-seven ; merchant. While at school, and afterward, he often had ejaculation with pleasurable feeling when he was seized with a spell of intense anxiety. Besides, almost every other physical or mental pain exerted a similar influence. E., as he states, has a normal sexual instinct, but suffers with nervous impotence." FETICHISM. 219 subject — i.e., the events at school just mentioned. On account of his unnatural feeling and sensibility the patient thinks he is incapable of loving a woman permanently. Treatment of the patient's perversion has not yet been possible. This case of hand-fetichism certainly does not depend on masochism or sadism, but is to be explained simply on the ground of early indulgence in mutual onanism. Neither is there contrary sexual instinct. Before the sexual appetite was clearly conscious of its object, the hands of school-fellows were used. As soon as the instinct for the opposite sex became evident, the interest for the hand was transferred to that of woman. In hand-fetichists, who, according to Binet, are numerous, it is possible that other associations lead to the same result. Next to the hand-fetichists, naturally come the foot- fetichists. While glove-fetichism, which belongs to the next group of object-fetichism, seldom takes the place of hand-fetichism, we find shoe- and boot-fetichism, of which there are innumerable cases occurring everywhere, taking the place of enthusiasm for the naked female foot. It is easy to see the reason for this. The female hand is usually seen uncovered ; the foot, covered. Thus the early associations which determine the direction of the vita sexualis are naturally connected with the naked hand, but with the foot when covered. This assumption is certainly correct with regard to those who have grown up in large cities, and easily explains the scarcity of foot-fetichism,^ which will be elucidated by the following cases. Case 75. Foot-fetichism. Acquired inverted sexuality ^ Exceptions are the cases of latent masochism in the form of Kopro- lagnia in wliich case the fetichistic stimulus is not to be found in the clean naked foot but c contra, cf. case 67. 220 PSTCHOPATHIA SEXUALIS. Mr. X., civil servant, twenty-nine years of age ; mother neuropathic, father diabetic. Has good mental qualities, is of nervous disposition, but never suffered from nervous disease, shows no signs of degeneration. Patient distinctly recalls that even at the age of six he became sexually excited when he saw the naked feet of women, and was impelled to follow them, 01: watch them when at work. At the age of fourteen he shpped one night into the room where his sister slept and kissed her foot. At the age of eight he began spontaneously to masturbate, think- ing all the while of the naked feet of women. When sixteen he often took shoes and stockings of servant girls to bed with him ; and whilst fingering them excited himself into masturbation. At the age of eighteen he began sexual intercourse with persons of the opposite sex. He had full power, and coitus satisfied him without the aid of a fetich. For males he had not the slightest sexual inclination, neither bad the feet of men any attraction for him. At the age of twenty-four a great change came over bis sexual feelings and his physical condition. Patient became neurasthenic and began to experience sexual inclination to males. No doubt excessive mastur- bation brought about neurosis and inverted sexuality to which he was led by libido nimia remaining unsated by coitus, and by the sight (accidental or otherwise) of female feet. As neurasthenia (at first sexualis) increased, a rapid cessation of libido, power and gratification, with regard to women set in. Parallel with this, inclination towards his own sex developed and his fetichism was transferred to males. With the age of twenty-five he had coitus cum muliere but rarely, and without satisfaction. He had lost nearly all interest in the foot of woman. The craving to have sexual intercourse with men grew daily stronger. When FETICniSM, 221 he was transferred to a large city he found the long- wished-for opportunity and actually revelled with intense passion in this unnatural love. He ejaculated during these acts with the utmost voluptuousness. By-and-by the sight of a sympathetic man, especially if he were barefooted, sufficed him. His nocturnal pollutions had now for their object intercourse with men, and, to be sure, in the fetichistic sense (feet). Shoes did not interest him. The naked foot was his charm. He often felt nnpelled to follow men in the street, hoping to find occasion for taking off their shoes. As a substitute he went barefooted himself. At times he was driven to walk along the street in his bare feet, thereby experiencing the most intense lustful feelings. If he resisted, agony, trembling, and palpitation of the heart set m. Often at nights he yielded to this impulse for hours, even m stormy, rainy weather, not minding the many risks and personal dangers to which he exposed himself oy so doing. He would carry the shoes in his hand, became sexually excited, and only found satisfaction in spontaneous, or induced ejaculation. He felt envious of navvies and the poor who could go barefoot without attracting attention. His happiest moments were the time which he spent m a hydropathic establishment, d la Kneipp, where he was allowed to go barefoot with the other men under treatment. An awkward affair, the result of his perverse sexual practices sobered him. He sought safety from his un- natural sexual existence by consulting a physician who sent him to me. The patient did his utmost to abstain from masturba- tion and perverse connection with men. He underwent treatment for neurasthenia in a hydropathic institute, regained some interest in the gentler sex — his foot-fetich- ism serving as a bridge — had once, with a degree of plea- sure, coitus with a barefooted peasant girl who acceded 222 PSYCHOPATHIA SEXIMLIS. to his wishes, and later on visited puellas a few times but without gratification. Then he turned again to pers( ns of his own sex, backsHded totally, felt irresistibly drawn to tramps and farm labourers, whom he paid for the favour to kiss their feet. An attempt to rescue the unfortunate man by suggestive treatment was wrecked on the impossibility to remove an enervation which was beyond therapeutic aid. Case 76. Foot-fetichism with continued hetero- sexuality . Mr. Y., fifty years of age, bachelor, belongs to high society. Consulted a physician on account of " nervous " troubles. Is tainted, from childhood nervous, very sensi- tive to cold and heat, troubled with delusions w^hich assume the character of transient dementia persecutoria. For instance, when he sits in a restaurant he imagines that everybody stares at him, talks about, and makes fun of him. As soon as he rises this feeling leaves him and he no longer believes his fancies. He never feels settled for any length of time, and moves about from one place to another. At times it happened that he engaged rooms at a hotel, but never went there on account of his peculiar delusions. He never had much libido. All his sentiments were heterosexual. Now and then he found gratification in coitus which he claims to have been normal. Y. admitted that his sexual life was peculiar from early youth. Neither women nor men excited him sexually, but the sight of female feet, be they of children or grown- up women would do so. All other parts of the female body have no attraction for him. If by chance he can see the naked feet of female gipsies or tramps he can gaze at them b}^ the hour and is driven by a " terrible " impulse terere genitalia propria ad pedes illarum. Thus far he has successfully resisted this impulse. What annoys him most is to see these feet covered with dirt. He would like to see them well washed and PETICHISM. 223 clean. He caunot say how this fetichism originated in him (from a communication of Professor Ford). Moll in his recent researches in libido sexualis, p. 288, relates a most interesting case of foot-fetichism which resembles case 75 above, in so far as the patient by force of the fetich became homosexual. Shoe-fetichism also finds its place in the following group of dress-fetichism ; however, on account of its demonstrable masochistic character in the majority of cases, it has been, for the most part, described already (p. 159 et seq.). Besides the eije, hand and foot, the moiUh and ear often play the role of a fetich. Among others, Moll (op. cit.) mentions such cases, {Cf. Belofs roma,nce, " La liouche de Madame X.," which, B. states, rests upon actual observation.) The following remarkable case came under my personal observation : — Case 77. A gentleman of very bad heredity consulted me concerning impotence that was driving him almost to despair. While he was young, his fetich was women of plump form. He married such a lady, and was happy and potent with her. After a few months the lady fell very ill, and lost much flesh. When, one day, he tried to resume his marital duty, he was absolutely impotent, and remained so. If, however, he attempted coitus with plump women, he was perfectly potent. Even bodily defects may become fetiches. Case 78. X,, twenty-eight years of age ; comes from heavily tainted family ; i.s neurasthenic; complains of want of self-confidence and frequent depression of mind, with fits of suicidal intentions, wljicli he has great trouble to ward 224 PSTCHOPATHIA SEXUA.LIS. off. The smallest worries throw him out of temper, and fill him with despair. He is an engineer in a factory in Rupsian- Poland, a man of robust frame, without signs of degenera- tion. He complains of a peculiar mania, which causes him to doubt his sanity. Since his seventeenth year he becomes sexually excited only at the sight of physical defects in women, especially lameness and disfigured feet. He is not conscious of the original associative connection between his libido and these defects in women. Ever since puberty he has been under the bane of this fetichism, which is painful to himself. Normal woman has no attraction for him. If a woman, however, is afflicted with lameness or with contorted or disfigured feet, she exercises a powerful sensual influence over him, no matter whether she is otherwise pretty or ugly. In his dreams, accompanied by pollutions, the forms of halting women are ever before him. At times he cannot resist the temptation to imitate their gait, which causes vehement orgasm, with lustful ejaculation. He claims to have strong libido, and suffers intensely when his sexual desire remains unsatisfied. Despite these facts, he had coitus for the first time when he was twenty-two years of age, and then but five times. He felt, however, not the slightest satisfaction in spite of complete ability. He thinks it would cause him intense pleasure if he had the chance to mate with a halting woman. At any rate, he could never marry any other than a lame woman. Since his twentieth year the patient manifests fetich- ism for garments. It often suffices him to put on female stockings, shoes and drawers. He buys such wearing apparel at times and, putting it on secretly, becomes lust- fully excited and ejaculates. Garments which have been worn by women have no attraction for him. He would fain prefer to wear female garb, so as to keep up sensual emotions, but has not yet dared to do so for fear of being detected. His vita sexualis is reduced to these practices. He is FETTCHTSM. 225 definite in asserting that he never was addicted to mastur- bation. Quite recently he has been, in consequence of his neurasthenic afflictions, much troubled with pollutions. Case 79. Mr V., thirty years, civil servant ; comes from very neuropathic parents. Since his seventh year he had for a playmate a lame girl of the same age. At the age of twelve, being of a nervous disposition and hypersexually inclined, the boy began spontaneously to masturbate. At that period puberty began to set in, and it lies beyond doubt that the first sexual emotions towards the other sex were coincident with the sight of the lame girl. For ever after only halting women excited him sexu- ally. His fetich is a pretty lady who, like the companion of his childhood, limps with the left foot. Always heterosexual but abnormally sensual he sought early relations with the opposite sex, but was absolutely impotent with women who were not lame. Virility and gratification were most strongly elicited if the puella limped with the left foot, but he was successful also if the lameness were in the right foot. As, in consequence of his fetichism the opportunities for coitus occurred but seldom, he resorted to masturbation, but found it a dis- gusting and miserable substitute. His sexual anomaly rendered him very unhappy, and he was often near com- mitting suicide, but regard for his parents prevented him. This moral affliction culminated in the desire for marriage with a sympathetic lame lady, but since he could not love the soul of such a wife, but only her defect of lameness, he considered such a union a profanation of matrimony and an unbearable, ignoble existence. On this account he had often thought of resignation and castration. When V. came to me for advice I obtained, in my examination of him, only negative results as regards signs of degeneration, nervous disease, etc. 15 226 PSYCHOPATHIA SEXUALIS. I enlightened the patient on the subject, and told him that it was difficult, if not absolutely impossible, for medical science to obliterate a fetichism so deeply rooted by old associations, but expressed the hope that if he made a limping maid happy in wedlock he himself would find happiness also. Descartes, who himself (" Traite des Passions," cxxxvi.) expresses some opinions concerning the origin of peculiar affections in associations of ideas, was always partial to cross-eyed women, because the object of his first love had such a defect {Binet, op. cit.). Lydston ("A Lecture on Sexual Perversion," Chicago, 1890) reports the case of a man who had a love affair with a woman whose right lower extremity had been amputated. After separation from her he searched for other women with a like defect. A negative fetich ! A peculiar variety of body fetichism may be found in the following case (strongly complicated with sadistic ele- ments), in which fine white virgin skin is the fetich, and sadism leads to lustful acts of cruelty (as an equivalent to coitus), even to anthropophagy (cf. p. 82 et seq.), for which the deeply degenerated and probably epileptic patient seeks to find a substitute in antomutilation and autophagy. C^se 80. L., labourer, was arrested because he had cut a large piece of skin from his left forearm with a pair of scissors in a public park. He confesses that for a long time he had been craving to eat a piece of the fine white skin of a maiden, and that for this purpose he had been lying in wait for such a victim with a pair of scissors ; but, as he had been unsuccessful, he desisted from his purpose and instead had cut his own skin. His father was an epileptic, and his sister an imbecile. Up to his seventeenth year he suffered from enuresis noc- turna, was dreaded by everybody on account of his rough PETICHISM. 227 and irascible nature, and dismissed from school because of his insubordination and viciousness. He began onanism at an early age, and read with preference pious books. His character showed traits of superstition, proneness to the mystic, and showy acts of devotion. When thirteen his lustful anomaly awoke at the sight of a beautiful young girl who had a fine white skin. The impulse to bite off a piece of that skin and eat it became paramount with him. No other parts of the female body excited him. He never had any desire for sexual inter- course, and never attempted such. He hoped to achieve his end easier with the aid of scissors than with his teeth, for which reason he always carried a pair with him for years. On several occasions his efforts were nearly successful. Since the previous year he found it most difficult to bear his failures any longer, when he decided upon a substitute — viz., each time when he had unsuccessfully pursued a girl he would cut a piece of skin from his own arm, thigh or abdomen and eat it. Imagining that it was a piece of the skin of the girl whom he had pursued, he would whilst masticating his own skin obtain orgasm and ejaculation. Many extensive and deep wounds and numerous scars were found on his body. During the act of self-mutilation, and for a long time afterwards, he suffered severe pains, but tbey were over- compensated by the lustful feelings which he experienced whilst eating the raw flesh, especially if the latter dripped with blood, and when he succeeded in his illusion that it was ctUis virginis. The mere sight of a knife or scissors sufficed to provoke this perverse impulse, which throws him into a state of anxiety, accompanied by profuse per- spiration, vertigo, palpitation of the heart, craving for cutis femincB. He must, with scissors in hand, follow the woman that attracts him, but he does not lose conscious- ness or self-control, for at the acme of the crisis he takes 228 PSYCHOPATHIA SEXUALIS. from his own what is denied him from the body of the girh During the whole crisis he has erection and orgasm, and at the very moment when he begins to chew the piece of his skin ejaculation sets in. After that he feels greatly relieved and comforted. L. is quite conscious of the pathological aspect of his condition. Of course, this dangerous character was sent to an insane asylum, where he attempted suicide (Magnan " Psychiatrische Vorlesungen "). An interesting category is formed by the hair-fetichists. The transition from " admirer of woman's hair " within physiological limits to pathological feticbism is easy. The beginning of the pathological series is formed by those cases in which the hair of a woman simply makes a sensual impression and incites to cohabitation. Then follow those in which virility is only possible with a woman who pos- sesses this individual fetich. Possibly various senses (sight, smell, hearing, through crepitant sounds, also touch as with velvet- and silk-fetichists, vide infra) are drawn into activity in this hair-fetichism as they receive lustful impulses. The end of the series is formed by those whom the hair of woman suffices even when severed from the body — so to speak, no longer a part of the living body, but only matter, even a mercantile article — to excite libido and sensual gratification by way of physical or psychical onan- ism, eventually under contact of the genitals with the fetich. An interesting instance of a hair-fetichist belong- ing to the second catagory is related by Dr. Gemij, under the title of " Histoire des peruques aphrodisiaques," in "La Medecine Internationale," September, 1894. A lady told Dr. Gemy that in the bridal night and in the night following her husband contented himself with kiss- ing her, andrunning his fingers through the wealth of her tresses. He then fell asleep. In the third night Mr X, produced an immense wig, with enormously long hair, and FETICHISM. 229 begged his wife to put it on. As soon as she had done so, he richly compensated her for his neglected marital duties. In the morning he showed again extreme tenderness, whilst he caressed the wig. When Mrs X. removed the wig she lost at once all charm for her husband. Mrs. X. recog- nised this as a hobby, and readily yielded to the wishes of her husband, whom she loved dearly, and whose libido depended on the wearing of the wig. It was remarkable, however, that a wig had the desired effect only for a fort- night or three weeks at a time. It had to be made of thick, long hair, no matter of what colour The result of this marriage was, after five years, two children, and a collection of seventy-two wigs. In those cases in which the female hair as mere matter possesses the properties of a fetich, it not uncom- monly happens that the fetichist seeks to possess himself of woman's hair by unlawful acts. These form the group of hair-despoilers, of no slight importance from the forensic aspect.^ Case 81 . A hair-despoiler. P., aged forty, artistic locksmith, single. His father was temporarily insane, and his mother was very nervous. He was well de- veloped and intelligent, but was early affected with tics and delusions. He had never masturbated. He loved platonically, and often busied himself with matrimonial plans. He had coitus infrequently with prostitutes, but never felt satisfied with such intercourse — rather, dis- gusted. Three years ago he was overtaken by misfortune (financial ruin), and besides, he had a febrile disease, with dehrium. These things had a very bad effect on his hereditarily predisposed nervous system. On 28th ^ Moll (op. cit., p. 131) reports : " A man, X., becomes intensely excited sexually whenever he sees a woman with the hair in a braid ; loose hair, no matter how beautiful, cannot produce this effect ". Of course, it is not justifiable to consider all hair-despoilers fetichists, for in a few cases such acts are done for the purpose of gain — i.e., the stolen hair is not a fetich. 230 PSTCHOPATHIA SEXUALIS. Au;];ust, 1889, P. was arrested at the Trocadero, in Paris, in flagranti, as he forcibly cut off a young girl's hair. He was arrested with the hair in his hand and a pair of scissors in his pocket He excused himself on the ground of momentary mental confusion and an unfortunate, irre- sistible passion ; he confessed that he had ten times cut off hair, which he took great delight in keeping at home. On searching his home, sixty-five switches and tresses of hair were found, assorted in packets. P. had already been once arrested, on 15th December, 1886, under similar circumstances, but was released for lack of evidence. P. states that, for the last three 3'ears, when he is alone in his room at night, he feels ill, anxious, excited and dizzy, and then is troubled by the impulse to touch female hair. When it happened that he could actually Lake a young girl's hair in his hand, he felt intensely excited sexually, and had erection and ejaculation without touching the girl in any other way. On reaching home, he would feel ashamed of what had taken place ; but the wish to possess hair, always accompanied by great sexual pleasure, became more and more powerful in him. He wondered that previously, even in the most intimate inter- course with women he had experienced no such feeling. One evening he could not resist the impulse to cut off a girl's hair. With the hair in his hand, at home, the sensuous process was repeated. He was forced to rub his body with the hair and envelop his genitals in it. Finally, quite exhausted, he grew ashamed, and could not trust himself to go out for several days. After months of rest he was again impelled to possess himself of female hair, indifferent as to whose it might be. If he attained his end, he felt himself possessed by a supernatural power and unable to give up his booty. If he could not attain the object of his desire, he became greatly depressed, hurried home, and there revelled in his collection of hair. He combed and fondled it, and thus had intense orgasm, satisfying himself by masturbation. Hair exposed in the FETICHISM. 231 show-cases of hair-dressers- made no impression on him ; it required hair hanginj^ down from a female head. At the height of his act, he states, he is in such a state of excitement that he has only imperfect appercep- tion and subsequent recollection of what he does. When he touches the hair with the scissors he has erection, and, at the instant of cutting it off, ejaculation. Since his misfortune, about three years ago, he states that he has had weakness of memory, is easily exhausted mentally, and has been troubled by sleeplessness and night-terrors. P. deeply regrets his crime. Not only hair, but a number of hair-pins, ribbons and other articles of the feminine toilet, were found in his possession, which he had had presented to him. He had always had an actual mania for collecting such things, as well as newspapers, pieces of wood and other worthless trash, which he would never give up. He also had a strange and, to him, inexplicable fear of passing a certain street ; if he ever tried it, it made him ill. The opinion (medico-legal) showed him to be heredi- tarily predisposed, and proved the imperative, impulsive and decidedly involuntary character of the criminal acts, which had the significance of an imperative act, induced by an imperative idea, with an accompaniment of over- powering abnormal sexual feeling. Pardon ; asylum for insane {Voisin, Socquet, Motet, "Annales d'hygiene," April, 1890). Following this case is a similar one, which also deserves attention, for it has been well studied, and may be called almost classical ; and it places also the fetich, as well as the original associative awakening of the idea, in a clear light :— Case 82. A hnir-de spoiler. E-., aged twenty-five. Maternal aunt, epileptic ; brother had convulsions. E. says he was fairly healthy as a child, and learned quite 232 rSYCHOPATHlA SEXUALIS. easily. At the age of fifteen he had an erotic feeling of pleasure, with erection, at the sight of one of the village beauties combing- her hair. Until that time persons of the opposite sex had made no impression on him. Two months later, in Paris, the sight of young girls with their hair flowing down over their shoulders always excited him intensely. One day he could not resist an opportunity to twist a young girl's hair in his fingers. For this he was arrested and sentenced to imprisonment for three months. After that he served five years in the army. During this time hair was not dangerous for him, because not very accessible ; but he dreamed sometim.es of female heads with the hair braided or flowing. Occasional coitus with women, but without their hair being effective as a fetich. Once more in Paris, he again dreamed as before, and became greatly excited by female hair. He never dreamed about the whole form of a woman, only of heads with braidSv of hair. His sexual excitement due to this fetich had become so intense of late that he had resorted to mas- turbation. The idea of touching female hair, or, better, of possessing it to masturbate w^hile handling it, grew more and more powerful. Of late, when he had female hair in his fingers, ejaculation was induced. One day he succeeded in cutting hair, about twenty-five centimetres long, from three little girls in the street, and keeping it in his possession, when he was arrested in a fourth attempt. Deep regret and shame. He was not sentenced. Since spending some time in the asylum, he has so far improved that female hair no longer excites him. Set at hberty, he thought of going to his native place, where the women wear their hair done up {Magnan, " Archiv. de I'anthro- pol. criminelle," v.. No. 28). A third case is the following, which is hkewise suited to illustrate the psychopathic nature of such pheno- mena ; and the remarkable means which induced a cure are worthy of note : — FETICHISM 233 Case 83. Hair-fctichism. Mr. X., between thirty and forty years old ; from the higher class of society ; single. He says that he comes of a healthy family, but from childhood has been nervous, vacillating and peculiar ; that since his eighth year he has been powerfully attracted by female hair. This was particularly true in the case of young girls. When he was nine years old, a girl of thirteen seduced him. He did not understand it, and was not at all excited. A twelve-year-old sister of this girl also courted, kissed, and hugged him. He allowed this quietly, because this girl's hair pleased him so well. When about ten years old, he began to have erotic feelings at the sight of female hair that pleased him. Gradually these feelings occurred spontaneously, and memory-pictures of girl's hair were always immediately associated with them. At the age of eleven he was taught to masturbate by school-mates. The associative connection of sexual feelings and a fetichistic idea were already established, and always appeared when the patient indulged in evil practices with his companions. With advancing years, the fetich grew more and more power- ful. Even false hair began to excite him, but he always preferred natural hair. When he could touch or kiss it, he was perfectly happy. He wrote essays and poems on the beauty of female hair ; he sketched heads of hair and masturbated. After his fourteenth year he became so powerfully excited by his fetich that he had violent erections. In contrast with his early taste while a boy, he was now charmed only by luxuriant, thick black hair. He experienced intense desire to kiss such hair, particu- larly to suck it. To touch such hair afforded him but httle satisfaction ; he obtained much more pleasure in looking at it, but particularly in kissing and sucking it. If this were impossible, he would become unhappy, even to the extent of tadium vitce. Then he would attempt to relieve himself, imagining fantastic " hair-adventures " and masturbating. Not infrequently, in the street and 234 PSYCHOPATHIA SBXUALIS. in crowds, he could not keep from imprinting a kiss on ladies' heads. He would then hurry home to masturbate. Sometimes he could resist this impulse ; but it was then necessary for him, filled with feehngs of fear, to run away as quickly as possible, in order to escape the domination of his fetich. He was only once impelled to cut off a girl's hair in a crowd. In the act he was seized with fear, and was not successful with his pocket-knife ; and, by flight, he narrowly escaped detection. When he became mature, he attempted to satisfy him- self in coitus with pucllis. He induced powerful erection by kissing the tresses, but could not induce ejaculation. Therefore, he was unsatisfied by coitus. At the same time, his favourite idea was coitus with kissing of hair ; but even this did not satisfy him, because it did not induce ejaculation. Faide de mieux, he once stole the combings of a lady's hair, put it in his mouth, and masturbated while calling its owner up in imagination. In the dark a woman could not interest him, because he could not then see her hair. Flowing hair also had no cbarm for him ; nor did the hair about the genitals. His erotic dreams were all about hair. Of late the patient had become so excited that he had a kind of satyriasis. He was incapable of business, and felt so unhappy that he sought to drown his soirow in alcohol. He drank large quantities, had alcohohc delirium, an attack of alcoholic epilepsy, and required hospital treatment. After the intoxication had passed away, under appropriate treatment, the sexual excitement soon disappeared ; and when the patient was discharged, he was freed from his fetichistic idea, save for its occasional occurrence in dreams. The physical examination showed normal genitals and no degenerative signs whatever. Such cases of hair-fetichism, which lead to attacks on female hair, seem to occur everywhere, from time to time. In November, 1890, according to reports in Amen- FETICIIISM. 235 can newspapers, several cities in the United States were troubled by such hair-despoilers. (b) The Fetich is an Article of Female Attire. The great importance of adornment, ornament and dress in the normal vita sexualis of man is very generally recognised. Culture and fashion have, to a certain extent, endowed woman with artificial sexual characteristics, the removal of which, when woman is seen unattired, in spite of the normal sexual effect of this sight, may exert an opposite influence.^ It should not be overlooked that female dress often shows a tendency to emphasise and exaggerate certain sexual peculiarities, — secondary sexual characteristics (bosom, waist, hips). In most individuals the sexual instinct awakes long before there is any possi- bility or opportunity of intimate intercourse, and the early desires of youth are concerned with the ordinary appear- ance of the attired female form. Thus it happens that not infrequently, at tlie beginning of the vita sexualis, ideas of the persons exerting sexual charms and ideas of their attire become associated. This association may be lasting — the attired woman may be always preferred — if the individuals dominated by this perversion do not in other respects attain to a normal vita sexualis, and find gratifi- cation in natural charms. In psychopathic individuals, sexually hypernesthetic, as a result of this, it actually happens that the dressed woman is always preferred to the nude female form. It may be recalled that in case 46 the woman was not to take off her chemise, and that in case 48, equus eroticus, the woman was preferred dressed. Further on a similar case will be referred to. Dr. Moll {op. cit. second edition) mentions a patient who could not perform coitus with jiit'dla nuda ; the woman had ' Cf. Goethe's remarks about his adventure in Geneva {" Briefc aus der Schweiz," 1 Abthcil., Schluss). 236 PSTCHOPATHIA SESUALIS. to have on a chemise, at least. The same author {op. cit., p. 166) mentions a man affected with contrary sexuahty, who is subject to the same dress-fetichism. The reason for this phenomenon is apparently to be found in the mental onanism of such individuals. In seeing innumerable clothed forms, they have cultivated desires before seeing nudity.^ A more marked form of dress-fetichism is that in which, instead of the dressed woman in general, a certain kind of ,attire in particular becomes a fetich. One can understand how, with an intense and early sexual impression, com- bined with the idea of a particular garment on the woman, in hyperaesthetic individuals, a very intense interest in this garment might be developed. Hammond {op. cit.,]). 46) reports the following case, taken from Boubaud (" Traite de I'impuissance," Paris, 1876) : — Case 84. X., son of a general. He was raised in the country. At the age of fourteen he was initiated into the joys of love by a young lady. This lady was a blonde, and wore her hair in ringlets ; and, in order to avoid detection in sexual intercourse with her young lover, she always wore her usual clothing,— gaiters, a corset, and a silk dress on such occasions. When his studies were completed, and he was sent to a garrison where he could enjoy freedom, he found that his sexual desire could be excited only under certain condi- tions. A brunette could not excite him in the least, and a woman in night-clothes would stifle every bit of love in him. In order to awaken his desire, a woman had to be a blonde, and wear gaiters, a corset and a silk dress, — in short, she had to be dressed like the lady who had first awakened his sexual desire. He was always compelled ^ The fact that the partly veiled form is often more charming than when it is perfectly nude, is, as far as object goes, similar, but quite dif- ferent psychically. This depends upon the effect of contrast and expecta- tion, which are common phenomena, and in no sense pathological. FETICHISM. 237 to give up thoughts of matriiiiony, because he knew he would be unable to fulfil his marital duty with a woman in night-clothes. Hammond (p. 42) reports another case where coitus maritalis could be performed only by the help of a certain costume ; and Dr. Moll mentions several similar cases in individuals of hetero- and homo-sexuahty. The cause may often be shown to be an early association, and such may always be assumed. It is only in this way that one can explain why a certain costume cannot be resisted by such individuals, no matter what person wears the fetich. Thus one can understand why, as Coffignon {op. cit.) relates, men at brothels demand that the women with whom they are concerned put on certain costumes, such as that of a ballet-dancer, or a nun, etc. ; and why these houses are furnished with a complete wardrobe for such purposes. Binet {op. cit.) relates the case of a judge who was exclusively m love with Italian girls who came to Paris as artists' models, and their peculiar costume. The cause was here demonstrably an impression made at the time of the awakening of the sexual instinct. There is but a step from such cases to the complete absorption of the whole vita sexualis by the fetich, the possession and manipulation of which may suf&ce to pro- voke orgasm and even ejaculation where irritable weak- ness of the centrum ejaculation prevails. Case 85. P., thirty-three years of age, business man, son of a mother who suffered from melancholia and committed suicide. He was tainted with several signs of anatomical degeneration, was looked upon by his neigh- bours as a " type," and had the nickname I'amouretix des nourrices et des bonnes d'enfants. He became a nuisance to these girls by his obtrusive behaviour, picked a quarrel with one of them who wore his fetich, and was arrested. 238 PSYCHOPATHIA SEXUALIS. He claimed to have always been vehemently excited at the sight of wet nurses and children's nurses, but not be- cause they were of the female sex, but because tliey wore a certain costume. Again, it was not certain portions, but the costume as a whole which attracted him. To be in the company of such persons was his greatest happi- ness. When he returned home from such interviews it was sufficient for him to recall the impressions just received, in order to produce orgasmus venereus. An analogous case is related by Motet. It refers to a young man, who became sexually excited only at the sight of a woman attired in bridal costume. The individuality of the woman was a matter of indifference to him. In order to gratify his fetichistic cravings, he spent a great deal of his time at the door of a restaurant where many weddings were celebrated {Gamier, "Les Fetichistes, p. 59). A third form of dress-fetichism, having a much highei degree of pathological significance, is by far the most fre- quent. In this form it is no longer the woman herself, dressed, or even dressed in a particular fashion, that constitutes the principal sexual stimulus, but the sexual interest is so concentrated on some particular article of female attire that the lustful idea of this object is entirely separated from the idea of woman, and thus obtains an independent value. This is the real domain of dress-fetichism, where an inanimate object — an isolated article of wearing-apparel — is alone used for the excitation and satisfaction of the sexual instinct. This third form of dress-fetichism is also the one which forensicaily is the most important. In a large number of these cases the fetiches are articles of female underwear, which, owing to their private use, are suited to occasion such associations. Case 86. K., aged forty-five, shoemaker, is reported FETICHISM. 239 to be without hereditary taint. He is peculiar, and has small mental endowment. He is of masculine habits, and without signs of degeneration. Previously blameless in conduct, on the evening of 5th July, 1876, he was detected removing stolen female under-garments from a place of concealment. There were found with him about 300 articles of the female toilet, among them, besides chemises and drawers, night-caps, garters, and a female doll. When arrested he was wearing a chemise. Since his thirteenth year he had been a slave to an impulse to steal women's linen ; but, after his first punishment for it, he became very careful, and stole with refinement and success. When this longing came over him, he would grow anxious, and his head would become heavy. Then he could not resist the im- pulse, cost what it might. It was a matter of indifference to him from whom he took the articles. At night, on going to bed, he would put on the stolen clothing and create beautiful women in imagination, thus inducing pleasurable feeling and ejaculation. This was apparently the motive of his thefts ; at least, he had never disposed of any of the articles, but had hidden them here and there. He declared that, earlier in his life, he had indulged in normal sexual intercourse with women. He denied onan- ism, pederasty, and other sexual acts. He said he was engaged at twenty-five, but the engagement was broken through no fault of his. He was incapable of grasping the abnormality of his condition and the wrong of his acts. (Passow, *' Vierteljahrsschrift f. ger. Medic," N. F. xxviii., p. 61 ; Krauss, " Psychologie des Verbrechens," 1884, p. 190). Case 87. J., a young butcher. When arrested he wore underneath his overcoat a bodice, a corset, a vest, a jacket, a collar, a jersey, and a chemise, also fine stockings and garters. Since he was eleven he was troubled by the desire to 240 PSYCHOPATHIA SEXUALIS. wear a chemise of his elder sister. Whenever he could do it unnoticed he indulged in this pleasure, and since the age of puberty the wearing of such a garment would bring on ejaculation. When he became independent he bought chemises and other articles of female toilet. In his room a complete outfit of female apparel was found. To put on such garments was the great aim of his sexual instinct. This fetichism had financially ruined him. At the hos- pital he begged the attending physician to permit him to wear female attire. Inverted sexuality did not exist (Gamier, " Les Fetich-istes," p. 62). Case 88. Z., thirty-six years of age, scholar ; has never heretofore felt interested in woman, only in her attire, and never had sexual intercourse. Besides the elegance and smartness of the female toilet in general, certain underwear, chemises made of cambric and trimmed with lace, silk corsets, embroidered silk skirts and silk stockings form his particular fetich. It caused him voluptuous feelings to inspect and finger such female garments at the draper's. His ideal was the female form in bathing costume, with silk stockings and corset, and clad in a morning-dress with a long train. He studied the costumes of the courenses des rues, but found them tasteless. He found more pleasure in gazing at the shop windows, but felt annoyed because the exhibits therein were not changed often enough. He found partial satisfaction in holding and studying fashion magazines, and in buying now and then single garments of excep- tional beauty. It would be the height of pleasure for him if he had access to the toilet arts of the boudoir or the fitting rooms of the dressmaker, or if he could be the femme de chambre of some wealthy lady of the world, and could arrange the toilet for her. There are no traces of masochism or homosexual inclination to be found on this pecuhar fetichist. He is of thoroughly manly presence {Gamier, " La folic a Paris," 1890). fetichiSm. 241 Hammond {op. cit.) reports a case of passionate interest in single articles of female wearing-apparel. Here, also, the patient's pleasure consisted in wearing a corset and other female garments (without any traces of contrary sexual instinct). The pain of tight lacing, experienced by himself or induced in women, is a delight to him, — sadistic-masochistic element. A case probably belonging here is one reported hy Diez (" Der Selbstmord," 1838, p. 24), where a young man could not resist the impulse to tear female linen. While tearing it, he always had ejaculation. A combination of fetichism with an impulse to destroy the fetich (in a certain sense, sadism with inanimate objects) seems to occur quite frequently (cf. case 99). An article of dress, which, though it has not really a private character, by its material and colour, as well as by the place where it is worn, might be suggestive of under- garments, and hence has sexual relations, is the apron (cf. also the metonymic use of the word " apron " for " petticoat " in the saying, " To chase every apron," etc.). This explains the following case : — Case 89. C, aged thirty-seven; of a badly tainted family ; of small mental endowment ; plagiocephalic. At fifteen his attention was attracted by an apron hung out to dry. He put it on and masturbated behind the fence. From that time he could not see aprons without repeating the act. If he met any one — no matter whether man or woman — with an apron on, he was compelled to run after the person. In order to free him from this constant steal- ing of aprons, he was sent as a marine in his sixteenth year. In this calling he saw no aprons, and had continual rest. When, at nineteen, he returned home, he was again compelled to steal aprons, and, as a result, got into serious complications, and was several times locked up. He sought to free himself of his weakness by a sojourn of several years with the Trappists. When he left them, he 16 242 PSTCHOPATHIA SEXUALIS. was just as bad as before. As a result of a new theft, he underwent a medico-legal examination, and was committed to an asylum. He never stole anything but aprons. It was a pleasure to him to revel in the memory of the first apron he ever stole. His dreams were filled with aprons. He occasionally used the memory of his thefts to make coitus possible, or for masturbation {Charcot - Magnan, "Arch, de neurolog.," 1882, No. 12). In a case reported by Lombroso ("Amori anomali pre- coci nei pazzi," "Arch, di psich.," 1883, p. 17), analogous to those of this series, a boy of very bad heredity, at the age of four, had erections and great sexual excitement at the sight of white garments, particularly underclothing. He was lustfully excited by handling and crumpling them. At the age of ten he began to masturbate at the sight of white, starched linen. He seems to have been affected with moral insanity, and was executed for murder. The following case of petticoat-fetichism is coupled with peculiar circumstances : — Case 90. Z., aged thirty-five; civil servant; the only child of a nervous mother and a healthy father. From childhood he was " nervous," and at the consul- tation his neuropathic eyes, delicate, slender body, fine features, very thin voice, and sparse growth of beard attracted attention. The patient presents nothing ab- normal except symptoms of slight neurasthenia. Genitals and sexual functions normal. Patient states that he has only masturbated four or five times when he was very young. As early as at the age of thirteen, the patient was powerfully excited sexually by the sight of wet female dresses, while the same dresses, when dry, had no effect upon him. His greatest delight was to look at women with wet garments in the rain. If he met a woman having a pleasing face under such circumstances, he experienced an intense feehng of lustful pleasure, had erection and felt FETICHISM. 243 impelled to perform coitus. He states that he has never had any desire to steal wet female dresses or to throw water on women. He can gi\e no explanation of the origin of his peculiarity. It is possible that, in this case, the sexual instinct was first awakened by the sight of a woman as she exposed her charms by raising her skirts in wet weather. The obscure instinct, not yet conscious of its object, then became directed to the wet garments, as in other cases. Lovers of female handkerchiefs are frequent, and, there- fore, important forensically. As to the frequency of handkerchief- fetichism, it may be remarked that the handkerchief is the one article of feminine attire which, outside of intimate association, is most frequently dis- played, and which, with its warmth from the person and specific odours, may by accident fall into the hands of others. The frequency of early association of lustful feelings with the idea of a handkerchief, which may always be presumed to have occurred in such cases of fetichism, probably is due to this. Case 91 . A baker's assistant, aged thirty-two, single, previously of good repute, was discovered stealing a hand- kerchief from a lady. In sincere remorse, he confessed that he had stolen from eighty to ninety such handker- chiefs. He had cared only for handkerchiefs, and, indeed, only for those belonging to young women attractive to him. In his outward appearance the culprit presents nothing peculiar. He dresses himself with much taste. liis con- duct is peculiar, anxious, depressed and unmanly, and he often lapses into whining and tears. Lack of self-reliance, weakness of comprehension, and slowness of perception and reflection are noticeable. One of his sisters is epilep- tic. He lives in good circumstances ; never had a severe illness ; is well developed. In relating his history, he shows 244 PSTCHOPATHIA SEXUALIS. weakness of memory and lack of clearness ; calculation is hard for him, though when young he learned and compre- hended easily. His anxious, uncertain state of mind gives rise to a suspicion of onanism. The culprit confessed that he had been given to this practice excessively since his nineteenth year. For some years, as a result of his vice, he had suffered with depression, lassitude, trembhng of the hmbs, pain in the back, and disinchnation for work. Fre- quently a depressed, anxious state of mind came over him, in which he avoided people. He had exaggerated, fantas- tic notions about the results of sexual intercourse with women, and could not bring himself to indulge in it. Of late, however, he had thought of marriage. With great remorse and in a weak-minded way, X. now confessed that six months ago, while in a crowd, he became violently excited sexually at the sight of a pretty young girl, and was compelled to crowd up against her. He felt an impulse to compensate himself for the want of a more complete satisfaction of his sexual excitement, by stealing her handkerchief. Thereafter, as soon as he came near attractive females, with violent sexual excitement, pal- pitation of the heart, erection and impetus coeundi, the impulse would seize him to crowd up against them and faute de mieux, steal their handkerchiefs. Althoagh the consciousness of his criminal act never left him for a moment, he was unable to resist the impulse. During the act he was uneasy, which was in part due to his inordinate sexual impulse, and partly to the fear of detection. The medico-legal opinion rightly gave weight to the congenital mental enfeeblement and the pernicious influence of masturbation, and referred the abnormal impulses to a perverse sexual impulse, cahing attention to the presence of an interesting and well-known physiological con- nection between the olfactory and sexual senses. The inability to resist the pathological impulse was recognised. X. was not punished {Zijype, "Wiener Med. Wochen- schrift," 1879, No. 23). FETICIIISM. 245 I am indebted to the kindness of Dr. Fritsch, of Vienna, for further facts concerning this handerchief- fetichist, who was again arrested in August, 1890, in the act of taking a handkerchief from a lady's pocket : — On searching his house, 446 ladies' handkerchiefs were found. He stated that he had already burned two bundles of them. In the course of the examination, it was further shown that X. had been punished with im- prisonment for fourteen days in 1883 for stealing twenty- seven handkerchiefs, and again with imprisonment for three weeks in 1886. for a similar crime. Concerning his relatives, nothing more could be learned than that his father was subject to congestions and that a brother's daughter was an imbecile and constitutionally neuro- pathic. X. had married in 1879, and embarked in an independent business, and in 1881 he made an assign- ment. Soon after that his wife, who could not live with him, and with whom he did not perform his marital duty (denied by X.), demanded a divorce. Thereafter he lived as assistant baker to his brother. He complained bitterly of an impulse for ladies' handkerchiefs, but when opportunity offered, unfortunatel}', he could not resist it. In the act he experienced a feeling of delight, and felt as if some one were forcing him to it. Sometimes he could restrain himself, but when the lady was pleasing to him he yielded to the first impulse. He would be wet with sweat, partly from fear of detection, and partly on account of the impulse to perform the act. He says he has been sexually excited by the sight of handkerchiefs belonging to women since puberty. He cannot recall the exact cir- cumstances of this fetichistic association. The sexual excitement occasioned by the sight of a lady with a handkerchief hanging out of her pocket had constantly increased. This had repeatedly caused erection, but never ejaculation. After his twenty-first year, he says, he had inclination to normal sexual indulgence, and had coitus 246 PSYCHOrATIIIA SEXUALIS. without difficulty without ideas of handkerchiefs. With increasing fetichism, the appropriation of handkerchiefs had afforded him much more satisfaction than coitus. The appropriation of the handkerchief of a lady attractive to him was the same to him as intercourse with her would have been. In the act he had true orgasm. If he could not gain possession of the handkerchief he desired, he would become painfully excited, tremble and sweat all over. He kept separate the handkerchiefs of ladies particularly pleasing to him, and revelled in the sight of them, taking great pleasure in it. The odour of them also gave him great delight, though he states that it was really the odour pecuhar to the linen, and not the perfume, which excited him sensually. He had masturbated but very seldom. X. complained of no physical ailments except occa- sional headache and vertigo. He greatly regretted his misfortune, his abnormal impulse,— the evil spirit that impelled him to such criminal acts. He had but one wish : that some one might help him. Objectively there are mild neurasthenic symptoms, anomalies of the distri- bution of blood, and unequal pupils. It was proved that X.had committed his crimes in obedience to an abnormal, irresistible impulse. Pardon. Such cases of handkerchief-fetichism, where an abnor- mal individual is driven to theft, are very numerous. They also occur in combination with inverted sexuality, as is proved by the following case, which I borrow from page 162 of Dr. Moll's frequently cited work : — ^ ^ On page 161 (op. cit.) Dr. Moll writes concerning this impulse in hotero-sexual individuals : " The passion for handkerchiefs may go so far that the man is entirely under their control. A woman tells me : ' I know , a certain gentleman, and when I see him at a distance I only need to draw .out my handkerchief so that it peeps out of my pocket, and I am certain that he will follow me as a dog follows its master. Go where I please, this • gentleman will follow me. He may be riding in a carriage or engaged in FETICHISM. 247 Case 92. Handkerchief -fcUchism in a case of contrary sexual instinct. K., aged thirty-eight ; mechanic ; a power- fully built man. He makes numerous complaints, — weakness of the legs, pain in the back, headache, want of pleasure in work, etc. The complaints give the decided impression of neurasthenia with tendency to hypochondria. Only after the patient had been under Dr. Moll's treatment for several months did he state that he was also abnormal sexually. K. had never had any inclination whatever for women ; but handsome men, on the other hand, had a peculiar charm for him. Patient had masturbated frequently until he came to Dr. Moll. He had never practised mutual onanism or pederasty. He did not think that he would have found satisfaction in this, because, in spite of his preference for men, an article of white linen was his chief charm, though the beauty of its owner played a role. The handkerchiefs of handsome men particularly excite him sexually. His greatest delight is to masturbate in men's handkerchiefs. For this reason he often took his friends' handkerchiefs. In order to save himself from detection, he always left one of his own handkerchiefs with his friends in place of the one he stole. In this way he sought to escape the suspicion of theft, by creating the appearance of a mistake. Other articles of men's linen also excited K. sexually, but not to the extent that handkerchiefs did. K. had often performed coitus with women, having erection and ejaculation, but without lustful pleasure. There was also nothing which could stimulate the patient to the performance of coitus. Erection and ejaculation occurred only when, during the act, he thought of a man's handkerchief ; and this was easier for the patient when he took a friend's handkerchief with him and had it in his hand during coitus. In accordance with his sexual per- importaat business, and yet, when he sees my handkerchief ho drops every- thing in order to follow me, — i.e., my handkerchief.' " 248 PSYCHOPATHIA SEXUALIS. version, in his nightly pollutions with lustful ideas, men's linen played the principal role} Still far more frequent than the fetichism of linen gar- ments is that of loomens shoes. These cases are, in fact, almost innumerable, and a great many of them have been scientifically studied ; but I have but a few reports at third hand of the similar glove-fetichism ; not to speak of case 101 {vide infra), in which glove-fetichism develops itself merely into " stuff-fetichism ". (Concerning the reason for the relative infrequency of glove-fetichism, vide p. 219.) In shoe-fetichism the close relationship of the object to the feminine person, which explains linen-fetichism, is absolutely wanting. For this reason, and because there is a large number of well-observed cases at hand, in which the feiichistic enthusiasm for the female shoe or boot consciously and undoubtedly arises from masochistic ideas, an origin of a masochistic nature, even when it is con- cealed, may always be assumed in shoe-fetichism when, in the concrete case, no other manner of origin is demon- strable. For this reason the majority of the cases of shoe- or foot-fetichism have been given under "Maso- chism ". There the constant masochistic character of this form of erotic fetichism has been sufficiently de- monstrated by means of transitional conditions. This presumption of the masochistic character of shoe-fetichism is weakened and removed only where another accidental cause for an association between sexual excitation and the 1 Another case of temporary, i.e., periodical handlierchief-fetichism, accompanied by anxiety and severe sweating, is related by Dr. Moll in the " Centralblatt f. d. Krankheiten der Harn- und Sexual-organe," v., 8. This might be a case of latent epilepsy. (Trauma capitis at the age of ten, imbecility, repeated fainting fits, later on partial amnesia for fetichistic conditions, accompanied by anxiety and sweating, etc.) In these attacks of morbid impulse to steal ladies' handkerchiefs, which set in after an attack of typhus at the age of thirty, the patient would wipe his face with the stolen article, which act produced erection, and at times also ejaculation. A physician whom he consulted had given him the advice never to wear linen shirts again, as his peculiar impulse was caused by them. FETICHISM. 249 idea of women's shoes — the occurrence of which is quite improbable a priori — is capable of proof. In the two following cases, however, there is such a demonstrable connection : — Case 93. Shoe-fetichism. Mr. v. P., of an old and honourable family, Pole, aged thirty-two, consulted me, in 1890, on account of " unnaturalness " of his vita sexualis. He gave the assurance that he came of a perfectly healtby family. He had been nervous from childhood, and had suffered with chorea minor at the age of eleven. For ten years he had suffered with sleeplessness and various neu- rasthenic ailments. From his fifteenth year he had recog- nised the difference of the sexes and been capable of sexual excitation. At the age of seventeen he had been seduced by a French governess, but coitus was not per- mitted ; so that intense mutual sexual excitement (mutual masturbation) was all that was possible. In this situation his attention was attracted by her very elegant boots. They made a very deep impression. His intercourse with this lewd person lasted four months. During this associa- tion her shoes became a fetich for the unfortunate boy. He began to have an interest in ladies' shoes in general, and actually went about trying to catch sight of ladies wearing pretty boots. The shoe-fetichism gained great power over his mind. He had the governess touch his penis with her shoes, and thus ejaculation with great lust- ful feeling was immediately induced. After separation from the governess he went to puellas, whom he made perform the same manipulation. This was usually suffi- cient for satisfaction. Only seldom did he resort to coitus as an auxiliary, and inclination for it grew less and less. His vita sexualis consisted of dream-pollutions, in which women's shoes played the exclusive role; and of gratifica- tion with women's shoes appositos ad mentulam, but this had to be done by the puella. In the society of the opposite sex the only thing that interested him was the 250 PSYCIIOPATHIA SEXUALIS. shoe, and that only wlien it was elegant, of the French style, with heels, and of a brilliant black, like the orignial. In the course of time the following conditions became accessory : a prostitute's shoe that is elegant and chic ; starched petticoats, and black hose, if possible. Nothing else in woman interests him. He is absolutely indifferent to the naked foot. Women have not the shghtest psychic charm for him. He had never had masochistic desires in the sense of being trod upon. In the course of years his fetichism had gained such power over him that when he saw a lady in the street, of a certain appearance and with certain shoes, he was so intensely excited that he had to masturbate. Slight pressure on the penis sufficed to induce ejaculation in this state of severe neurasthenia. Shoes displayed in shops, and, of late, even advertise- ments of shoes, sufficed to excite him intensely. In states of intense libido he made use of onanism if shoes were not at his immediate command. The patient quite early recognised the pain and danger of his condition, and, even when he was free from neurasthenic ailments, he was morally very much depressed. He sought help of various physicians. Cold-water cures and hypnotism were unsuccessful. The most celebrated physicians advised him to marry, and assured him that, as soon as he once really loved a girl, he would be free from his fetichism. The patient had no confidence in his future, but he followed the advice of the physicians. He was cruelly disappointed in the hope which the authority of the phy- sicians had aroused in hnu, though he led to the altar a lady distinguished by both mental and physical charms. The wedding-night was terrible ; he felt like a criminal, and did not approach his wife. The next day he saw a prostitute with the required chic. He was weak enough to have intercourse with her in his way. Then he bought a pair of elegant ladies' boots and hid them in bed, and, by touching them, while in marital embrace, after a few days, he was able to perform his marital duty. He ejacu- FETICHISM. 251 lated tardily, for he had to force himself to coitus; and after a few weeks this artifice failed, because his imagina- tion failed. He felt unspeakably miserable, and would have preferred to make an end of himself. He could no longer satisfy his wife, who was sensual, and much excited by their previous intercourse ; and he saw her suffering severely, both mentally and morally. He could not, and would not, disclose his secret. He experienced disgust in marital intercourse ; he felt afraid of his wife, and feared the coming of night and being alone with her. He could no longer induce erection. He again made attempts with prostitutes, and satisfied himself by touching their shoes. Then the pnclla had to touch his penis, when he would have ejaculation ; but, if this did not take place, he would attempt coitus with the lewd woman ; without success, however, for ejacula- tion would occur immediately. In absolute despair, the patient comes for consultation. He deeply regrets that, against his inner conviction, he had followed the un- fortunate advice of the physicians, and made a virtuous wife unhappy, having deeply injured her, both mentally and morally. Could he answer God for continuing such a marriage ? Even if he were to discover himself to his wife, and she were to do everything for him, it would not lielp him ; for the familiar perfume of the demi-monde was also necessary. Aside from his mental pain, this unfortunate man presented no remarkable symptoms. Genitals perfectly normal. Prostate somewhat enlarged. He complained that he was so under the domination of his boot-ideas that he would even blush when boots were talked about. His whole imagination was given up to such ideas. When he was on his estate, he often suddenly had to go a distance of ten miles to the city, to satisfy his fetichism at shoe-shops or with pucllis. This pitiable man could not bring himself to take treatment ; for his faith in physicians had Ijecn greatly 252 PSTCHOPATHTA SEXUALIS. shaken. An attempt to ascertain whether hypnosis and a removal of the fetichistic association by this means, were possible, proved abortive on account of the mental excitement of the unfortunate man,, who was exclusively controlled by the thought that he had made his wife un- happy. Case 94. X., aged twenty-four, from a badly tainted family (mother's brother and grandfather insane, one sister epileptic, another sister subject to migraine, parents of excitable temperament). During dentition he had con- vulsions. At the age of seven he was taught to mastur- bate by a servant-girl. X. first experienced pleasure in these manipulations cum ilia pttella for hiito pede calceolo tecto penem tetigit. Thus, in the predisposed boy, an association was established, as a result of which, from that time on, merely the sight of women's shoes, and, finally, merely the idea of them, sufficed to induce sexual excitement and erection. He now masturbated while looking at women's shoes, or while calling them up in imagination. The shoes of the schoolmistress excited him intensely, and in general he was affected by shoes that were partly con- cealed by female garments. One day he could not keep from grasping the teacher's shoes — an act that caused him great sexual excitement. In spite of punishment he could not keep from performmg this act repeatedly. Finally, it was recognised that there must be an abnormal motive in play, and he was sent to a male teacher. He then revelled in the memory of shoe-scenes with his former school-mistress, and thus had erections, orgasm, and, after his fourteenth year, ejaculation. At the same time, lie masturbated while thinking of a woman's shoe. One day the thought came to him to increase his pleasure by using such a shoe for masturbation. Thereafter he frequently took shoes secretly, and used them for that purpose. Nothing else in a woman could excite him ; the thought of coitus filled him with horror. Men did not interest PETICHISM. 253 him in any way. At the age of eighteen he opened a shop, and, among other things, dealt in ladies' shoes. He was excited sexually by fitting shoes for his female patrons, or by manipulating shoes that they had work. One day while doing this he had an epileptic attack, and, soon after, another while practising onanism in his customary way. Then he recognised for the first time the injury to health caused by his sexual practices. He tried to overcome his onanism, sold no more shoes, and strove to free himself from the abnormal association be- tween women's shoes and the sexual function. Then fre- quent pollutions, with erotic dreams about shoes, occurred, and the epileptic attacks continued. Though devoid of the slightest feeling for the female sex, he determined on marriage, which seemed to him to be the only remedy. He married a pretty young lady. In spite of lively erections when he thought of his wife's shoes, in attempts at cohabitation he was absolutely impotent, because his distaste for coitus and for close intercourse in general was far more powerful than the influence of the shoe-idea, which induced sexual excitement. On account of his im- potence, the patient applied to Dr. Hammond, who treated his epilepsy with bromides, and advised him to hang a shoe up over his bed, and look at it fixedly during coitus, at the same time imagining his wife to be a shoe. The patient became free from epileptic attacks, and potent so that he could have coitus about once a week. His sexual excitation by women's shoes also grew less and less {Hammond, " Sexual Impotence "). These two cases of shoe-fetichism,^ which apparently depend upon subjective accidental associations, as is the ' other cases of shoe-fetichism without distinct relations to masochism are given by Alzheimer, " A Congenital Criminal," " Archiv f. Psychiatric u. Nerven Krankheiten," Bd. 28, p. 350. This same case was declared by Rurella, " Fetischismus oder Simulation," ibid., Bd. 28, p. 964, to be simulation ; but the reasons given are trivial and easily refuted. Vide also Moll, " Untersuchungen iiber libido sexualis," case 32. 254 PSTCHOPATHIA SEXUALIS. case in fetichism generally, do not offer anything startling with reference to their objective cause, because, in the former case, it is only a matter of partial impression of the general appearance of woman, and in the latter, a partial impression of the exciting manipulation. But there are cases — up till now only two have been closely observed — in which the determining association has decidedly not been brought about by any connection of the nature of the object with the otherwise normally exciting fcause. Case 95. L., aged thirty-seven, clerk, from tainted family, had his first erection at five years, when he saw his bed-fellow — an aged relative — put on his night-cap. The same thing occurred later, when he saw an old servant put on her night-cap. Later, simply the idea of an old, uj^ly woman's head, covered with a night-cap, was sufficient to cause an erection. The sight of a cap or of a naked woman or man only made no impression, but the mere touch of a night-cap induced erection, and sometimes even ejaculation. L. was not a masturbator, and had never been sexually active until his thirty-second year, when he mar- ried a young girl with whom he had fallen in love. On his marriage-uight he remained cold until, from necessity, he brought to his aid the memory-picture of an ugly woman's head with a ni^ht-cap. Coitus was immediately successful. Thereafter it was always necessary for him to use this means. Since childhood he had been subject to occasional attacks of depression, with tendency to suicide, and now and then to frightful hallucinations at night. When looking out of a window, he became dizzy and anxious. He was a perverse, peculiar, and easily embar- rassed man, of bad mental constitution {Charcot- Magnan, "Arch, de neurol.," 1882, No. 12). In this very peculiar case, the siojultaneous coin- cidence of the first sexual citation and an absolutely FETICHISM. 255 heterogeneous impression seems to have determined tiie association. Hammond {op. cit.) also mentions a case of accidental associative fetichism that is quite as peculiar. A married man, aged thirty, who, in other respects, was healthy, physically and mentally, is said to have suddenly lost his sexual power after moving to another house, and to have regained it as soon as the furniture of the sleeping-room had been arranged as it was before. (c) The Fetich is Some Special Material. There is a third principal group of fetichists who have as a fetich neither a portion of the female body nor a part of female attire, but some particular material which is so used, not because it is a material for female garments, but because in itself it can arouse or increase sexual feelings. Such materials are furs, velvets and silks. These cases differ from the foregoing instances of erotic dress-fetichism, in this, that these materials, unlike female linen, do not have any close relation to the female body ; and, unlike shoes and gloves, they are not related to cer- tain parts of the person which have peculiar symbolic sig- nificance. Moreover, this fetichism cannot be due to an accidental association, like that in the cases of the night- caps and the arrangement of the sleeping-room ; for these cases form an entire group having the same object. It must be presumed that certain tactile sensations (a kind of tickhng irritation which stands in some distant relation to lustful sensations ?), in hypersesthetic individuals, fur- nish the occasion for the origin of this fetichism. The following is a personal observation of a man affected with this peculiar fetichism : — Case 96. N. N., aged thirty-seven ; of a neuropathic family ; neuropathic constitution. He makes the follow- ing statement : " From luy earliest youth I have always 256 PSYCHOPATHIA SEXUALIS. had a deeply rooted partiality for furs and velvets, in so far that these materials cause me sexual excitement, and the sight and touch of them give me lustful pleasure. I can recall no event that caused this peculiarity (such as the simultaneous occurrence of the first sexual excitation and an impression of these materials, — i.e., first excitation by a woman dressed in them) ; in fact, I cannot remember when this enthusiasm began. However, by this I would not exclude the jossibility of such an event, — of an acci- dental connection in a first impression and consequent association ; but 1 think it very improbable that such a thing took place, because I believe such an occurrence would have deeply impressed me. All I know is, that even when a small child I had a lively desire to see and stroke furs, and thus had an obscure sexual pleasure. With the first occurrence of definite sexual ideas, — i.e., the direction of sexual thoughts to woman, — the peculiar pre- ference for women dressed in such materials was present. Since then, up to mature manhood, it has remained un- changed, A woman wearing furs or velvet, or, even better, both, excites me much more quickly and intensely than one devoid of these auxiliaries. To be sure, these materials are not a conditio sine qua non of excitation ; the desire occurs also without them in response to the usual stimuli ; but the sight and, particularly, the touch of these fetich- materials form for me a powerful aid to other normal stimuli and intensify erotic pleasure. Often merely the sight of only a passably pretty girl dressed in these materials causes me vivid excitement, and overcomes me completely. Even the sight of my fetich-materials gives me pleasure, but the touch of them much more. (To the penetrating odour of furs I am indifferent — rather, it is unpleasant — and it is endurable only by reason of the association with pleasing visual and tactile impressions.) I have an intense longing to touch these materials while on a woman's person, to stroke and kiss them, and bury my face in them. My greatest pleasure is, FETICHISM. 257 inter actum, to see and feel my fetich on the woman's shoulder. " Fur, or velvet alone, exerts on me the effect described, the former much more intensely than the latter. The combination of the two has the most intense effect. Again, female garments made of velvet and fur, seen and touched without the wearer, cause me sexual excitement ; indeed, though to a less extent, the same effect is exerted by furs or robes having no relation to female attire, and also by the velvet and plush of furniture and drapery. Merely pictures of costumes of furs and velvet are objects of erotic interest to me ; indeed, the very word " fur " has a magic charm, and immediately calls up erotic ideas. " Fur is such an object of sexual interest to me that a man wearing fur that is effective {v. infra) makes a very unpleasant, repugnant, and disgusting impression on me, such as would be made on a normal person by a man in the costume and attitude of a ballet-dancer. Similarly repugnant to me is the sight of an old or ugly woman clad in beautiful furs, because contradicting feelings are thus aroused. " This erotic delight in furs and velvet is something entirely different from simple aesthetic pleasure. I have a very lively appreciation of beautiful female attire, and, at the same time, a particular partiahty for point-lace ; but this is purely of an aesthetic nature. A woman dressed in a point-lace toilette (or in other elegant, elaborate attire) is more beautiful than another ; but one dressed in my fetich- material is more charming. " Furs, however, exercise on me the effect described only when the fur has very thick, fine, smooth and rather long hair, that stands out like that of the so-called bearded furs. I have noticed that the effect depends upon this. I am entirely indifferent not only to the ordinary, coarse, bushy furs, but also to those that are commonly regarded as beautiful and precious, from which the long hair has been removed (seal, beaver), or of which the hair is natu- 17 268 PSYCHOPATHIA SEXUALIS. rally short (ermine) ; and likewise to those of which the hair is overlong and lies down (monkey, bear). The speci- fic effect is exerted only by the standing long hair of the sable, marten, skunk, etc. Now, velvet is made of thick, fine, standing hairs (fibres) ; and its effect may be due to this. The effect seems to depend upon a very definite im- pression of the points of thick, fine hair upon the terminals of the sensory nerves. " But how this pecuhar impression on the tactile nerves is related to sexual instinct is a perfect enigma to me. The fact is, that this is the case with many men. I would also state expressly that beautiful female hair pleases me, but plays no more important part than the other charms ; and that while touching fur I have no thought of female hair (the tactile sensation, also, has not the least resemblance to that imparted by female hair). There is never associa- tion of any other idea. Fur, per se, arouses sensuahty in me, — how, I cannot explain. " The mere aesthetic effect, the beauty of costly furs, to which every one is more or less susceptible, and which, since Eaphael's Fornarina and Eeuben's Helene Four- ment, has been used as the foil and frame of female beauty by innumerable painters ; which also plays so important a role in fashion,— the art and science of female dress,— this esthetic effect, as has been remarked, explains nothing here. Beautiful furs have the same aesthetic effect on me as on normal individuals, and affect me in the same way that flowers, ribbons, precious stones, and other orna- ments affect every one. Such things, when skilfully used enhance female beauty, and thus, under certain circum- stances, may have an indirect sensual effect. They never have a direct, powerful,, sensual effect on me, as do the fetich-materials mentioned. " Though in me, and, in fact, in all ' fetichists,' the sensual and aesthetic effect must be strictly differentiated, nevertheless, that does not prevent me from demanding in my fetich a whole series of isesthetic qualities in form, style, FETICHISM. 259 colour, etc. I could give a very lengthy description of these qualities that my taste demands ; but I omit it as not being essential to the real subject in hand. I would only call attention to the fact that erotic fetichism is compH- eated v^ith purely aesthetic tastes. " The specific erotic effect of my fetich-materials can be explained no better by the association with the idea of the person of the female wearing them, than by their gesthetic impression. For, in the first place, as has been said, these materials, as such, affect me when entirely isolated from the body ; and, in the second place, articles of clothing of a much more private nature, and which undoubtedly call up associations, exert a much weaker influence over me. Thus the fetich-materials have an independent sensual value for me. Why, is an enigma to me. " Feathers in women's hats, fans, etc., have the same erotic fetichistic effect on me as furs and velvet (similar tactile sensation of airy, peculiar tickling). Finally, the fetichistic effect, with much less intensity, is exerted by other smooth materials (satin and silk) ; but rough goods (cloth, flannel) have a repelling effect. " In conclusion, I will mention that somewhere I read an article by Carl Vogt on microcephalic men, according to which these creatures, at the sight of furs, rushed for them and stroked theni with every manifestation of de- light. I am far from any thought, on this ground, to see in widespread fur-fetichism an atavistic retrogression to the taste of our hairy ancestors. Every cretin, with that simplicity belonging to his condition, touches anything that pleases him, and the act is not necessarily of a sexual nature ; just as many normal men like to stroke a cat and the like, or even velvet and furs, and are not thus excited sexually." In the literature of this subject, there are a few cases belonging here ; — 260 PSYCnOPATHIA SEXUALIS. Case 97. A boy, aged twelve, became powerfully excited sexually, when, by chance, he covered himself with a fox-skin. From that time on there was mastur- bation with the employment of furs, or by means of taking a furry dog to bed. Ejaculation would result, sometimes followed by a hysterical attack. His nocturnal pollutions were induced by dreaming that he lay entirely covered up in a soft skin. He was absolutely insuscep- tible to stimuli coming from men or women. He was neurasthenic, suffered with delusions of being watched, and thought that every one noticed his sexual anomaly. He had tadium vitcn on account of this, and finally became insane. He had marked taint ; his genitals were imperfectly formed, and he presented other signs of degeneration {Tarnowshij, op. cit., p. 22). Case 98. C. is an especial lover of velvet. He is attracted in a normal way by beautiful women, but it particularly excites him to have the person with whom he has sexual intercourse dressed in velvet. In this, it is remarkable that it is not so much the sight as the touch of the velvet that causes the excitation. C. told me that stroking a woman's velvet jacket would excite him sexually to an extent scarcely possible in any other way (Dr. Moll, op. cit., p. 127). A physician communicated to me the following case : — In a brothel a man was known under the name of "Velvet". He would dress a sympathetic puella with a garment made of black velvet, and would excite and satisfy his sexual desires simply by stroking his face with a corner of her velvety dress, not touching any other part of the person at all. Another authority assures me that this weakness for FETICHISM. 261 furs, velvets and silU and feathers, is quite common among masochists (c/. cases 41 and 42).^ The following is a very peculiar case of material- fetichism. It is combined with the impulse to injure the fetich, which, in this case, represents an element of sadism toward the woman wearing the fetich, or impersonal sadism toward objects, which is of frequent occurrence in fetichists (cf. p. 241). This impulse to cause injury made this a remarkable criminal case : — Case 99. In July, 1891, Alfred Bachmann, aged twenty-five, locksmith, was brought before Judge N., in the second term of the criminal court, in Berlin. In April, 1891, the 'police had bad numerous complaints, according to which some evil hand had cut women's dresses with a very sharp instrument. In the evening of 25th April, they were successful in arresting the perpe- trator in the person of the accused. A policeman noticed how the accused pressed, in a remarkable manner, against a lady in the company of a gentleman, while they were going through a passage. The officer requested the lady to examine her dress, while he held the man under suspicion. It was ascertained that the dress had received quite a long sht. The accused was taken to the station, where he was examined. Besides a sharp knife, which he confessed he used for cutting dresses, two silk sashes, such as ladies wear on their dresses, were found on him ; he also confessed that he had taken these from dresses in crowds. Finally, the examination of his person brought to light a lady's silk neck-scarf. The accused said he had found this. Since his statement in this case could not be refuted, complaint was therefore made to rest on the result 1 In the novels of Sacher-Masoch, fur plays an imporUnt r6lc ; in fact, it serves as a title in some of them. The explanation given is that fur (ermin) is the symhol of sovereignty, and therefore the fetich of the men described in these novels, seems unsatisfactory and far-fetched. 262 PSTCHOPATHIA SEXUALIS. of the search ; in two instances in which complaint was made by the injured parties his acts were designated as injury to property, and in two other instances as theft. The accused, a man who had been often punished before, with a pale, expressionless face, before the judge, gave a strange explanation of his enigmatical action. A major's cook had once thrown him downstairs when he was begging of her, and since that time he had entertained great hatred of the whole female sex. There was a doubt about his responsibility, and he was therefore examined by a physician. The medical expert gave the opinion at the final trial that there was no reason to regard the accused as insane, though he was of low intelhgence. The culprit defended himself in a peculiar manner. An irresistible impulse forced him to approach women wear- ing silk dresses. TJie touch of silk material gave him a feeling of delight, and this went so far that, while in prison for examination, he had been excited if a silk thread happened to pass through his fingers while ravelhng rags. Judge Miiller considered the accused to be simply a dangerous, vicious man, who should be made harmless for a long time. He advised imprisonment for one year. The court sentenced him to six months' imprisonment, with loss of honour for a year. A classical case of material-fetichism (silk) is the following related by Dr. P. Gamier. Case 100. On 22nd September, 1881, V. was arrested in the streets of Paris whilst he interfered with the silk dress of a lady in a manner which aroused the suspicion of his being a pick-pocket. At first he was very much confused, but finally, after many vain excuses, made a clean confession of his " mania ". He was an assistant in a bookseller's shop, twenty-nine years of age ; his father was a drunkard and a rehgious zealot, his mother of ab- normal character. She wished to make a priest of him. FETICHISM. 203 Since his early youth he felt an instinctive impulse — con- genital as he behaves — to touch silk. When at the age of twelve as a choir boy he was allowed to wear a silk sash, he could not often enough finger it. He could not describe the pecuhar sensation which he experienced in doing so. Later on he became acquainted with a ten- year-old girl for whom he had a childish affection. When on Sundays he met this girl clad in a silk dress, he was impelled to lovingly put his arms around her and touch her silk dress. Later on he found exceeding great pleasure in gazing at the silk gowns exposed in a dressmaker's shop and to feel them. When they gave him remnants of silk material, he would hasten to put them next to his body, which act immedi- ately produced erection, orgasm and even ejaculation. These lustful desires made him uneasy, so that he doubted his vocation to the priesthood and obtained his discharge from the seminary. In consequence of habitual mastur- bation he was at that time very neurasthenic. His silk- fetichism swayed him as ever. Only when a woman wore a silk gown could she charm him. Even when a child, ladies with silk gowns played a prominent part in his dreams ; later on the latter were accompanied by pollutions. On account of his natural shyness he did not resort to coitus until later in life, and then he could only succeed in it with a woman dressed in silk. He much preferred to mix with crowds in the street and there touch the silk gowns of ladies, which always produced ejaculation accompanied by powerful orgasms and intense lustful feelings. What gratified him more than being with the prettiest woman was to put on a silk petticoat when going to bed. The forensic medical opinion declared him to be a heavily tainted subject who gave way to abnormal desires under the strain of morbid impulses. Pardon (Dr. Gamier, " Annales d'hygiene pubhque," 3" serie xxix., 5) 264 PSTCHOPATHIA SEXUALIS. The following case of kid-glove-feticMsm is peculiarly adapted to show the origin of fetichistic associations as well as the enormous influence permanently exercised by such an association, although itself based upon a psychico- physical and morbid predisposition. Case 101. Mr. Z., an American, thirty-three years of age, manufacturer, for eight years enjoying a happy married life, blessed with offspring ; consulted me for a peculiar troublesome glove-fetichism. He despised him- self on account of it, and said it brought him well-nigh to the verge of despair and even insanity. He claims to come of thoroughly sound parents, but since infancy has been neuropathic and very excitable. By nature is very sensual, whilst his wife is very frigid. At the age of nine, he was seduced by schoolmates to practise masturbation, which gratified him immensely, and he yielded to it with passion. One day when sexually excited he found a small bag of chamois skin. He stripped it over his membrum and experienced thereby great sensual pleasure. After that he used it for onanistic manipulations, put it around his scrotum and carried it about with him by day and night. This aroused in him an unusual interest for leather in general, but particularly for kid gloves. With puberty this centred entirely in ladies' kid gloves, which simply fascinated him. If he touched his penis with one such glove it produced erection andeven ejacula- tion. Men's gloves did not excite him in the least, although he loved to wear them. In consequence, nothing about woman attracted him but her kid gloves. These were his fetich. They must be long, with many buttons, and if worn out, dirty and saturated with perspiration on the finger-tips, they are preferable. Women wearing such, even if ngly and old, had a particular charm for him. Ladies with silk, or FETICHISM. 265 cotton gloves did not attract him. He always looked at her gloves first when meeting a lady. As for the rest he took very little interest in the female sex. When he could shake hands with a lady gloved with kid, the contact with the soft, warm leather would cause erection and orgasm in him. Whenever he could get hold of such a glove he would at once retire to a lavatory, wrap it around his genitals and masturbate. Later on when visiting brothels he would beg the 'pudla to put on long gloves provided by himself for that purpose, which act alone would excite him so much that ejaculation ensued forthwith. Z. become a collector of ladies' kid gloves. He would hide away hundreds of pairs in various places. These he would count and gloat over in his spare time, " as a miser would over his gold," place them over his genitals, bury his face in a pile of them, put one on his hand and then masturbate. This gave him more intense pleasure than coitus. He made covers for his penis of them, or suspensories, wearing them for days. He preferred black, soft leather. He would fasten ladies' kid gloves around his waist in such a fashion that they would, apron-like, hang down over his genitals. After marriage this fetichism grew worse. As a rule he was only virile when he put a pair of his wife's gloves during coitus by her head so that he could kiss them. The acme of pleasure was when he could persuade his wife to put on kid gloves and thus touch his genitals previous to cohabitation. Z. felt very unhappy on account of tliis fetichism, and made repeated but vain attempts to free himself of the curse. Whenever he came across the word, or the picture of a glove in novels, fashion-plates, advertisements, etc., he was simply fascinated. At the theatre his eyes were 266 PSYCHOPATIIIA SEXUALIS. riveted on the hands of the actresses. He could scarcely tear himself away from the show-windows of glove-dealers. He often would stuff long gloves with wool or some such material to make them resemble arms and hands. Then he would make tritus membri inter brachia talia arti- Hcialia, until he had achieved his object. It is his habit to take ladies' kid gloves to bed with him and wrap them around his penis until he can feel it like a large leathern priapus between his legs. In the larger towns he buys from the cleaners ladies' gloves which have not been called for, but prefers those most soiled and worn. Twice he admits to have yielded to the temptation to steal such gloves, although in every other respect he is absolutely correct. When in a crowd he must touch ladies' hands whenever possible. At his office he allows no opportunity to pass without shaking hands with ladies, in order to feel for " at least a second the soft, warm leather ". His wife must wear as much as possible kid gloves or such made of chamois, with which he provides her lavishly. At his office he always has ladies' gloves lying on his desk. Not an hour passes in which he does not touch and stroke them. When especially excited (sexually) he puts such a glove in his mouth and chews it. Other articles of the female toilet, likewise other parts of the female body besides the hand, do not attract him. Z. feels much depressed about this anomaly. He feels ashamed to look into the innocent eyes of his children, and prays God to protect them from this curse of their father. The object of fetichism may also be found in a thing which only by sheer accident stands in relation to the body of woman, as may be gathered from the following instance related by Moll. It proves, moreover, how by the merely accidental association of an apperception with a parallel sexual emotion — based, of course, upon a special psychic FETICHISM. 267 process — the object of such apperception may become a fetich which in its turn may some day disappear again. The theory of association in connection with original perverse manifestations (based on organo-psychical mo- tives) seems here quite acceptable. The same may be said of the data relating to masochism, and sadism. Case 102. B., thirty years of age, apparently un- tainted, refined and sensitive ; great lover of flowers ; likes to kiss them, but without any sensual motive or sensual excitement ; rather of natura frigida; did not before twenty- one practise onanism, and subsequently only at periods. When twenty-one he was introduced to a young lady who wore some large roses on her bosom. Ever since then large roses have dominated over his sexual feelings. He incessantly bought roses ; kissing them would produce erection. He took them to bed with him although he never touched his genitals with them. His pollutions henceforth were accompanied by dreams of roses. He would dream of roses of fairy-like beauty and, inhaling their fragrance, have ejaculation. He became secretly engaged to his "lady of roses," but the platonic relations grew colder, and when the engagement was broken off the rose-fetichism suddenly and permanently disappeared. It never returned, even when he became again engaged after a long spell of melancholia {A. Moll, " Centralb. f. d. Krankheiten der Harn- und Sexual-organe," v., 8). (d) Beast-fetichism. In close relation to stuft'-fetichism, certain cases must be considered in which beasts exercise an aphrodisical influence over human beings. One feels tempted to call it Zoophilia Erotica. This perversion seems to be rooted in a fetichism the object of which is the skin of the beast. 268 PSTCHOPATHIA SEXUALIS. The transmitting medium of this fetichism may, perhaps, be found in a peculiar idiosyncrasis of the tactile nerves which, by touching furs or animal skins, produces peculiar and lustful emotions (analogous to hair-, braid-, velvet- and silk-fetichism). This may, perhaps, also explain that peculiar hobby for cats and dogs at times met with in sexually perverted persons {vide pp. 255-260, especially case 97). The following case, coming under my personal observation, seems to favour this assumption. Case 103. Zoophilia erotica, fetichism. Mr. N. N., twenty-one years of age, comes from a neuropathically tainted family, and is himself congenitally neuropathic. Even as a child he often felt impelled to perform at times quite indifferent actions for fear of encountering some untoward event. He learned easily, never had a severe illness, had early a great love for domestic animals, especially dogs and cats, because when petting them he experienced lustful emotions. For years he indulged in this play with animals, which sensually stimulated him, although in an innocent fashion, as it were. When he arrived at the age of puberty he recognised the immorality of his acts and tried to free himself from the habit. He succeeded in this, but henceforth he was troubled in his dreams by such situations which produced pollutions. He then began onanism. At first he practised it by manipula- tion accompanied by the idea that he was petting and stroking animals. After some time he arrived at psychical onanism, produced by vividly imagining such situations, and accompanied by orgasm and ejaculation. This made him neurasthenic. He claims that sodomitic ideas never entered his mind, that the sexus bestiarum never influenced his fancies or actions, in fact he had given it no thought. He never had homosexual instinct ; but heterosexual desires were not foreign to him, though he had never HOMO-SEXUALITY. 269 indulged in coitus because of want of libido {ex masturba- tione et neurasthenia !) and from fear of infection. He is drawn only to women of lithe figure and with a proud gait. The usual symptoms of cerebro-spinal neurasthenia are present. Patient is of slight build and anaemic. He is greatly concerned to know whether his lost virility can be restored, as this would raise his waning self-esteem. Suggestions how to avoid psychic onanism, to remove neurasthenia, to strengthen the sexual centres, to satisfy the vita sexualis in the normal way as soon as this should be possible and successful. Ejjicrisis. No bestiality, but fetichism. Very likely the petting of domestic animals coupled with an abnormally premature vita sexualis coincided with a primary sexual emotion — probably originating from tactile sensations — and thus established an association between the two facts which by repetition became permanent (" Zeitschr. f. Psychiatrie," Bd, 50). II. Great Diminution or Complete Absence of Sexual Feeling for the Opposite Sex, with Substitution of Sexual Feeling and Instinct for the Same Sex (Homo- sexuality, or Antipathic Sexual Instinct). After the attainment of complete sexual development, among the most constant elements of self-consciousness in the individual are the knowledge of representing a definite sexual personality and the consciousness of desire, during the period of physiological activity of the reproductive organs (prodaction of semen and ova), to perform sexual acts corresponding with that sexual personality, — acts which, consciously or unconsciously, have a procreative purpose. The sexual instinct and desire, save for indistinct feelings and impulses, remain latent until the period of development of the sexual organs. The child is generis 270 PSYCHOPATHIA SEXUADIS. neutrius ; and though, during this latent period, — when sexuality has not yet risen into clear consciousness, is but virtually present, and unconnected with powerful organic sensations, — abnormally early excitation of the genitals may occur, either spontaneously or as a result of external influence, and find satisfaction in masturbation ; yet, notwithstanding this, the psychical relation to persons of the opposite sex is still absolutely wanting, and the sexual acts during this period exhibit more or less a reflex spinal character. The existence of innocence, or of sexual neutrality, is the more remarkable, since very early in education, employ- ment, dress, etc., the child undergoes a differentiation from children of the opposite sex. These impressions remain, however, devoid of psychical significance, becaulse they apparently are stripped of sexual meaning ; for the central organ {cortex) of sexual emotions and ideas is not yet capable of activity, owing to its undeveloped condition. With the inception of anatomical and functional development of the generative organs, and the differen- tiation of form belonging to each sex, which goes hand in hand with it (in the boy as well as in the girl), rudi- ments of a mental feeling corresponding with the sex are developed ; and in this, of course, education and external influences in general have a powerful effect upon the individual, who now begins to observe. If the sexual development is normal and undisturbed, a definite character, corresponding with the sex, is devel- oped. Certain well-defined inclinations and reactions in intercourse with persons of the opposite sex arise ; and it is psychologically worthy of note with what relative rapidity each individual psychical type corresponding with the sex is evolved. While modesty, for instance, during childhood, is essentially but an uncomprehended and incomprehensible exaction of education and imitation, expressed but im- perfectly in the innocence and naivete of the child; in HOMO- SEXUALITY. 271 the youth and maiden it becomes an imperative require- ment of self-respect ; and, if in any way it is offended, intense vaso - motor reaction (blushing) and psychical emotions are induced. If the original constitution is favourable and normal, and factors injurious to the psycho-sexua^l development exercise no adverse influence, then a psycho - sexual personality is developed which is so unchangeable and corresponds so completely and harmoniously with the sex of the individual in question, that subsequent loss of the generative organs (as by castration), or the climacterium or senility, cannot essentially alter it. This, however, must not be taken as a declaration that the castrated man or woman, the youth and the aged man, the maiden and the matron, the impotent and the potent man, do not differ essentially from each other in their psychical existence. An interesting and important question for what follows is, whether the peripheral influences of the generative glands (testes and ovaries), or central cerebral conditions, are the determining factors in psycho-sexual development. The fact that congenital deficiency of the generative glands, or removal of tbem before puberty, have a great influence on physical and psycho-sexual development, so that the latter is stunted and assumes a type more closely resembhng the opposite sex (eunuchs, certain viragoes, etc.), betokens their great importance in this respect. That the physical processes taking place in the genital organs are only co-operative, and not the exclusive factors, in the process of development of the psycho-sexual char- acter, is shown by the fact that, notwithstanding a normal anatomical and physiological state of these organs, a sexual instinct may be developed which is the exact opposite of that characteristic of the sex to which the individual belongs. In this case, the cause is to be sought only in an anom- aly of central conditions,— in an abnormal psycho-sexual 272 PSTCHOPATHIA SEXUALIS. constitution. This constitution, as far as its anatomical and functional foundation is concerned, is as yet unknown. Since, in nearly all such cases, the individual tainted with inverted sexual instinct displays a neuropathic predispo- sition in several directions, and the latter may be brought into relation with hereditary degenerate conditions, this anomaly of psycho-sexual feeling may be called, clinically, a functional sign of degeneration. This inverted sexuality appears spontaneously, without external cause, with the development of sexual life, as an individual manifestation of an abnormal form of the vita sexualis. having the force of a congenital phenomenon ; or it develops upon a sexuality the beginning of which was normal, as a result of very definite injurious influences, and thus appears as an acquired anomaly. Upon what conditions this enigmatical phenomenon of acquired homo-sexual instinct depends remains still unexplained, and is a mere matter of hypothesis. Careful examination of the so-called acquired cases makes it probable that the predisposition — also present here — consists of a latent homo-sexuality, or, at any rate, bi-sexuality, which, for its manifestation, requires the influence of accidental exciting causes to rouse it from its dormant state. In so-called antipathic sexual instinct there are degrees of the phenomenon which quite correspond with the degrees of predisposition of the individuals. Thus, in the milder cases, there is simple hermaphrodism ; in more pronounced cases, only homo-sexual feeling and instinct but limited to the vita sexualis ; in still more complete cases, the whole psychical personality, and even the bodily sensations^ are transformed so as to correspond with the sexual inversion; and, in the complete cases, the physical form is correspondingly altered. The following division of the various phenomena of this psycho-sexual anomaly is made, therefore, in accord- ance with these clinical tacts. HOMO-SEXUAL FEELING IN BOTH SEXES. 273 A. Homo-sexual Feeling as an Acquired Manifestation in Both Sexes. The determining factor here is the demonstration of perverse feeling for the same sex ; not the proof of sexual acts with the same sex. These two phenomena must not be confounded with each other ; perversity must not be taken ior perversion. Perverse sexual acts, without being dependent upon perversion, often come under observation. This is espe- cially true with reference to sexual acts between persons of the same sex, particularly in pederasty. Here pares- thesia sexualis is not necessarily at work ; but hyperses- thesia, with physical or psychical impossibility for natural sexual satisfaction. Thus we find homo - sexual intercourse in impotent masturbators or debauchees, or faute de mieux in sensual men and women under imprisonment, on ship-board, in garrisons, bagnios, boarding-schools, etc. There is an immediate return to normal sexual inter- course as soon as the obstacles to it are removed. Very frequently the cause of such temporary aberration is masturbation and its results in youthful individuals. Nothing is so prone to contaminate — under certain circumstances, even to exhaust — the source of all noble and ideal sentiments, which arise of themselves from a normally developing sexual instinct, as the practice of masturbation in early years. It despoils the unfolding bud of perfume and beauty, and leaves behind only the coarse, animal desire for sexual satisfaction. If an individual, thus depraved, reaches the age of maturity, there is wanting in him that gesthetic, ideal, pure and free impulse which draws the opposite sexes together. The glow of sensual sensibility wanes, and the inclination toward the opposite sex is weakened. This defect influences the morals, the character, fancy, feeling and instinct of the youthful masturbator, male or female, in an unfavourable manner, even causing, under certain 18 274 PSYCHOPATHIA SEXUALIS. circumstances, the desire for the opposite sex to sink to nil ; so that masturbation is preferred to the natural mode of satisfaction. Sometimes the development of the nobler sexual feelings toward the opposite sex suffers, on account of hypochondriacal fear of infection in sexual intercourse ; or on account of an actual infection ; or as a result of a faulty education which points out such dangers and exaggerates them. Again (especially m females), fear of the result of coitus (pregnancy), or abhorrence of men, by reason of physical or moral defects, may direct into perverse chan- nels an instinct that makes itself felt with abnormal intensity. On the other hand, premature and perverse sexual satisfaction injures not merely the mind, but also the body ; inasmuch as it induces neuroses of the sexual apparatus (irritable weakness of the centres governing erection and ejaculation; defective pleasurable feehng in coitus, etc.), while, at the same time, it maintains imagin- ation and libido in continuous excitement. Almost every masturbator at last reaches a point where, frightened on learning the results of the vice, or on ex- periencing them (neurasthenia), or led by example or seduction to the opposite sex, he wishes to free himself of the vice and re-instate his vita sexualis. The moral and mental conditions are here the most unfavourable possible. The pure glow of sexual feeling is destroyed ; the fire of sexual instinct is wanting, and self- confidence is lost ; for every masturbator is more or less timid and cowardly. If the youthful sinner at last comes to make an attempt at coitus, he is either disappointed because enjoyment is wanting, on account of defective sensual feeling, or he is lacking in the physical strength necessary to accomplish the act. The fiasco has a fatal effect, and leads to absolute psychical impotence. A bad conscience and the memory of past failures prevent suc- cess in any further attempts. The ever present libido sexualis, however, demands satisfaction, and this moral HOMO-SEXUAL FEELING IN BOTH SEXES. 275 and mental perversion separates further and further from woman. For various reasons, however (neurasthenic complaints, hypochondriacal fear of the results, etc.), the individual is also kept from masturbation. At times, under such cir- cumstances, bestiality is resorted to. Intercourse with the same sex is then near at hand, — as the result of seduction or of the feelings of friendship which, on the level of patho- logical sexuality, easily associate themselves with sexual feelings. Passive and mutual onanism now become the equiv- alent of the avoided act. If there is a seducer, — which, unfortunately often happens, — then the cultivated pederast is produced, — i.e., a man who performs quasi acts of onan- ism with persons of his own sex, and, at the same time, feels and prefers himself in an active role corresponding with his real sex ; who is mentally indifferent not only to persons of the opposite sex, but also to those of his own. Sexual aberration reaches this degree in the normally constituted, untainted, mentally healthy individual. No case has yet been demonstrated in which perversity has been transformed into perversion — i.e., into an inversion of the sexual instinct.^ 1 Gamier (" Anomalies Sexuelles," Paris, pp. 508, 509) reports two cases (cases 222 and 223) that are apparently opposed to this assumption, par. ticularly the first, in whicn despair about the unfaithfulness of a lover led the individual to submit to the seductions of men. But the case itself clearly shows that this individual never found pleasure in homo-sexual acts. In case 223, the individual was effeminated ab origine, or was at least a psychical hermaphrodite. Those who hold to the opinion that the origin of homo-sexual feelings and instinct is found to be exclusively in defective education and other psychological influences are entirely in error. An untainted male may be raised never so much like a female, and a female like a male, but they will not become homosexual. The natural disposition is the determining condition ; not education and other accidental circumstances, like seduction. There can be no thought of antipathic sexual instinct save when the person of the same sex exerts a psycho-sexual influ- ence over the individual, and thus brings about libido and orgasm, — i.e., has a psychical attraction. Those cases are quite different in which, faute 276 PSYCHOPATHIA SEXUALIS. With tainted individuals, the matter is quite different. The latent perverse sexuality is developed under the influ- ence of neurasthenia induced by masturbation, abstinence, or otherv/ise. Gradually, in contact with persons of the same sex, sexual excitation by them is induced. Eelated ideas are coloured v/ith lustful feelings, and awaken correspondinj^f desires. This decidedly degen^erate reaction is the begin- ning of a process of physical and mental transformation, a description of which is attempted in what follows, and which is one of the most interesting psychological phenomena that have been observed. This metamor- phosis presents different stages, or degrees. I. Degree : Simple Beversal of Sexual Feeling. This degree is attained when a person exercises an aphrodisiac effect over another person of the same sex who reciprocates the sexual feeling. Character and in- stinct, however, still correspond with the sex of the indi- vidual presenting the reversal of sexual feeling. He feels himself in the active role; he recognises his impulse toward his own sex as an aberration, and finally seeks aid. With episodical improvement of the neurosis, at first demieux, with great sensuality and a defective aesthetic sense, the body of a person of the same sex is used for an onanistic act (not for coitus in a psychical sense). In his excellent monograph, Moll shows very clearly and convincingly the importance of original predisposition in contrast with exciting causes (c/. op. cit., pp. 212-231). He knows " many cases where early sexual intercourse with men was not capable of inducing perversion ". Moll sig- nificantly says, further : " I know of such an epidemic (of mutual onanism) in a Berlin school, where a person who is now an actor shamelessly intro- duced mutual onanism. Though I now know the names of very many urnings in Berlin, yet I could not ascertain, even with anything like pro- bability, that among all the pupils of that school at that time there was one that had become an urning ; but, on the other hand, I have quite certain knowledge that many of those pupils are now normal sexually, in feeling and intercourse." HOMO-SEXUAL FEELING IN BOTH SEXES. 277 even normal sexual feelings may reappear and assert themselves. The following case seems well suited to exemplify this stage of the psycho-sexual degeneration : — Case 1 04. Acquired Antipathic Sexual Instinct. " I am an official, and, as far as I know, come of an untainted family. My father died of an acute disease; my mother, still living, is very nervous. A sister has been very intensely religious for some years. "I myself am tall, and, in speech, gait and manner, give a perfectly masculine impression. Measles is the only disease I have had ; but since my thirteenth year I have suffered with so-called nervous headaches. "My sexual life began in my thirteenth year, when I became acquainted with a boy somewhat older than myself, quocum alter altcrius genitalia tangendo delectabar. I had the first ejaculation in my fourteenth year. Seduced to onanism by two older school-mates, I practised it partly with others and partly alone ; in the latter case, however, always with the thought of persons of the female sex. My libido sexualis was very great, as it is to-day. Later, I tried to win a pretty, stout servant-girl who had very large mammce ; id solum assecutus sum, ut me pras- sente superiorem corporis sui partem enudaret mihique concederet os mammasque osculari, dum ipsa penem meum valde erectum in manum suam recepit eumque trivit. " Quamquam violentissime coitum rogarem hoc solum concessit, ut genitalia ejus tangerem. "After going to the university, I visited a brothel and succeeded without especial effort. "Then an event occurred which brought about a change in me. One evening I accompanied a friend home, and in a mild state of intoxication I grasped him ad genitalia. He made but slight opposition. I then went up to his room with him, acd we practised mutual masturbation. From that time we indulged in it quite 278 PSYCHOPATHIA SEXUALIS. frequently ; in fact, it came to immissio penis in os, with resultant ejaculations. But it is strange that I was not at all in love with this person, but passionately in love with another friend, near whom I never felt the slightest sexual excitement, and whom I never connected with sexual matters, even in thought. My visits to brothels, where I was gladly received, became more infrequent ; in my friend I found a substitute, and did not desire sexual intercourse with women. "We never practised pederasty, and that word was not even known between us. From the beginning of this relation with my friend, I again masturbated more fre- quently, and naturally the thought of females receded more and more into the background, and I thought more and more about young, handsome, strong men with the largest possible genitals. I preferred young fellows, from sixteen to twenty-five years old, without beards, but they had to be handsome and clean. Young labourers dressed in trousers of Manchester cloth or Enghsh leather, par- ticularly masons, especially excited me. " Persons in my own position had hardly any effect on me; but, at the sight of one of those strapping fellows of the lower class, I experienced marked sexual excitement. It seems to me that the touch of such trousers, the opening of them and the grasping of the penis, as well as kissing the fellow, would be the greatest dehght. My sensibility to female charms is somewhat dulled ; yet in sexual intercourse with a woman, particularly when she has well-developed mammae, I am always potent without the help of imagination. I have never attempted to make use of a young labourer, or the like, for the satisfaction of my evil desires, and never shall ; but I often feel a longing to do it. I often impress on myself the mental image of such a man, and then masturbate at home. "I am absolutely devoid of taste for female work. I rather like to move in female society, but dancing is repugnant to me. I have a lively interest in the fine arts. HOMO-SEXUAL FEELING IN BOTH SEXES. 279 That my sexual sense is partly reversed is, I believe, in part due to greater convenience, which keeps me from entering into a relation with a girl ; as the latter is a matter of too much trouble. To be constantly visiting houses of prostitution is, for aesthetic reasons, repugnant to me; and thus I am always returning to sohtary onanism, which is very difficult for me to avoid. " Hundreds of times I have said to myself that, in order to have a normal sexual sense, it would be neces- sary for me, first of all, to overcome my irresistible passion for onanism, — a practice so repugnant to my aesthetic feeling. Again and again I have resolved with all my mic^ht to fight this passion ; but I am still unsuccessful. When I felt the sexual impulse gaining strength, instead of seeking satisfaction in the natural manner, I preferred to masturbate, because I felt that I would thus have more enjoyment. " And yet experience has taught me that I am always potent with girls, and that, too, without trouble and with- out the vision of masculine genitals. In one case, how- ever, I did not attain ejaculation because the woman — it was in a brothel — was devoid of every charm. I cannot avoid the thought and severe self-accusation that, to a certain extent, my inverted sexuality is the result of excessive onanism ; and this especially depresses me, be- cause I am compelled to acknowledge that I scarcely feel strong enough to overcome this vice by the force of my own will. " As a result of my relations for years with a fellow- student and pal, mentioned in this communication — which, however, began while we were at the university, and after we had been friends for seven years — the im- pulse to unnatural satisfaction of libido has grown much stronger. I trust you will permit the description of an incident which worried me for months : — " In the summer of 1882, I made the acquaintance of a companion six years younger than myself, who, with 280 PSTCHOPATHIA SEXUALIS. several others, had been introduced to me and my ac- quaintances. I' very soon felt a deep interest in this handsome man, who was unusually well-proportioned, shm, and full of health. After a few weeks of associa- tion, this hking ripened into friendship, and at last into passionate love, with feelings of the most intense jealousy. I very soon noticed that in this love sexual excitation was also very marked ; and, notwithstanding my determina- tion, aside from all others, to keep myself in check in relation to this man, whom I respected so highly for his superior character, one night, after free indulgence in beer, as we were enjoying a bottle of champagne in my room, and drinking to good, true and lasting friendship, I yielded to the irresistible impulse to embrace him, etc. " When I saw him next day, I was so ashamed that I could not look him in the face. I felt the deepest regret for my action, and accused myself bitterly for having thus suUied this friendship, which was to be and remain so pure and precious. In order to prove to him that I had lost control of myself only momentarily, at the end of the semester I urged him to make an excursion with me ; and after some reluctance, the reason of which was only too clear to me, he consented. Several nights we slept in the same room without any attempt on my part to repeat my action. I wished to talk with him about the event of that night, but I could not bring myself to it ; even when, during the next semester, we were separated, I could not induce myself to write to him on the subject ; and when I visited him in March at X., it was the same. And yet I felt a great desire to clear up this dark point by an open statement. In October of the same year I was again in X., and this time found courage to speak without reserve ; indeed, I asked him why he had not resisted me. He answered that, in part, it was because he wished to please me, and, in part, owing to the fact that he was somewhat apathetic as a result of being a little intoxicated. I explained to him my condition, and HOMO-SEXUAL FEELING IN BOTH SEXES. 281 also gave him " Psychopathia Sexualis " to read, express- ing the hope that by the force of my own will I should become fully and lastingly master of my unnatural im- pulse. Since this confession, the relation between this friend and me has been the most delightful and happy possible ; there are the most friendly feelings on both sides, which are sincere and true ; and it is to be hoped that they will endure. " If I should not improve my abnormal condition, I am determined to put myself under your treatment ; the more because, after a careful study of your work, I can- not count myself as belonging to the category of so-called urnings ; and also because I have the firm conviction, or hope, at least, that a strong will, assisted and combined with skilful treatment, could transform me into a man of normal feeling." Case 105. lima S.,^ aged twenty-nine; single; mer- chant's daughter. She comes of a family having bad nervous taint. Father was a drinker and died by suicide, as also did the patient's brother and sister. A sistei suffers with convulsive hysteria. Mother's father shot himself while insane. Mother was sickly, and paralysed after apoplexy. The patient never had any severe illness. She is bright, enthusiastic and dreamy. Menses at the age of eighteen without difficulty ; but thereafter they were very irregular. At fourteen, chlorosis and catalepsy from fright. Later, hysteria gravis and an attack of hysterical insanity. At eighteen, relations with a young man which were not platonic. This man's love was pas- sionately returned. From statements of the patient, it seems that she was very sensual, and after separation from her lover practised masturbation. After this she led a romantic life. In order to earn a living, she put on male clothing, and became a tutor ; but she gave up ^ Cf. author's " Experimental Study in the Domain of Hypnotism," third edition, 1893. 282 PSYCHOPATHIA SEXUALIS. her place because her mistress, not knowing her sex, fell in lo\e with her and courted her. Then she became a railway-employee. In the company of her companions, in order to conceal her sex, she was compelled to visit brothels with them, and hear the most vulgar stories. This became so distasteful to her that she gave up her place, resumed the garments of a female, and again sought to earn her living. She was arrested for a theft, and on account of severe hystero-epilepsy was sent to the hos- pital. There inclination and impulse toward the same sex were discovered. The patient became troublesome on account of passionate love for female nurses and patients. Her sexual inversion was considered congenital. With regard to this, the patient made some interesting statements : — " I am judged incorrectly, if it is thought that I feel myself a man toward the female sex. In my whole thought and feeling I am much more a woman. Did I not love my cousin as only a woman can love a man ? " The change of my feeling originated in this, that, in Pesth, dressed as a man, I had an opportunity to observe my cousin. I saw that I was wholly deceived in him. That gave me terrible heart-pangs. I knew that I could never love another man ; that I belonged to those who love but once. Of similar effect was the fact that, in the society of my companions at the railway, I was compelled to hear the most offensive language and visit the most disreput- able houses. As a result of the insight into men's motives, gained in this way, I took an unconquerable dislike to them. However, since I am of a very passionate nature and need to have some loving person on whom to depend, and to whom I can wholly surrender myself, I felt myself more and more powerfully drawn toward intelligent women and girls who were in sympathy with me." The antipathic sexual instinct of this patient, which was clearly acquired, expressed itself in a stormy and decidedly sensual way, and was further augmented by masturbation; HOMO-SEXUAL FEELING IN BOTH SEXES. 283 because constant control in hospitals made sexual satisfac- tion with the same sex impossible. Character and occupa- tion remained feminine. There were no manifestations of viraginity. According to information lately received by the author, this patient, after two years of treatment in an asylum, was entirely freed from her neurosis and sexual inversion, and discharged cured. Case 106. Mr. X., aged thirty-five, single, civil servant ; mother insane, brother hypochondriacal. Patient was healthy, strong, of lively sensual tempera- ment. He had manifested powerful sexual instinct abnor- mally early, and masturbated while yet a small boy. He had coitus the first time at the age of fourteen, he says, with enjoyment and complete power. When fifteen years old, a man sought to seduce him, and performed manustu- pration on him. X. experienced a feeling of repulsion, and freed himself from the disgusting situation. At maturity he committed excesses in libido, with coitus ; in 1880 he became neurasthenic, being afflicted with weakness of erec- tion and ejaculatio prcecox. He thus became less and less potent, and no longer experienced pleasure in the sexual act. At this period of sexual decadence, for a long time he still had what was previously foreign to him, and is still incomprehensible to him, — an inclination for sexual intercourse with immature girls of the age of twelve or thirteen. His libido increased as virility diminished. Gradually he developed inclination for boys of thirteen or fourteen. He was impelled to approach them. Quodsi ei occasio data est ut tangere posset pueros qui ei placuere, penis vehementer se erexit turn maxime quum crura puerorum tangere potuisset. Abhinc feminas non cupivit. Nonnunquam feminas ad coitum coegit sed erectio debilis, ejaculatio praematura erat sine ulla voluptate. Now only youths interested him. He dreamed about them and had pollutions. After 1882 he now and then had opportunity concumbere cum jtcvenibus. This led to 284 PSTCHOPATHIA SEXUALTS. powerful sexual excitement, which he satisfied by mas- turbation. It was quite exceptional for him to venture touching his bed-fellow and indulging in mutual mas- turbation. He shunned pederasty. For the most part, he was compelled to satisfy his sexual needs by means of solitary masturbation. In the act he called up the vision of pleasing boys. After sexual intercourse with such boys, he always felt strengthened and refreshed, but morally depressed ; because there was consciousness of having performed a perverse, indecent and punishable act. He found it painful that his disgusting impulse was more powerful than his will. X. thinks that his love for his own sex has resulted from great excess in natural sexual intercourse, and be- moans his situation. On the occasion of a consultation, in December, 1889, he asked whether there weie any means to bring him back to a normal sexual condition, since he had no real horror femincz, and would very gladly marry. This intelligent patient, free from degenerative signs, presented no abnormal symptoms except those of sexual and spinal neurasthenia in a moderate degree. II. Degree : Eviration and Defemination. If, in cases of antipathic sexual instinct thus developed, no restoration occurs, then deep and lasting transforma- tions of the 2) sy chic al personality may occur. The process completing itself in this way may be briefly designated »viration (defemination in woman). The patient undergoes a deep change of character, particularly in his feelings and inclinations, which thus become those of a female. After this, he also feels himself to be a woma.n during the sexual act, has desire only for passive sexual indulgence, and, under certain circumstances, sinks to the level of a prostitute. In this condition of deep and more lasting psycho-sexual transformation, the individual is like unto HOMO-SEXUAL FEELING IN BOTH SEXES. 285 the (congenital) urning of high grade. The possibility of a restoration of the previous mental and sexual personality seems in such a case, precluded. The following case is a classical example of this variety of lasting acquired antipathic sexual instinct : — Case 107. Sch., aged thirty, physician, one day told me the story of his Hfe and malad}^, asking for explana- tion and advice concerning certain anomalies of his vita sexualis. The following description gives, for the most part verbatim, the details of the autobiography ; only in some portions it is shortened : — " My parents were healthy. As a child I was sickly ; but with good care I thrived, and got on well in school. When eleven years old, I was taught to masturbate by my playmates, and gave myself up to it passionately. Until I was fifteen, I learned easily. On account of frequent pollutions, I became less capable, did not get on well in school, and was uncertain and embarrassed when called on by the teacher. Frightened by my loss of capability, and recognising that the loss of semen was responsible for it, I gave up masturbation ; but the pollutions became even more frequent, so that I often had two or three in a night. In despair, I now consulted one physician after another. None were able to help me. " Since I grew weaker and weaker, by reason of the loss of semen, with the sexual appetite growing more and more powerful, I sought houses of prostitution. But I was there unable to find satisfaction ; for, even though the sight of a naked female pleased me, neither orgasm nor erection occurred ; and even manustupration by the puella was not capable of inducing erection. Scarcely would I leave the house, when the impulse would seize me again, and I would have violent erections. I grew ashamed before the girls, and ceased to visit such houses. Thus a couple of years passed. My sexual life consisted of pollu- tions. My inclination toward the opposite sex grew less 286 PSYCHOPATHIA SEXUALIS. and less. At nineteen I went to the university. The theatre had more attractions for me. I wished to become an actor. My parents were not wilhng. At the metro- pohs I was compelled now and then to visit girls with my comrades. I feared such a situation ; because I knew that coitus was impossible for me, and because my friends might discover my impotence. Therefore, I avoided, as far as possible, the danger of becoming the butt of their jokes and ridicule. " One evening, in the opera-house, an old gentleman sat near me. He courted me. I laughed heartily at the foolish old man, and entered into his joke. Exinopinato genitalia mea prehendit, quo facto statim penis meus se erexit. Frightened, I demanded of him what he meant. He said that he was in love with me. Having heard of hermaphrodites in the clinics, I thought I had one before me, and became curious to see his genitals. The old man was very willing, and went with me to the water-closet. Sicuti penem maximum ejus erectum adspexi, perterritus effugi. " This man followed me, and made strange proposals which I did not understand, and repelled. He did not give me any rest. I learned the secrets of male love for males, and felt that my sexuality was excited by it. But I resisted the shameful passion (as I then regarded it), and, for the next three years, I remained free from it. During this time I repeatedly attempted coitus with girls in vain. My attempts to free myself of my impotence by means of medical treatment were also in vain. Once, when my libido sexualis was troubling me again, I recalled what the old man had told me : that male-loving men were accustomed to meet on the E. Promenade. " After a hard struggle, and with beating heart, I went there, made the acquaintance of a blonde man, and allowed myself to be seduced. The first step was taken. This kind of sexual love was satisfactory to me. I always preferred to be in the arms of a strong man. The satis- HOMO-SEXUAL FEELING IN BOTH SEXES. 287 faction consisted of mutual manustupration ; occasionally in osculum ad penem aUerius. I was then twenty-three years old. Sitting, together with my comrades, on the beds of patients in the clinic during the lectures, excited me so intensely that I could scarcely listen to the lectures. In the same year I entered into a formal love-relation with a merchant of thirty-four. We lived as man and vnie. X. played the man, and fell more and more in love. I gave up to him, but now and then I had to play the man. After a time I grew tired of him, became unfaithful and he grew jealous. There were terrible scenes., which led to temporary separation, and finally to actual rupture. (The merchant afterwards became insane, and died by suicide.) " I made many acquaintances, and loved the most or- dinary people. I preferred those having a full beard, and who were tall and of middle age, and able to play the active role well. I developed a proctitis. The professor thought it was the result of sitting too much while preparing for examinations. I developed a fistula, and had to undergo an operation ; but this did not cure me of my desire to let myself be used passivelj'. I became a physician and went to a provincial town, where I had to live like a nun. I developed a desire to move in ladies' society, and was gladly welcomed there ; because it was found that I was not so one-sided as most men, and was interested in toilettes and such feminine things. However, I felt very unhappy and lonesome. Fortunately, in this town, I made the acquaintance of a man, a ' sister,' who felt hke me. For some time I was taken care of by him. When he had to leave I had an attack of despair, with depres- sion, which was accompanied by thoughts of suicide. " When it became impossible for me to longer endure the town, I became a military surgeon in the capital. There I began to hve again, and often made two or three acquaintances in one day. I had never loved boys or young people ; only fully developed men. The thought of falling into the hands of the police was Ixightful. Thus I 288 PSTCHOPATHIA SEXUALIS. have escaped the clutches of the blackmailer. At the same time, I could not keep myself from the gratification of my impulse. After some months I fell in love vi^ith an official of forty. I remained true to him for a year, and we lived like a pair of lovers. I was the wife, and was formally courted by the lover. One day I was transferred to a small town. We were in despair. The last night was spent in continually kiosing and caressing one another. "In T. I was unspeakably unhappy, in spite of some ' sisters ' whom I found. I could not forget my lover. In order to satisfy my sexual desire, which cried for satis- faction, I chose soldiers. Money obtained men ; but they remained cold, and I had no enjoyment with them. I was successful in being retransferred to the capital, where there was a new love relation, but much jealousy; because my lover liked to go into the society of ' sisters,' and was proud and coquettish. There was a rupture. I was very unhappy and very glad to be transferred from the capital. I now stayed in C, alone and in despair. Two infantry privates were brought into service, ' but with the same unsatisfactory results. When shall I ever find true love again? " I am over medium height, well developed, and look somewhat aged ; and, therefore, when I wish to make conquests I use the arts of the toilet. My maimer, move- ments and face are mascuhne. Physically I feel as youth- ful as a boy of twenty. I love the theatre, and especially art. My interest in the stage is in the actresses, whose every movement and gesture I notice and criticise. "In the society of gentlemen I am silent and em- barrassed, while in the society of those like myself I am free, witty, and as fawning as a cat if a man is sympathetic. If I am without love, I become deeply melancholic ; but the favours of the first handsome man dispel my depres- sion. In other ways I am frivolous and very ambitious. My profession is nothing to me. Masculine pursuits do not interest me. I prefer novels and going to the theatre. HOMO-SEXUAL FEELING IN BOTH SEXES. 289 I am effeminate, sensitive, easily moved, easily injured and nervous. A sudden noise makes my whole body tremble, and I have to collect myself in order to keep from crying out." Remarks : The foregoing case is certainly one of acquired antipathic sexual instinct, since the sexual instinct and impulse were originally directed toward the female sex. Sch. became neurasthenic through masturbation. As an accompanying manifestation of the neurasthenic neurosis, lessened impressionability of the erection-centre and consequent relative impotence developed. As a result of this, sexual sensibility toward the opposite sex de- creased, with simultaneous persistence of libido sexualis. The acquired antipathic sexual instinct must be abnormal, since the first touch by a person of the same sex is an adequate stimulus for the erection-centre. The perverse sexual feeling becomes complete. — At first Sch. felt like a man in the sexual act ; but more and more, as the change progressed, the feeling and desire of satisfaction changed to the form which, as a rule, characterises the (congenital) urning. This eviration induces a desire for the passive role, and, further, for (passive) pederasty. It makes a deeper impress on the character. The character becomes femi- nine, inasmuch as Sch. now prefers to move in the society of actual females, has an increasing desire for feminine occupations, and indeed makes use of the arts of the toilet in order to improve his fading charms and make " conquests ". The foregoing facts concerning acquired antipathic sexual instinct and effemination find an interesting con- firmation in the following ethnological data : — Herodotus already describes a peculiar disease which frequently affected the Scythians. The disease consisted in this : that men became effeminate in character, put 19 290 PSYGH.OPATHIA SEXUALIS. on female garments, did the work of women, and even became effeminate in appearance. As an explanation of this insanity of the Scythians/ Herodotvs relates the myth that the goddess Venus, angered by the plundering of the temple at Ascalon by the Scythians, had made women of these plunderers and their posterity. IIij)'pocrates, not believing in supernatural diseases, re- cognised that impotence was here a causative factor, and explained it, though incorrectly, as due to the custom of the Scythians to have themselves bled behind the ears in order to cure disease superinduced by constant horse-back riding. He thought that these veins were of great import- ance in the preservation of the sexual powers, and that when they were severed, impotence was induced. Since the Scythians considered their impotence due to divine punishment and incurable, they put on the clothing of females, and lived as women among women. It is worthy of note that, according to Klaproth (" Reise •In dem Kaukasus," Berlin, 1812, v., p. 285) and Chotomshi. even at the present time impotence is very frequent among the Tartars, as a result of riding unsaddled horses. The same is observed among the Apaches and Navajos of the western continent who ride excessively, scarcely ever going on foot, and are remarkable for small genitals and mild libido and virility. Sprengel, Lallemaiid and Nystcn recognised the fact that excessive riding may be injurious to the sexual organs. Hammond reports analogous observations of great in- terest concerning the Pueblo Indians of New Mexico. These descendants of the Aztecs cultivate so-called " mu- 1 Cf. Sprengel, " Apologie des Hippokrates," Leipzig, 1792, p. 611 Friedreich, " Literargeschichte der psych. Krankheiten," 1830, p. 31 Lalkmand, "Des pertes seminales," Paris, 1836, L, p. 581; Nysten, "Die, tionn. de medecine," xi. edit., Paris, 1858, Art. " Eviration et Maladie des Scythes"; Marandon, " De la maladie des Scythes"; " Annal. mldico- psychol.," 1877, Mars, p. 161; Hammond, 'American Journal of Neu- rology and Psychiatry," August, 1882. HOMO-SEXUAL FEELING IN BOTH SEXES. 291 jerados," of which every Pueblo tribe requires one in the reh'gious ceremonies (actual orgies in. the spring), in which pederasty plays an important part. In order to cultivate a " mujerado," a very powerful man is chosen, and he is made to masturbate excessively and ride constantly. Gradually such irritable weakness of the genital organs is engendered that, in riding, great loss of semen is induced. This condition of irritability passes into paralytic im- potence. Then atrophy of the testicles and penis sets in the hair of the beard falls out, the voice loses its depth and compass, and physical strength and energy decrease. Inclinations and disposition become feminine. The " mu- jerado " loses his position in society as a man. He takes on feminine manners and customs, and associates with women. Yet, for rehgious reasons, he is held in honour. It is probable that, at other times than during the festivals he is used by the chiefs for pederasty. Hammond had an opportunity to examine two " mujerados ". One had become such seven years before, and was thirty-five years old at the time. Seven years previous, he was entirely masculine and potent. He had noticed gradual atrophy of the testicles and penis. At the same time he lost lihido and the power of erection. He differed in nowise, in dress and manner, from the women among whom Ham- rmnd found him. The genital hair was wanting, the penis was shrunken, the scrotum lax and pendulous, and the testicles were very much atrophied and no longer sensitive to pressure. The " mujerado " had large mavimcB like a pregnant woman, and asserted that he had nursed several children whose mothers had died. A second " mu- jerado," aged thirty-six, after he had been ten years in the condition, presented the same peculiarities, though with less development of mamma. Like the first, the voice was high and thin. The body was plump. 292 PSYCHOPATHIA SEXUALIS. III. Degree : Stage of Transition to Metamoiyhosis Sexualis Paranoica. A further degree of development is represented by those cases in which physical sensation is also transformed in the sense of a transmutatio sexus. In this respect the following case is unique : — Case 108. Autohiograj)Mj . "Born in Hungary in 1844, for many years I was the only child of my parents ; for the other children died for the most part of general weakness. A brother of later birth is still living. " I come of a family in which nervous and mental diseases have been numerous. It is said that I was very pretty as a Httle child, with blonde locks and transparent skin ; very obedient, quiet and modest, so that I was taken everywhere in the society of ladies without any offence on my part. " With a very active imagination — my enemy through life — my talents developed rapidly. I could read and write at the age of four ; my memory reaches back to my third year. I played with everything that fell into my hands, — with leaden soldiers, or stones, or ribbons from a toy-shop ; but a machine for working in wood, that was given to me as a present, I did not like. I hked best to be at home with my mother, who was everything to me. I had two or three friends with whom I got on good-naturedly; but I liked to play with their sisters quite as well, who always treated me like a girl, which at first did not embarrass me. I must have already been on the road to become just like a girl ; at least, I can still well remember how it was always said : ' He is not intended for a boy '. At this I tried to play the boy,— imitated my companions in every- thing, and tried to surpass them in wildness. In this I succeeded. There was no tree or building too high for me to reach its top. I took great delight in soldiers. I avoided girls more, because I did not wish to play with HOMO-SEXUAL FEELING IN BOTH SEXES. 293 their playthings ; and it always annoyed me that they treated me so much like one of themselves. " In the society of mature people, however, I was always modest, and, also, always regarded with favour. Fantastic dreams about wild animals — which once drove me out of bed without waking me — frequently troubled me. I was always very simply but very elegantly dressed, and thus developed a taste for beautiful clothing. It seems peculiar to me that, from the time of my school-days, I had a partiality for ladies' gloves, which I put on secretly as often as I could. Thus, when once my mother was about to give away a pair of gloves, I made great opposi- tion to it, and told her, when she asked why I acted so, that I wanted them myself. I was laughed at ; and from that time I took good care not to display my preference for female things. Yet my delight in them was very great. I took especial pleasure in masquerade costumes — i.e., only in female attire. If I saw them, I envied their owners. What seemed to me the prettiest sight was : two young Jnen, beautifully dressed as white ladies, with masks on ; and yet I would not have shown myself to others as a girl for anything ; I was so afraid of being ridiculed. At school I worked very hard, and was always among the first. From childhood my parents taught me that duty came first ; and they always set me an example. It was also a pleasure for me to attend school ; for the teachers were kind, and the elder pupils did not plague the younger ones. We left my first home ; for my father was compelled, on account of his business, — which was dear to him, — to sepa- rate from his family for a year. We moved to Germany. Here there was a stricter, rougher manner, partly in teachers and partly in pupils ; and I was again ridiculed on account of my girlishness. My schoolmates went so far as to give a girl, who had exactly my features, my name, and me hers ; so that I hated the girl. But I later came to be on terms of friendship with her after her marriage. My mother tried to dress me elegantly ; but 294 PSYCHOPATHIA SEXUALIS. this was repugnant to me, because it made me the object of taunting. So, finally, I was delighted when I had correct trousers and coats. But with these came a new annoyance. They irritated my genitals, particularly when the cloth was rough ; and the touch of tailors while measuring me, on account of their tickling, which almost convulsed me, was unendurable, particularly about the genitals Then I had to practise gymnastics ; and I simply could do nothing at all, or only indifferently the things that even girls can do easily. While bathing I was troubled by feeling ashamed to undress ; but I liked to bathe. Until my twelfth year I had a great weakness, in my back. I learned to swim late, but ultimately so well that I took long swims. At thirteen I had pubic hair, and was about six feet tall ; but my face was feminine until my eighteenth year, when my beard came in abundance and gave me rest from resemblance to woman. An inguinal hernia that was acquired in my twelfth year, and cured when I was twenty, gave me much trouble, particularly in gymnastics. Besides, from my twelfth year on, I had, after sitting long, and particularly while working at night, an itching, burning and twitching, extending from the penis to my back, which the acts of sitting and standing increased, and which was made worse by catching cold. But I had no suspicion what- ever that this could be connected with the genitals. Since none of my friends suffered in this way, it seemed strange to me ; and it required the greatest patience to endure it ; the more owing to the fact that my abdomen troubled me. " In sexualibus I was still perfectly innocent ; but now, as at the age of twelve or thirteen, I had a definite feeling of preferring to be a young lady. A young lady's form was more pleasing to me ; her quiet manner, her deport- ment, but particularly her attire, attracted me. But I was careful not to allow this to be noticed ; and yet I am sure that I should not have shrunk from the castration-knife, HOMO-SEXUAL FEELING IN BOTH SEXES. 295 could I have thus attained my desire. If I had been asked to say why I preferred female attire, I could have said nothing more than that it attracted me powerfully ; per- haps, also, I seemed to myself, on account of my uncom- monly white skin, more like that of a girl. The skin of my face and hands, particularly, was very sensitive. Girls liked my society ; and, though I should have preferred to have been with them constantly, I avoided them when I could ; for I had to exaggerate in order not to appear feminine. In my heart I always envied them. I was par- ticularly envious when one of my young girl friends got long dresses and wore gloves and veils. When, at the age of fifteen, I was on a journey, a young lady, with whom I was boarding, proposed that I should mask as a lady and go out with her ; but, owing to the fact that she was not alone, I did not acquiesce, much as I should have hked it. While on this journey, I was pleased at seeing boys in one city wearing blouses with short sleeves, and the arms bare. A lady elaborately dressed was hke a goddess to me ; and if even her band touched me coldly I was happy and envi- ous, and only too gladly would have put myself in her place in the beautiful garments and lovely form. Never- theless, I studied assiduously, and passed through the Realschule and the Gymnasium in nine years, passing a good final examination. I remember, when fifteen, to have first expressed to a friend the wish to be a girl. In answer to his question, I could not give the reason why. At seventeen I got into fast society ; I drank beer, smoked, and tried to joke with waiter-girls. The latter liked my society, but they always treated me as if I wore petti- coats. I could not take dancing lessons, they repelled me so ; but if I could have gone as a mask, it would have been different. My friends loved me dearly ; I hated only one, who seduced me into onanism. Shame on those days, which injured me for life ! I practised it quite frequently, but in it seemed to myself like a double man, I cannot describe the feeling ; I think it was masculine, but mixed 296 PSTCHOPATHIA SEXUALIS. with feminine elements. I could not approach girls ; I feared them, but they were not strange to me. They im- pressed me as being more like myself ; I envied them. I would have denied myself all pleasures if, after my classes, at home I could have been a girl and thus have gone out. Crinoline and a smoothly-fitting glove were my ideals. With every lady's gown I saw I fancied how I should feel in it, — i.e., as a lady. I had no inchnation toward men. But I remember that I was somewhat lovingly attached to a very handsome friend with a girl's face and dark hair, though I think I had no other wish than that we both might be girls. " At the high-school I finally once had coitus ; hoc modo sensi, me libentius sub puella concubuisse et penem meum cum cunno mutatum maluisse. To her astonish- ment, the girl had to treat me as a girl, and did it willingly ; but she treated me as if I were she (she was still quite inexperienced, and, therefore, did not laugh at me). " When a student at times I was wild, but I always felt that I assumed this wildness as a mask. I drank and duelled, but I could not take lessons in dancing, because I was afraid of betraying myself. My friendships were close, but without other thoughts. It pleased me most to have a friend masked as a lady, or to study the ladies' costumes at a ball. I understood such things perfectly. Gradually I began to feel hke a girl. " On account of unhappy circumstances, I twice at- tempted suicide. Without any cause I once did not sleep for fourteen days, had many hallucinations (visual and auditory at the same time), and was with both the living and the dead. The latter habit of thought remains. I also had a friend (a lady) who knew my hobby and put on my gloves for me ; but she always looked upon me as a girl. Thus I understood women better than other men did, and in what they differed from men ; so I was always treated more feminarum — as if they had found in HOMO-SEXUAL FEELING IN BOTH SEXES. 297 me a female friend. On the whole, I could not endure obscenity, and indulged in it myself only out of braggadocio when it was necessary. I soon overcame my aversion to foul odours and blood, and even liked them. Only some things I could not look at without nausea. I was want- ing in only one respect : I could not understand my own condition. I knew that I had feminine inclinations, but believed that I was a man. Yet I doubt whether, with the exception of the attempts at coitus, which never gave me pleasure (which I ascribe to onanism), I ever admired a woman without wishing I were she ; or without asking myself whether I should not like to be the woman, or be in her attire. Obstetrics I learned with difficulty (I was ashamed for the exposed girls, and had a feeling of pity for them) ; and even now I have to overcome a feehng of fright in obstetrical cases ; indeed, it has happened that I thought I felt the traction myself. After fining several positions successfully as a physician, I went through a military campaign as a volunteer surgeon. Eiding, which, while a student, was painful to me, because in it the genitals had more of a feminine feehng, was difficult for me (it would have been easier in the female style). " Still, I always thought I was a man with obscure masculine feeling ; and whenever I associated with ladies, I was still soon treated as an inexperienced lady. When I wore a uniform for the first time, 1 should have much preferred to have slipped into a lady's costume, with a veil ; I was disturbed when the stately uniform attracted attention. In private practice I was successful in the three principal branches. Then I made another military campaign ; and during this I came to understand my nature ; for I think that, since the first ass ever made, no beast of burden has ever had to endure with so much patience as I have. Decorations wore not wanting, but I was indifferent to them. " Thus I went through life, such as it was, never satis- 298 PSTCHOPATHIA SEXUALIS. fied with myself, full of dissatisfaction with the world, and vacillating between sentimentality and a wildness that was for the most part affected. " My experience as a candidate for matrimony was very peculiar. I should have preferred not to marry, but family circumstances and practice forced me to it. I married an energetic, amiable lady, of a family in which female government was rampant. I was in love with her as much as one of us can be in love — i.e., what we love we love with our whole hearts, and live in it, even though we do not show it as much as a genuine man does. We love our brides with all the love of a woman, almost as a woman might love her bridegroom. But I cannot say this for myself; for I still believed that I was but a depressed man, who would come to himself, and find him- self out by marriage. But, even on my marriage night, I felt that I was only a woman in man's form ; sub femina locum meum esse mihi visum est. On the whole, we hved contented and happy, and for two years were child- less. After a difficult pregnancy, during which time I lay at the point of death in the enemy's own country, my wife gave birth to our first boy in a difficult labour, — a boy still afflicted with a melancholy nature. Then came a second, who is very quiet ; a third, full of peculiarities ; a fourth, a fifth ; and all have predisposition to neuras- thenia. Since I always felt out of my own place, I went much in gay society ; but I always worked as much as human strength would endure. I studied and operated ; and I experimented with many drugs and methods of cure, always on myself. I left the regulation of the house to my wife, as she understood housekeeping very well. My marital duties I performed as well as I could, but without personal satisfaction. Since the first coitus, the mascuhne position in it has been repugnant, and also difficult for me. I should have much preferred to have the other role. When I had to dehver my wife, it almost broke my heart ; for I knew how to appreciate her pain. HOMO-SEXUAL FEELING IN BOTH SEXES. 299 Thus we lived long together, until severe gout drove me to various baths, and made me neurasthenic. At the same time, I became so anaemic that every iew months I had to take iron for some time ; otherwise I would be almost chlorotic or hysterical, or both. Stenocardia often troubled me ; then came unilateral cramps of chin, nose, neck and larynx ; hemicrania and cramps of the dia- phragm and chest muscles. For about three years I had a feeling as if the prostate were enlarged, — a bearing-down feeling, as if giving birth to something ; and also pain in the hips, constant pain in the back, and the like. Yet, with the strength of despair, I fought against these com- plaints, which impressed me as being female or effeminate, until three years ago, when a severe attack of arthritis completely broke me down. "But before this terrible attack of gout occurred, in despair, to lessen the pain of gout, I had taken hot baths, as near the temperature of the body as possible. On one of these occasions it happened that I suddenly changed, and seemed to be near death. I sprang with all my remaining strength out of the bath : I had felt exactly like a woman with libido. This happened when the extract of Indian hemp came into vogue, and was highly prized. In a state of fear of a threatened attack of gout (feeling perfectly indifferent about life), I took three or four times the usual dose of it, and almost died of hashish poison- ing. Convulsive laughter, a feeling of unheard of strength and swiftness, a peculiar feeling in brain and eyes, millions of sparks streaming from the brain through the skin, — all these feelings occurred. But I could not force myself to speak. All at once I saw myself a woman from my toes to my breast ; I felt, as before while in the bath, that the genitals had shrunken, the pelvis broadened, the breasts swollen out; a feeling of unspeakable deliglit came over me. I closed iny eyes, so that at least I did not see the face changed. My physician looked as if he had a gigantic potato instead of a head ; my wife had the full moon on 300 PSYCHOPATHIA SEXUALIS. her thorax. And yet, I was strong enough to briefly record my will in my note-book when both left the room for a short time. " But who could describe my fright when, on the next morning, I awoke and found myself feeling as if com- pletely changed into a woman ; and when, on standing and walking, I felt vulva and mammce. ! When at last I raised myself out of bed, I felt that a complete trans- formation had taken place in me. During my illness a visitor said : ' He is too -patient for a man '. And the visitor gave me a plant in bloom, which seemed strange, but pleased me. From that time I was patient, and would do nothing in a hurry ; but I became tenacious, like a cat, though, at the same time, mild, forgiving and no longer bearing enmity, — in short, I had a woman's disposition. During the last sickness I had many visual and auditory hallucinations, — spoke with the dead, etc. ; saw and heard familiar spirits ; felt like a double person ; but, while lying ill, I did not notice that the man in me had been extinguished. The change in my disposition was a piece of good fortune, for I had a stroke of paralysis which would certainly have killed me had I been of my former disposition ; but now I was reconciled, for I no longer recognised myself. Owing to the fact that I still often confounded neurasthenic symptoms with the gout, I took many baths, until an itching of the skin, with the feeling of scabies, instead of being diminished, was so increased that I gave up all external treatment (I was made more and more anaemic by the baths), and hardened myself as best I could. But the imperative female feeling remained, and became so strong that I wear only the mask of a man, and in everything else feel hke a woman ; and gradually I have lost memory of the former individuality. What was left of me by the gout, influenza ruined entirely. ''Present condition: I am tall, slightly bald, and the beard is growing grey. I begin to stoop. Since having influenza I have lost about one-fourth of my strength. HOMO-SEXUAL FEELING IN BOTH SEXES. 301 Owing to a valvular lesion, my face looks somev^hat red ; full beard ; chronic conjunctivitis ; more muscular than fat. The left foot seems to be developing varicose veins, and it often goes to sleep ; but it is not really thickened, though it seems to be. " The mammary region, though small, svp'ells out per- ceptibly. The abdomen is feminine in form ; the feet are placed like a woman's, and the calves, etc., are feminine ; and it is the same with arms and hands. I can wear ladies' hose and gloves 7^ to 7| in size. I also wear a corset with- out annoyance. My weight varies between 168 and 184 pounds. Urine without albumen or sugar, but it contains an excess of uric acid. But when there is not too much uric acid in it, it is clear, and almost as clear as water after any excitement. Bowels usually regular ; but should they not be, then come all the symptoms of female consti- pation. Sleep is poor, — for weeks at a time only of two or three hours' duration. Appetite quite good ; but, on the whole, my stomach will not bear more than that of a strong woman, and reacts to irritating food with cutaneous eruption and burning in the urethra. The skin is white, and, for the most part, feels quite smooth ; there has been unbearable cutaneous itching for the last two years ; but during the last few weeks this has diminished, and is now present only in the popHteal spaces and on the scrotum. " Tendency to perspire. Perspiration was previously as good as wanting, but now there are all the odious pecuharities of the female perspiration, particularly about the lower part of the body ; so that I have to keep myself cleaner than a woman (I perfume my handkerchief, and use perfumed soap and eau-de-Cologne). " General feeling : I feel like a woman in a man's form ; and even though I often am sensible of the man's form, yet it is always in a feminine sense. Thus, for example, I feel the penis as chtoris ; the urethra as urethra and vaginal orifice, which always feels a httle wet, even when 302 PSYCHOPATHIA SEXUALIS. it is actually dry ; the scrotum as labia majora ; in short, I always feel the vulva. And all that that means one alone can know who feels or has felt so. But the skin all over my body feels feminine; it receives all impressions, wl ether of touch, of warmth, or whether unfriendly, as feminine, and I have the sensations of a woman. I cannot go with bare hands, as both heat and cold trouble me. When the time is past when we men are permitted to carry sun- umbrellas, I have to endure great sensitiveness of the skin of my face, until sun-umbrellas can again be used. On awaking in the morning, I am confused for a few moments, as if I were seeking for myself ; then the imperative feel- ing of being a woman awakens. I feel the sense of the vulva (that one is there), and always greet the day with a soft or loud sigh ; for I have fear again of the play that must be carried on throughout the day. I had to learn everything anew ; the knife— apparatus, everything — has felt different for the last three years ; and with the change of muscular sense I had to learn everything over again. I have been successful, and only the use of the saw and bone-chisel are difficult ; it is almost as if my strength were not quite sufficient. On the other hand, I have a keener sense of touch in working with the curette in the soft parts. It is unpleasant that, in examining ladies, I often feel their sensations ; but this, indeed, does not repel them. The most unpleasant thing I experience is foetal movement. For a long time — several months — I was troubled by reading the thoughts of both sexes, and I still have to fight against it. I can endure it better with women ; with men it is repugnant. Three years ago I had not yet consciously seen the world with a woman's eyes ; this change in the relation of the eyes to the brain came almost suddenly, with violent headache. I was with a lady whose sexual feeling was reversed, when sud- denly I saw her changed in the sense I now feel myself, — viz., she as man, — and I felt myself a woman in contrast vvith her ; so that I left her with ill-concealed vexation. HOMO-SEXUAL FEELING IN BOTH SEXES. 303 At that time she had not yet come to understand her own condition perfectly. " Since then, all my sensory impressions are as if they were feminine in form and relation. The cerebral system almost immediately adjusted itself to the vegetative ; so that all my ailments were manifested in a feminine way. The sensitiveness of all nerves, particularly that of the auditory and olfactory and trigeminal, increased to a con- dition of nervousness. If only a window slammed, I was frightened inwardly ; for a man dare not tremble at such things. If food is not absolutely fresh, I perceive a cadav- erous odour. I could never depend on the trigeminus ; for the pain would jump whimsically from one branch of it to another ; from a tooth to an eye. But, since my transformation, I bear toothache and migraine more easily, and have less feeling of fear with stenocardia. It seems to me a strange fact that I feel myself to be a fearful, weak being, and yet, when danger threatens, I am much rather cool and collected , and this is true in dangerous opera- tions. The stomach rebels against the slightest indiscre- tion (in female diet) that is committed without thought of the female nature, either by ructus or other symptoms ; but particularly against abuse of alcoholics. The indis- position after intoxication that a man who feels like a woman experiences is much worse than any a student could get up. It seems to me almost as if one feeling like a woman were entirely controlled by the vegetative system. " Small as my nipples are, they demand room, and I feel them as mamma ; just as during the beginning of puberty the nipples swelled and pained. On this account, the white shirt, the waistcoat and the coat trouble me. I feel as though the pelvis were female ; and it is the same with the anus and nates. At first the sense of a female abdomen was troublesome to me ; for it cannot bear trousers, and it always possesses or induces the feminine feeling. I also have the imperative feeling of a waist. It 304 PSYCHOPATHIA SEXUALIS. is as if I were robbed of my own skin, and put in a woman*'s skin that fitted me perfectly, but which felt everything as if it covered a woman ; and whose sensations passed through the man's body, and exterminated the masculine element. The testes, even though not atrophied or degenerated, are still no longer testes, and often cause me pain, with the feeling that they belong in the abdomen, and should be fastened there ; and their mobility often bothers me. " Every four weeks, at the time of the full moon, I have the molimen of a woman for five days, physically and mentally, only I do not bleed ; but I have the feeling of a loss of fluid ; a feeling that the genitals and abdomen are (internally) swollen. A ver}^ pleasant period comes when, afterward and later in the interval for a day or two, the physiological desire for procreation comes, which with all power permeates the woman. My whole body is then filled with this sensation, as an immersed piece of sugar is filled with water, or as full as a soaked sponge. It is like this : first, a woman longing for love, and then, for a man ; and, in fact, the desire, as it seems to me, is more a longing to be possessed than a wish for coitus. The intense natural instinct or the feminine concupiscence overcomes the feel- ing of modesty, so that indirectly coitus is desired. I have never felt coitus in a masculine way more than three times in my life ; and even if it were so in general, I was always indifferent about it. But, during the last three years, I have experienced it passively, like a woman ; in fact, oftentimes with the feeling of feminine ejaculation ; and I always feel that I am impregnated. I am always fatigued as a woman. is after it, and often feel ill, as a man never does. Some- times it caused me such great pleasure that there is nothing with which I can compare it ; it is the most blissful and powerful feeling in the world ; at that moment the woman is simply a vulva that has devoured the whole person. " During the last three years I have never lost for an instant the feeling of being a woman, and now, owing to habit, this is no longer annoying to me, though during HOMO-SEXUAL FEELING IN BOTH SEXES. 305 this period I have felt debased ; for a man could endure to feel like a woman without a desire for enjoyment ; but when desires come, the happiness ceases ! Then come the burning, the heat, the feeling of turgor of the genitals (when the penis is not in a state of erection the genitals do not play any part). In case of intense desire, the feeling of sucking in the vagina and vulva is really terrible — a hellish pain of lust hardly to be endured. If I then have opportunity to perform coitus, it is better ; but, owing to defective sense of being possessed by the other, it does not afford complete satisfaction ; the feeling of sterility comes with its weight of shame, added to the feeling of passive copulation and injured modesty. I seem almost like a prostitute. Eeason does not give any help ; the imperative feeling of femininity dominates and rules everything. The difficulty in carrying on one's occupa- tion, under such circumstances, is easily appreciated ; but it is possible to force one's self to it. Of course, it is almost impossible to sit, walk, or lie down ; at least, any one of these cannot be endured long ; and with the constant touch of the trousers, etc., it is unendurable. " Marriage then, except during coitus, where the man has to feel himself a woman, is like two women living together, one of whom regards herself as in the mask of a man. If the periodical molimina fail to occur, then come the feelings of pregnancy or of sexual satiety, which a man never experiences, but which take possession of the whole being, just as the feeling of feminity does, and are repugnant in themselves ; and, therefore, I gladly welcome the regular molimina again. When erotic dreams or ideas occur, I see myself in the form I have as a woman, and see erected organs presenting. Since the anus feels fem- inine, it would not be hard to become a passive pederast ; only positive religious command prevents it, as all other deterrent ideas would be overcome. Since such conditions are repugnant, as they would be to any one, I have a desire to be sexless, or to make myself sexless. If I had 20 306 PSYCHOPATHIA SEXUALIS. been single, I should long ago have taken leave of testes, scrotum and penis. " Of what use is female pleasure, vv^hen one docs not conceive ? What good comes from excitation of female love, when one has only a wife for gratification, even though copulation is felt as though it were with a man ? What a terrible feeling of shame is caused by the feminine perspiration ! How the feeling for dress and ornament lowers a man ! Even in his changed form, even when he can no longer recall the masculine sexual feeling, he would not wish to be forced to feel like a woman. He still knows very well that, heretofore, he did not con- stantly feel sexually ; that he was merely a human being uninfluenced by sex. Now, suddenly, he has to regard his former individuality as a mask, and constantly feel like a woman, only having a change when, every four weeks, he has his periodical sickness, and in the intervals his insatiable female desire. If he could but avv^ake without immediately being forced to feel like a woman ! At last he longs for a moment in which he might raise his mask ; but that moment does not come. He can only find amelioration of his misery when he can put on some bit of female attire or finery, an under-garment, etc. ; for he dare not go about as a woman. To be compe]led to fulfil all the duties of a calling with the feeling of being a woman costumed as a man, and to see no end of it, is no trifle. Religion alone saves from a great lapse ; but it does not prevent the pain when temptation affects the man who feels as a woman ; and so it must be felt and endured ! When a respectable man who enjoys an un- usual degree of public confidence, and possesses authority, must go about with his vulva — imaginary though it be ; when one, leaving his arduous daily task, is compelled to examine the toilette of the first lady he meets, and criti- cise her with feminine eyes, and read her thoughts in her face ; when a journal of fashions possesses an interest equal to that of a scientific work (I felt this as a child) ; HOMO-SEXUAL FEELING IN BOTH SEXES. 307 when one must conceal his condition from his wife, whose thoughts, the moment he feels hke a woman, he can read in her face, while it becomes perfectly clear to her that he has changed in body and soul — what must all this be ? The misery caused by the feminine gentleness that must be overcome ! Oftentimes, of course, when I am away alone, it is possible to live for a time more Hke a woman ; for example, to wear female attire, especially at night, to keep gloves on, or to wear a veil or a mask in my room, so that thus there is rest from excessive libido. But when the feminine feeling has once gained an entrance, it imperatively demands recognition. It is often satisfied with a moderate concession, such as the wearing of a bracelet above the cuff ; but it imperatively demands some concession. My only happiness is to see myself dressed as a woman without a feehng of shame ; indeed, when my face is veiled or masked, I prefer it so, and thus think of myself. Like every one of Fashion's fools, I have a taste for the prevaiHng mode, so greatly am I trans- brmed. To become accustomed to the thought of feehng only like a woman, and only to remember the previous manner of thought to a certain extent in contrast with it, and, at the same time, to express one's self as a man, requires a long time and an infinite amount of persistence. " Nevertheless, in spite of everything, it will happen that I betray myself by some expression of feminine feehng, either in sexualibus, when I say that I feel so and so, expressing what a man without the female feehng cannot know ; or when I accidentally betray that female attire is my talent. Before women, of course, this does not amount to anything ; for a woman is greatly flattered when a man understands something of her matters ; but this must not be displayed to my own wife. How fright- ened I once was when my wife said to a friend that I had great taste in ladies' dress ! How a haughty, stylish lady was astonished when, as she was about to make a great 308 PSYCHOPATHIA SEXUALIS. error in the education of her httle daughter, I described to her in writing and verbally all the feminine feelings ! To be sure, I hed to her, saying that my knowledge had been gleaned from letters. But her confidence in me is as great as ever ; and the child, who was on the road to insanity, is rational and happy. She had confessed all the feminine inclinations as sins ; now she knows what, as a girl, she must bear and control by will and religion ; and she feels that she is human. Both ladies would laugh heartily if they knew that I had only drawn on my own sad experience. I must also add that I now have a finer sense of temperature and, besides, a sense of the elasticity of the skin and tension of the intestines, etc., in patients, that was unknown to me before ; that in operations and autopsies, poisonous fluids more readily penetrate my (uninjured) skin. Every autopsy causes me pain ; examina- tion of a prostitute, or a woman having a discharge, a cancerous odour, or the like, is actually repugnant to me. In all respects I am now under the influence of antipathy and sympathy, from the sense of colour to my judgment of a person. Women usually see in each other the periodical sexual disposition ; and, therefore, a lady wears a veil, if she is not always accustomed to wear one, and usually she perfumes herself, even though it be only with handker- chief or gloves ; for her olfactory sense in relation to her own sex is intense. Odours have an incredible effect on the female organism ; thus, for example, the odours of violets and roses quiet me, while others disgust me ; and with Ylang-Ylang I cannot contain myself for sexual excitement. Contact with a woman seems homogeneous to me ; coitus with my wife seems possible to me because she is somewhat masculine, and has a firm skin ; and yet it is more an amor lesbicus. " Besides, I always feel passive. Often at night, when I cannot sleep for excitement, it is finally accomplished, si femora mea distensa habeo, sicuti mulier cum viro con- cumbens, or if I lie on my side ; but an arm or the bed- • HOMO-SEXUAL FEELING IN BOTH SEXES. 309 clothing must not touch the mamma, or there is no sleep ; and there must be no pressure on the abdomen. I sleep best in a chemise and night-robe, and with gloves on ; for my hands easily get cold. I am also comfortable in female drawers and petticoats, because they do not touch the genitals. I liked female dresses best when crinolines were worn. Female dresses do not annoy the feminine-feeling man ; for he, like every woman, feels them as belonging to his person, and not as something foreign. " My dearest associate is a lady suffering with neuras- thenia, who, since her last confinement, feels like a man, but who, since I explained these feelings to her, coitu abstinet as much as possible, a thing I, as a husband, dare not do. She, by her example, helps me to endure my condition. She has a most perfect memory of the female feelings, and has often given me good advice. Were she a man and I a young girl I should seek to win her ; for her I should be glad to endure the fate of a woman. But her present appearance is quite different from what it formerly was. She is a very elegantly dressed gentleman, notwithstanding bosom and hair ; she also speaks quickly and concisely, and no longer takes pleasure in the things that please me. She has a kind of melancholy dissatis- faction with the world, but she bears her fate worthily and with resignation, finding her comfort only in religion and the fulfilment of duty. At the time of the menses, she almost dies. She no longer likes female society and conversation, and has no liking for delicacies. " A youthful friend felt like a girl from the very first, and had incHnations towards the male sex. His sister had the opposite condition ; and when the uterus de- manded its right, and she saw herself as a loving woman in spite of her masculinity, she cut the matter short, and committed suicide by drowning. " Since complete effemination, the principal changes I have observed in myself are : — 310 PSYCHOPATHIA SEXUALIS. "1. The constant feeling of being a woman from top to toe. " 2. The constant feehng of having female genitals. *' 3. The periodicity of the monthly molimina. " 4. The regular occurrence of female desire, though not directed to any particular man. "5. The passive female feeling in coitus. " 6. After that, the feeling of impregnation. " 7. The female feehng in thought of coitus. "8. At the sight of women, the feeling of being of their kind, and the feminine interest in them. "9. At the sight of men, the feminine interest in them. " 10. At the sight of children, the same feeling. " 11. The changed disposition and much greater patience. "12. The final resignation to my fate, for which I have nothing to thank but positive religion ; without it I should have long ago committed suicide. " To be a man and to be compelled to feel that chaque fcmme est future ou elle desire d'etre is hard to endure." The foregoing autobiography, scientifically so import- ant, was accompanied by the following no less interesting letter : — " Sm, — I must next beg your indulgence for troubling you with my communication. I lost all control, and thought of myself only as a monster before which I myself shuddered. Then your work gave me courage again ; and I determined to go to the bottom of the matter, and examine my past life, let the result be what it might. It seemed a duty of gratitude to you to tell you the result of my recollection and observation, since I had not seen any description by you of an analogous case ; and, finally, I also thought it might perhaps interest you to learn, from the pen of a physician, how such a worthless human, or HOMO-SEXUAL FEELING IN BOTH SEXES. 311 masculine, being thinks and feels under the weight of the imperative idea of being a woman. " It is not perfect ; but I no longer have the strength to reflect more upon it, and have no desire to go into the matter more deeply. Much is repeated ; but I beg you to remember that any mask may be allowed to fall off, particularly when it is not voluntarily worn, but enforced. "After reading your work, I hope that, if I fulfil my duties as physician, citizen, father and husband, I may still count myself among human beings who do not deserve merely to be despised. " Finally, I washed to lay the result of my recollection and reflection before you, in order to show that one think- ing and feehng hke a woman can still be a physician. I consider it a great injustice to debar woman from Medi- cine. A woman, through her feehng, gets on the track of many ailments which, in spite of all skill in diagnosis, remain obscure to a man ; at least, in the diseases of women and children. If I could have my way, I should have every physician Hve the Hfe of a woman for three months ; then he would have a better understanding and more con- sideration in matters affecting the half of humanity from which he comes ; then he would learn to value the great- ness of woman, and appreciate the difficulty of her lot." BemarJcs : The badly tainted patient is originally psycho- sexually abnormal, in that, in character and in the sexual act, he feels as a female. This abnormal feehng remained purely a psychical anomally until three years ago, when, owing to severe neurasthenia, it received overmastering support in imperative bodily sensations of a transmutatio sexus, which now dominate consciousness. Then, to the patient's horror, he felt bodily like a woman ; and, under the impulse of his imperative feminine sensations, he ex- perienced a complete, transformation of his former mascu- hne feeling, thought and will ; in fact, of his whole vita sexualis, in the sense of eviration. At the same time, his "ego" is able to control these abnormal psycho-physical 312 PSYCHOPATHIA SEXUALIS. manifestations, and prevent descent to paranoia, — a remarkable example of imperative feelings and ideas on the basis of neurotic taint, which is of great value for a com- prehension of the manner in v^hich the pyscho-sexual transformation may be accomphshed. In 1893, three years later, this unhappy colleague sent me a new account of his present state. This corresponds essentially with the former. His physical and psychical feelings are absolutely those of a woman ; but his intellectual powers are intact, • and he is thus saved from paranoia (vide infra). A counterpart to this case, which is of clinical and psychological moment, is that of a lady as given in : — Case 109. Mrs. X., daughter of a high official. -Her mother died from nervous disease. The father was un- tainted, and died from pneumonia at a good old age. Her brothers and sisters had inferior psychopathic dispositions ; one brother was of abnormal character, and very neuras- thenic. As a girl Mrs. X. had decided inchnations for boys sports. So long as she wore short dresses she used to rove • about the fields and woods in the freest manner, and climbed the most dangerous rocks and cliffs. She had no taste for dresses and finery. Once, when they gave her a dress made in boys' fashion, she was highly dehghted ; and when at school they dressed her up in boy's clothes on the occasion of some theatrical performance she was filled with bHss. Otherwise nothing betrayed her homo-sexual inclina- tions. Up to her marriage (at the age of twenty-one) she cannot call to mind a single instance in which she felt her- self drawn to persons of her own sex. Men were equally indifferent to her. When matured she had many admirers. This flattered her greatly. However, she claims that the difference of the sexes never entered her mind ; she was only influenced by the difference in the dress. HOMO-SEXUAL FEELING IN BOTH SEXES. 318 When attending the first and only ball she felt interest only in intellectual conversation, but not in dancing or the dancers. At the age of eighteen the menses set in without diffi- culty. She always looked upon riienstruation as an unnecessary and bothersome function. Her engagement with a man who, though good and rich, yet possessed not the slightest knowledge of woman's nature, was a matter of utter indifference to her. She had neither sympathy for nor antipathy against matrimony. Her connubial duties were at first painful to her, later on simply loathsome. She never experienced sensual pleasure, but became the mother of six children. When her husband began to observe coitus intemi'ptus, on account of the prolific conse- quences, her religious and moral sentiments were hurt. Mrs. X. grew more and more neurasthenic, peevish and unhappy. She suffered from descensus uteri, erosions on the portio vaginalis, and became anaemic. Gynecological treatment and visits to watering-places procured but slight improve- ments. At the age of thirty-six she had an apoplectic stroke, which confined her to bed for two years, with heavy neurasthenic ailments (agrypnia, pressure in the head, palpitation of the heart, psychical depression, feelings of lost physical and mental power, bordering even on in- sanity, etc.). During this long illness a pecuHar change of her psychical and physical feelings took place. The small talk of the ladies visiting her about love, toilet, finery, fashions, domestic and servants' affairs dis- gusted her. She felt mortified at being a woman. She could not even make up her mind again to look in the mirror. She loathed combing her hair and making her toilet. Much to the surprise of her own people her hitherto soft and decidedly feminine features assumed a strongly masculine character, so much so that she gave the impression of being a man clad in female garb. She 314 PSYCHOPATHIA SEXUALIS. complained to her trusted physician that her periods had stopped, — in fact, she had nothing to do with such functions. When they recurred again she felt ill-tempered, and found the odour of the menstual flow most nauseating, but definitely refused the use of perfumes, which affected her in a similar unpleasant manner. But in other ways she felt that a peculiar change had come over her entire being. She had athletic spells, and great desire for gymnastic exercises. At times she felt as if she were just twenty. She was startled, — when her aeurasthenic brain allowed of thought at all, — at the flight and novelty of her thoughts, at her quick and precise method of arriving at conclusions and forming opinions, at the curt and short way of expressing herself, and her novel choice of words not always becoming a lady. Even an inclination to use curse words and oaths were noticeable in this otherwise so pious and correct woman. She reproached herself bitterly, and grieved because she had lost her feminity, and scandalised her friends by her thoughts, sentiments, and actions. She also perceived a change in her body. She was horrified to notice her breasts disappearing, that her pelvis grew smaller and narrower, the bones became more massive, and her skin rougher and harder. She refused to wear any more a lady's night-dress or a lady's cap, and put away her bracelets, earrings and fans. Her maid and her dressmaker noticed a different odour coming from her person ; her voice also grew deeper, rougher and quite masculine. When the patient was finally able to leave her bed, the female gait had altered, feminine gestures and movements in her female attire were forced, and she could no longer bear to wear a veil over her face. Her former period of life spent as a woman seemed strange to her, as if it did not belong to her existence at all ; she could play no longer the role of woman. She assumed more and more the character of a man. She experienced strange feelings in HOMO-SEXUAL FEELING IN BOTH SEXES. 315 her abdomen ; and complained to the physician attending her that she could feel no longer the internal organs of generation, that her body was closed up, the region of her genitals enlarged, and often had the sensation of possessing a penis and scrotum. She showed, also, unmistakable symptoms of male libido. All these observations affected her deeply, filled her with horror, and depressed her so much that an attack of insanity was apprehended. But by incessant efforts and kind advice the family physician finally succeeded in calming the patient and piloting her safely over this dangerous point. Little by little she gained her equilibrium in this novel, strange and morbid physico- psychical form. She took pains in performing her duties as housewife and mother. It was interesting to observe the truly manly firmness of will which she developed, but her former softness of character had vanished. She assumed the role of the man in her house, a circumstance which led to many dissensions and misunderstandings. She became an enigma which her husband was unable to solve. She complained to her physician that at times a '* bestial masculine libido " threatened to overcome her, which made her despondent. Marital intercourse with the husband appeared to her most repulsive — in fact, impossible. Periodically the patient experienced feminine emotions, but they became scarcer and weaker as time went by. At such periods she became conscious again of her female genitals and breasts, but these episodes affected her painfully, and she felt that such a " second trans- mutation " would be unbearable, and would drive her to insanity. Now she has become reconciled to her transmutatio sexus, brought about by her severe illness, and bears her fate with resignation, finding much support in her religious convictions. What affects her most keenly is the fact tiiat, like an actress, she must move in a strange spliere — i.e., in tliat of a woman (" Status Prnnsens," Sept., LS92).' 316 PSYCHOPATHIA SEXUALIS. TV. Degree : Metamorphosis Sexualis Paranoica. A final possible stage in this disease-process is the delusion of a transformation of sex. It arises on the basis of sexual neurasthenia that has developed into neuras- thenia universalis, resulting in a mental disease, — paranoia. The following cases show the development of the interesting neuro-psychological process to its height : — Case 110. K., aged thirty-six, male, single, servant, received at the chnic on 26th February, 1889, is a tjrpical case of paranoica persecutoria, resulting from neurasthenia sexualis, with olfactory hallucinations, sensations, etc. He comes of a predisposed family. Several brothers and sisters were psychopathic. Patient has a hydro- cephalic skull, depressed in the region of the right fon- tanelle ; eyes neuropathic. He has always been very sensual ; began to masturbate at nineteen ; had coitus at twenty-three ; begat three illegitimate children. He gave up further sexual intercourse on account of fear of begetting more children, and of being unable to provide for them. Abstinence proved very painful to him. He also gave up masturbation, and was then troubled with pollutions. A year and a half ago he became sexually neurasthenic, had diurnal pollutions, became thereafter ill and miserable, and, after a time, generally neurasthenic, finally developing paranoia. A year ago he began to have parsesthetic sensations, — as if there were a great coil in the place of his genitals ; and then he felt that his scrotum and penis were gone, and that his genitals were changed into those of a female. He felt the growth of his breasts ; that his hair was that of a woman ; and that feminine garments were on his body. He thought himself a woman. The people in the street gave utterance to corresponding remarks : " Look at the woman ! The old blowhard ! " In a half-dreamy state, he had the feeling as if he played the part of a HOMO-SEXUAL FEELING IN BOTH SEXES. 317 woman in coitus with a man, which caused him the most lively feelings of pleasure. During his stay at the clinic, a remission of the paranoia occurred, and, at the same time, a marked improvement of the neurasthenia. Then the feelings and ideas due to a developing metamorphosis sexualis disappeared. A more advanced case of eviration, on the way to a transformatio sexus paranoica, is the following : — Case 111. Franz St., aged thirty-three; school- teacher , single ; probably of tainted family ; always neuropathic; emotional, timid, intolerant of alcohol ; began to masturbate at eighteen. At thirty there were mani- festations of neurasthenia sexualis (pollutions with conse- quent fatigue, soon beginning to occur during the day ; pain in the region of the sacral plexus, etc.). Gradually, spinal irritation, pressure in the head, and cerebral neuras- thenia were added. Since the beginning of 1885 the patient had given up coitus, in which he no longer experi- enced pleasurable feeling. He masturbated frequently. In 1888 he began to have delusions of suspicion. He noticed that he was avoided, and that he had unpleasant odours about him (olfactory hallucinations). In this way he explained the altered attitude of people, and their sneezing, coughing, etc. He could smell corpses and foul urine. He recognised the cause of his bad smells in inward pollutions. He recognised these in a feeling he had as if a fluid flowed up from the symphysis toward the breast. Patient soon left the clinic. In 1889 he was again received in an advanced stage of paranoia masturbatoria persecutoria (delusions of physical persecution). In the beginning of May, 1889, the patient attracted notice, in that he was cross when he was addressed as ** mister ". He protested against it because he was a 318 PSYCHOPATHIA SEXUALIS. woman. Voices told him this. He noticed that his breasts were growing. Some weeks before, others had touched him in a sensual manner. He heard it said that he was a whore. Of late, dreams of pregnancy. He dreamed that, as a woman, he indulged in coitus. He felt the immissio penis, and, during the hallucinatory act, also a feeling of ejaculation. Head straight ; facial form long and narrow ; parietal eminences prominent ; genitals normally developed. The following case, observed in the asylum at Illenau, is a pertinent example of lasting delusional alteration of sexual consciousness : — Case 112. Metamorphosis sexualis paranoica. N., aged twenty-three, single, pianist, was received in the asylum at Illenau in the last part of October, 1S65. He came of a family in which there was said to be no hereditary taint ; but there was phthisis (father and brother died of pul- monary tuberculosis). Patient, as a child, was weakly and dull, though especially talented in music. He was always of abnormal character ; silent, retiring, unsocial, and sullen. He practised masturbation after fifteen. After a few years neurasthenic symptoms (palpitation of the heart, lassitude, occasional pressure in the head, etc.) and also hypochondriacal symptoms were manifested. During the last year he had worked with great difficulty. For about six months neurasthenia had increased. He complained of palpitation of the heart, pressure in the head and sleeplessness; was very irritable, and seemed to be sexually excited. He declared that he must marry for his health. He fell in love with an artiste, but almost at the same time (September, 1865) he fell ill with paranoia perse- cutoria (ideas of enemies, derision in the street, poison in food ; obstacles were placed on the bridge to keep him from going to his inamorata). On account of increasing excitement and conflicts with those about him that he HOMO-SEXUAL FEELING IN BOTH SEXES. 319 considered inimical to him he -was taken to the asylum. At first he presented the picture of a typical paranoia 'pcrsecxitoria with symptoms of sexual, and later general, neurasthenia, though the delusions of persecution did not rest upon this neurotic foundation. It was only occasionally that the patient heard such sentences as this : " Now the semen will be drawn from him. Now the bladder will be cut out." In the course of the years 1866-68, the delusions of persecution became less and less apparent, and were for the most part replaced by erotic ideas. The somatic and mental basis was a lasting and powerful excitation of the sexual sphere. The patient fell in love with every woman he saw, heard voices which told him to approach her, and beg to be allowed to marry, declaring that, if he were not given a wife, he would waste away. With continu- ance of masturbation, in 1869, signs of future effemination made themselves manifest. " He would, if he should get a wife, love her only platonically." The patient grows more and more peculiar, lives in a circle of erotic ideas, sees prostitution practised in the asylum, and now and then hears voices which impute immoral conduct with women to him. For this reason he avoids the society of women, and only associates with them for the sake of music when two witnesses are with him. In the course of the year 1872, the neurastlicnic condition became markedly increased. Now paranoia jjcr- secutoria again comes into the foreground, and takes on a clinical colouring from the neurotic basis. Olfactory hallucinations occur. Magnetic influences are at work on him — " magnetic waves produced by striking an anvil '' (false interpretation of sensations due to spinal asthenia). With continued and intense sexual excitement and excess in masturbation, the process of effemination constantly progresses. Only episodically is he a man and inclined toward a woman, complaining that the shameless prosti- tution of the men in the house makes it impossible for a 320 PSYCHOPATHIA SEXUALIS. lady to come to him. He is dying of magnetically poisoned air and unsatisfied love. Without love he cannot live. He is poisoned by lewd poison that affects his sexual desire. The lady that he loves is surrounded here by the lowest vice. The prostitutes in the house have fortune- chains ; that is, chains in which, without moving, a man can indulge in lustful pleasure. He is ready now to satisfy himself with prostitutes. He is possessed of a wonderful ray of thought that emanates from his eyes, which is worth 20,000,000. His compositions are worth 500,000 francs. With these indications of delusions of grandeur, there are also those of persecution — the food is poisoned by venereal excrements ; he tastes and smells poison, hears in- famous accusations, and asks for appHances to close his ears. From August, 1872, however, the signs of effemination become more and more frequent. He acts somewhat affectedly, declaring that he can no longer live among men that drink and smoke. He thinks and feels like a woman. He must thenceforth be treated hke a woman and trans- ferred to a female ward. He asks for confections and dehcate desserts. Occasionally, on account of tenesmus and cystospasm, he asks to be transferred to a lying-in hospital and treated as a woman very ill in pregnancy. The abnormal magnetism of masculine attendants has an unfavourable effect on him. At times he still feels himself to be a man, but in a way which indicates his abnormally altered sexual feeling. He pleads only for satisfaction by means of masturbation, or for marriage without coitus. Marriage is a sensual institution. The girl that he would take for a wife must be a masturbator. About the end of December, 1872, his personality became completely feminine. From that time he remained a woman. He had always been a woman, but in his babyhood a French Quaker, an artist, had put masculine genitals on him, and by rubbing and distorting his thorax had prevented the development of his breasts. HOMO-SEXUAL FEELING IN BOTH SEXES. 321 After this he demanded to be transferred to the female department, protection from men that wished to violate him, and asked for female clothing. Eventually he also desired to be given employment in a toy - shop, with crocheting and embroidery work to do, or a place in a dressmaking establishment with female work. From the time of the transformatio sexus, the patient begins a new reckoning of time. He conceives his previous personality in memory as that of a cousin. He always speaks of himself in the third person, and calls himself the Countess V., the dearest friend of the Empress Eugenie ; asks for perfumes, corsets, etc. He takes the other men of the ward for girls, tries to raise a head of hair, and demands "Oriental Hair - Kemover," in order that no one may doubt his gender. He takes delight in praising onanism, for " she had been an onanist from fifteen, and had never desired any other kind of sexual satisfaction ". Occasionally neurasthenic symptoms olfactory hallucinations, and persecutory delusions are observed. All the events up to the time of December, 1872, belong to the personality of the cousin. The patient's delusion that he is the Countess V. can no longer be corrected. She proves her identity by the fact that the nurse has examined her, and finds her to be a lady. The countess will not marry, because she hates men. Since he is not provided with female clothing and shoes, he spends the greatest part of the day in bed, acts like an invahd lady of position, affectedly and modestly, and asks for bon-bons and the like. His hair is done up in a knot as well as it allows, and the beard is pulled out. Breasts are made out of rolls of bread. In 1874 caries began in the left knee-joint, to which pulmonary tuberculosis was soon added. Death on 2nd December, 1874. Skull normal. Frontal lobes atrophic. Brain anaemic. Microscopical (Dr. Schille). In the superior layer of the frontal lobe, ganglion cells somewhat shrunken; in the adventitia of the vessels, numerous fat-corpuscles ; 21 322 PSYCHOPATHIA SEXUALIS. glia unchanged ; isolated pigment particles and colloid bodies. The lower layers of the cortex normal. Genitals very large ; testicles small, lax, and show no change macroscopically on section. The delusion of sexual transformation, displayed in its conditions and phases of development in the foregoing case, is a manifestation remarkably infrequent in the pathology of the human mind. Besides the foregoing cases, personally observed, I have seen such a case, as an episodical phenomenon, in a lady having sexual inversion (case 118, of the seventh edition of this work), one in a girl affected with original paranoia, and another in a lady suffering with origiiial paranoia. Save for a case briefly reported by Arndt ^ in his text- book, and one quite superficially described by S&icux (" Eecherches Clinique," p. 33), and the two cases known to Esquirol,'^ 1 cannot recall any cases of delusion of sexual transformation in literature. I have already mentioned on page 289 the interesting relations existing between the facts of delusional trans- formation of sex and the so-called insanity of the Scythians. Maratidon (" Annales medico-psychologiques," 1877, p. 161), like others, has erroneously presumed that with the ancient Scythians there was an actual delusion, and that the condition was not merely that of eviration. According to the law of empirical actuahty, the delusion, so infrequent to-day, must also have been very infrequent in ancient times. Since it can only be conceived as arising on the basis of a paranoia, there can be no thought of its endemic occurrence ; it can only be regarded as a superstitious manifestation of eviration (the result of anger of the goddess), as is also evident from the statements of Hippo- crates. 1 An abstract of this may be found in case 103 of the ninth edition of this book. - Cf. ibid., cases 104 and 105. HOMO-SEXUAL FEELING AS ABNORMAL MANIFESTATION. 323 The facts of the so-called Scythian insanity, as well as the facts lately learned about the Pueblo Indians, are also worthy of note anthropologically, in so far as atrophy of the testes and genitals in general, and approximation to the female type, physically and mentally, were observed. This is the more remarkable, since, in men who have lost their procreative organs, such a reversal of instinct is quite as unusual as in women, mutatis mutandis, after the natural or artificial climacteric. B. Homo-Sexual Feeling as an Abnormal Congenital Manifestation.^ The essential feature of this strange manifestation of the sexual life is the want of sexual sensibility for the opposite sex, even to the extent of horror, while sexual inclination and impulse toward the same sex arc present. At the same time, the genitals are normally developed, the sexual glands perform their functions properly, and the sexual type is completely differentiated. ^ Bibliography (besides works mentioned hereafter) : Tardieu, " Des attentats aux moeurs," 7 6dit., 1878, p. 210. Hofmann, " Lehrb. d. ger. Med.," 6 Aufl., pp. 170, 887. Gley, "Revue philosophique," 1884, No. 1. Magnan, " Annal. med.-psychol.," 1885, p. 458. Sliaw and Ferris, " Journal of Nervous and Mental Diseases," 1883, April, No. 2. Dernhardi, " Der Uranismus," Berlin (Volksbuchhandlung), 18852. Chevalier, " De I'inversion de I'instinct sexual," Paris, 1885. Ritti, " Gaz. hebdom. de medecine at de chirurg.," 1878, 4. Januar. Tamassia, " Rivista sperim," 1878, pp. 97-117. Lombroso, " Archiv. di Psichiatr.," 1881. Charcot et Magtvan, "Archiv. de neurologie," 1882, Nr. 7, 12. Moll, " Die contriire Sexualempfindung," Berlin, 2nd edit., 1893 (numerous bibliographic refer- ences). Chevalier, "Archives de I'anthropologie criminelle," vol. v., No. 27 ; vol. vi.. No. 31. Reuss, " Aberrations du sens g6n6sique," " Annales d'hygi^ne publique," 1886. Saury, " Etude clinique sur la folio hore- ditaire," 1886. Brouardel, " Gaz. des hopitaux," 1886 and 1887. Tilier "L'instinct sexuel chez I'homme et chez les animaux," 1889. Carlicr, " Les deux prostitutions," 1887. Lacassagne, art. " P^derastio," in the "Diction, encyclopedique." Viber t, a.vt. " P6derastie," in the "Diction, mod. et de chirurgie." Coutagne, "Lyon medical," 1880, Nos. 35, 30. Blumer, " Americ. Journ. of Insanity," July, 1882. V. Krafft, " Zeitschr. f. Psychiatrie," No. 38. Blumenstock, art. " Contriiro Soxualcmplhidung," 324 PSYCHOPATHIA SEXUALIS. Feeling, thought, will, and the whole character, in cases of the complete development of the anomaly, corre- spond with the peculiar sexual instinct, but not with the sex which the individual represents anatomically and physiologically. This abnormal mode of feeling may not infrequently be recognised in the manner, dress and caUing of the individuals, who may go so far as to yield to an impulse to don the distinctive clothing corresponding with the sexual role in which they feel themselves to be. Anthropologically and clinically, this abnormal mani- festation presents various degrees of development : — 1 Traces of hetero-sexual, with predominating homo- sexual, instinct (psycho-sexual hermaphrodism). 2. There exists incHnation only toward the same sex (homo-sexuahty). 3. The entire mental existence is altered to correspond with the abnormal sexual instinct (effemiuation and viraginity). 4. The form of the body approaches that which corresponds to the abnormal sexual instinct. However actual transitions to hermaphrodites never occur, but, on the contrary, completely differentiated genitals ; so that, "Realencyclop. d ges. Heilkunde," 2 Aufl. vi. Brouardel, " Gaz. des hfipiteaux," 1887. Eriese, "Inaugural dissert.," Wiirzburg, 1888. Hofman, art. " Paederastie," "Realencyclop. d. ges. Heilkunde," 2 Aufl. xv. Tar- nowsky, " Die krankhaften Erscheinungen des Geschlechtsinnes," ?«rlii. 1886. Magnan, " Stance de racademie de m^decine du 13 Janvier," 1885, i(Zem, " Annales medico psychol.," 1886 ("Anomalies du sens genital"; " Discussion sur la folie hereditaire "). Serieux, " Recherches cliniques sur les anomalies de I'instinct sexuel," Paris, 1886. Chevalier, " L'inversion sexuelle," Lyon, Paris, 1893. Ladame, " Revue de I'hypnotisme," Sept., 1889. Peyer, " Miinch. med. Wochenschrift," 1890, No. 23. Leimn, "Neurolog. Centralblatt," 1891, No. 18. V. Schrenck-Notzing, "Die Suggestions-therapie," etc., Stuttgart. Eulenhurg, op. ci^., p. 66, " Homo- sexuelle Parerosie ". Raffalovich, " Die Entwickelung der Homo- sexualitfit," Berlin, 1895 , idem, " Uranisme et Unisexualite," Paris, 1886. V. Schrenck-Notzing, " Klin. Zeit- und Streitfragen," ix. 1 (Wien, 1895). Laupts, "Perversion et perversite sexuelles," Paris, 1896. Ellis, "Das contriire Geschlechtsgefuhl," Leipzig, 1896. Legrain, " Des anomalies de I'instinct sexuel," etc., Paris, 1896. HOMO-SEXUAL FEELING AS ABNOEMAL MANIFESTATION. 325 just as in all pathological perversions of the sexual Hfe, the cause must be sought in the brain {androgyny and gynandry). The first definite communications ^ concerning this enigmatical phenomenon of Nature are made by Gasper (" Ueber Nothzucht und Paderastie," Casper's " Viertel- jahrsschrift," 1852, i.), who, it is true, classes it with pederasty, but makes the pertinent remark that this anomaly is, in most cases, congenital, and, at the same time, to be regarded as a mental hermaphrodism. There exists here an actual disgust of sexual contact with women, while the imagination is filled with beautiful young men, and with statues and pictures of them. It did not escape Casper that in such cases emissio penis in anum (pederasty) is not the rule, but that, by means of other sexual acts (mutual onanism), sexual satisfaction is sought and obtained. In his " Chnical Novels " (1863, p 33) Gasper gives the interesting confession of a man showing this perversion of the sexual instinct, and does not hesitate to assert that, aside from vicious imagination and vice, as a result of over-indulgence in normal sexual intercourse, there are numerous cases in which " pederasty " has its origin in a remarkable, obscure impulse, which is congenital and inexplicable. About the middle of the " sixties " a certain assessor, Ulrichs, himself subject to this perverse instinct, 1 Dr Moll, of Berlin, called my attention to the fact that in Moritz's " Magazin f. Erfahrungsseelenkunde," vol. viii., Berlin, 1791, references are made to antipathic sexual instinct in man. In fact, two biographies of men are there reported who manifested an enthusiastic love for persons of their own sex. In the second case, which is particularly noteworthy, the patient himself explains his aberration by the fact that, as a child he was caressed only by grown persons, and as a boy of ten or twelve years only by his school - fellows. "This, and the want of association with persons of the opposite sex, in me caused the natural inclination toward the female sex to be entirely diverted to the male sex. i am still quite indifferent to women." It cannot be determined whotlier such a case is one of congenital (psycho-sexual hermaphrodisia ?) or acquired antipathic sexual instinct. 326 PSYCHOPATHIA SEXUALIS. came out and declared, in numerous articles, under the nom-de-plume " Numa Numantius,^ that the sexual mental life was not connected with the bodily sex ; that there were male individuals that felt like women toward men {anima muliebris m corpore virili inclusa). He called these people " urnings," and demanded nothing less than the legal and social recognition of this sexual love of the urnings as congenital and, therefore, as right ; and the permission of marriage among them Ulrichs failed, however, to prove that this certainly congenital and paradoxical sexual feeling was physiological, and not pathological. Griesinger (" Archiv f. Psychiatric," i., p. 651) threw the first ray of light on these facts, anthropologically and clinically by pointing out the marked hereditary taint of the individual in a case which came under his own observation. We owe thanks to Westphal (" Archiv f. Psychiatric," ii., p. 73) for the first systematic consideration of the manifestation in question, which he defined as "congenital reversal of the sexual feeling, with consciousness of the abnormality of the manifestation," and designated with the name, since generally accepted, of antipathic sexual instinct. At the same time, he began a series of cases, which up to this time has numbered about 200, those reported in this monograph not being included. West2Jhal leaves it undecided as to whether inverted sexual feeling is a symptom of a neuropathic or of a psychopathic condition, or whether it may occur as an isolated manifestation. He holds fast to the opinion that the condition is congenital. From the cases published up to 1877 I have desig- nated this peculiar sexual feeling as a functional sign of degeneration, and as a partial manifestation of a neuro- (psycho-) pathic state, in most cases hereditary, — a *" Vindex, Inclusa, Vindicta, Pormatrix, Ara spei, Gladius furens " (Leipzig, H. Matthes, 18G4 and 1865) ; Ulrichs, " Ki-itische Pfeilc," IST'J, in Commission, by H. Cronlein, Stuttgart, Augustenstrasse, 5. HOMO-SEXUAL FEELING AS ABNORMAL MANIFESTATION. 327 supposition which has found renewed confirmation in a consideration of additional cases. The following pecu- liarities may be given as the signs of this neuro- (psycho-) pathic taint : — 1. The sexual hfe of individuals thus organised mani- fests itself, as a rule, abnormally early, and thereafter with abnormal power. Not infrequently still other perverse manifestations are presented besides the abnormal method of sexual satisfaction, which in itself is conditioned by the peculiar sexual feeling. 2. The psychical love manifest in these men is, for the most part, exaggerated and exalted in the same way as their sexual instinct is manifested in consciousness, with a strange and even compelling force. 3. By the side of the functional signs of degeneration attending antipathic sexual feeling are found other functional, and in many cases anatomical, evidences of degeneration. 4. Neuroses (hysteria, neurasthenia, epileptoid states, etc.) co-exist. Almost invariably the existence of temporary or lasting neurasthenia may be proved. As a rule, this is constitutional, having its root in congenital conditions. It is awakened and maintained by masturbation or enforced abstinence. In male individuals, owing to these practices or to congenital disposition, there is finally neurasthenia sextialis, which manifests itself essentially in irritable weakness of the ejaculation centre. Thus it is explained that, in most of the cases, simply embracing and kissing, or even only the sight of the loved person, induce the act of ejaculation. Frequently this is accompanied by an abnormally powerful feeling of lustful pleasure, which may be so intense as to suggest a feeling of "magnetic" currents passing through the body. 5. In the majority of cases, psychical anomalies (bril- liant endowment in art, especially music, poetry, etc., by the side of bad intellectual powers or original eccentricity) 328 PSYCHOPATHIA SEXUALIS. are present, which may even go so far as pronounced con- ditions of mental degeneration (imbecihty, moral insanity). In many urnings, either temporarily or permanently, insanity of a degenerative character (pathological emo- tional states, periodical insanity, paranoia, etc.) makes its appearance. 6. In almost all cases v^here an examination of the physical and mental peculiarities of the ancestors and blood relations has been possible, neuroses, psychoses, degenerative signs, etc., have been found in the families.^ The depth of congenital inverted feeling is shown l)y the fact that the lustful dream of the male-loving urning has for its content only male individuals ; that of the female-loving woman, only female individuals, with corre- sponding situations. The observation of West2)hal, that the consciousness of one congenitally defective in sexual desires toward the opposite sex is painfully affected by the impulse toward the same sex, is true in only a number of cases. Indeed, in many instances, the consciousness of the abnormality of the condition is wanting. The majority of urnings are happy in their perverse sexual feeling and impulse, and unhappy only in so far as social and legal barriers stand in the way of the satisfaction of their instinct toward their own sex. The study of antipathic sexual feeling points directly to anomalies of the cerebral organisation of the affected individuals. The very fact that in these cases, with few exceptions, the sexual glands are found quite normal, anatomically and functionally, seems to favour this assumption. 1 Tarnowshy {op. cit., p. 34) records a case which shows that antipathic sexual feeling, as a concomitant manifestation with neurotic degeneration, may also affect the descendants of parents having no neurotic taint. In tliis instance, lues of the parents plaj'ed a part, as in a similar case of Scholz (" Vierteljahrsschr. f. ger. Med."), in which the perversion of the sexual desires stood in causal relation with an arrest of psychical develop- ment, caused by traumatism. HOMO-SEXUAL FEELING AS ABNORMAL MANIFESTATION. 329 This enigmatical manifestation in the nature of man has led to many attempts of explanation. Among lay persons, it is called vice ; in the language of the law, crime. Those tainted with it, although recog- nising it as an abnormality, claim for it the same rights and privileges that are accorded to normal (hetero-sexual) love, on account of its being based upon a freak of nature. From Plato down to Ulrichs, m antipathic sexual circles, this standpoint is maintained, Plato's " Banquet," chapters viii. and ix., are quoted for that purpose, viz. : " There is no Aphrodites without an Eros. But there are two goddesses. The older Aphrodites came into existence without a mother ; being the daughter of Uranos she is called Urania. The younger Aphrodites is the daughter of Zeus and Diana and is called Pandemos. The Eros of the former must, therefore, be Uranos, that of the latter Pandemos. With the love of Eros Pandemos the ordinary human beings love ; Eros Uranos did not choose a female but a male , this is the love for boys. Whoever is inspired with this love turns to the male sex." From many other places m the classics the impression may be won that Uranic love attained a higher position even than her sister. More recent explanations of the homo- sexual instinct have emanated from philosophers, psj^cho- logists and natural scientists. One of the most peculiar explanations is advanced by Schojjenhauer (" Die Welt als Wille und Vorstellung "), who seriously contends that nature seeks to prevent old men {i.e., over fifty years of age) from begetting children, since experience teaches that these never turn out good. For this purpose nature in her wisdom has turned the sexual instinct in old men towards their own sex ! The great philosopher and thinker evidently was not aware that sexual inversion, as a rule, exists ab origine, and that pederasty, occurring in the senium, is only sexual perversity, but by no means proves the presence of perversion. Binet attempts to explain these pecuhar manifestations 330 PSTCHOPATHIA SEXUALIS. from a psycJwlogical standpoint, thinking (with Condillac) to reduce them— together with other bizarre psychical phenomena — to the law of association of ideas {i.e., association of ideas with sentiments in statu nascendi. This clever psychologist assumes that the instinct not as yet sexually differentiated is determined by the coin- cidence of a vivid sexual emotion with the simultaneous sight or contact of a person of the opposite sex. In this manner a mighty association is created, which takes root by repeating itself, whilst the original associative process is forgotten or becoiaes latent. Even to-day v. Schrenck-Notzing and others lean to this opinion, in their efforts to explain the inverted sexual instinct (chiefly when acquired); but it cannot withstand serious criticism. Psychological forces are insufficient to explain manifes- tations of so thoroughly degenerated a character {vide infra) . Chevalier ("Inversion Sexuelle," Paris, 1893) rightly demurs against Binet that these attempts at psychological explanations explain neither the precocity of homo-sexual impulses, i.e., such as have existed long before sexual feelings were associated with imagination, nor the aver- sion towards the opposite sex, nor early appearance of secondary psychico-sexual manifestations. Nevertheless, Binct's subtle remark that the lasting presence of such associations is only possible in predisposed (tainted) indi- viduals is worthy of note. Neither do the explanations attempted by physicians and naturalists prove anything to satisfaction. Glcy (" Revue philosophique," January, 1884) maintains that those afflicted with inverted sexual instinct have a female brain (!) but mascuHne sexual glands, and that an existing morbid condition of the brain determines the sexual life, whilst e contra and normally the sexual glands influence the sexual cerebral functions. Magnan (" Annales med. psychol.," 1885, p. 458) also speaks of a female brain in the body of a man and vice versa. Ulrichs (" Memnon," HOMO-SEXUAL FEELING AS ABNORMAL MANIFESTATION. 331 1868) comes closer to the point when he speaks of a anima muliehris virili corpori innata, and thus seeks to explain congenital effeminaioO. According to Mantegazza {op. cit. 1886, p. 106), anatomical anomalies exist in such persons in so far as the natural plexus of the genital nerves terminates in the rectum, thus misdirecting thither all lustful desires. But surely nature never is guilty of such errors or " saltus ". Neither does she burden a mascuhne body v^ith a female brain. The author of this hypothesis, otherwise so acute, quite overlooks the fact that the individuals given to sexual inversion, as a rule, abhor the use of the anus — viz., pederasty. Mantegazza reverts, as a support for his hypothesis, to the communications which he received from a well-known prominent author, who assured him that he was not as yet satisfied in his own mind whether he derived greater pleasure from coitus than from defaecation. Even if we admit the correctness of this statement, it would only prove that its author was sexually abnormal, and that he derived but a minimum of pleasure from coitus. Moreover, one would come to the conclusion that the mucous membrane of his rectum was, in some abnormal manner, erogenous. Bernhardi (" Der Uranismus," Berlin, 1882) casually found in five effeminati (" Pathici ") absence of spermatozoa, in four cases not even sperm crystals, and thought to find the solution of this " enigma of many thousand years" in the assumption that the pathicus was a " monster of the feminine sex, having nothing else in common with the male than the male genitals, which in some cases are even only imperfectly developed ". This author could not even base his contention upon an autopsy, which, no doubt, would have eventually established a case of hermaphrodism . Those practising active viraginity and gynandry ho styles as " monsters of mascuhne gender in opposition to which the passive tribadc is as perfect a woman as the active pa^dicator is a perfect man ". 332 PSTCnOPATHIA SEXUALIS. The author of this book has made an attempt to utiHse facts of heredity for an explanation of this anomaly. Proceeding from the experience that manifestations of sexual perversion are frequently found in the parents, he suspects that the various grades of congenital sexual inversion represent various grades of sexual anomaly inherited by birth, acquired by ascendency, or otherwise developed. In this connection, the lavy of progressive heredity must also be considered. All attempts at explanation made hitherto on the ground of natural philosophy or psychology, or those of a merely speculative character are insufficient. Later researches, hovi^ever, proceeding on embryo- logical (onto- and phylogenetic) and anthropological lines seem to promise good results. Emanating from Frank Lydston (" Philadelphia Med. and Surg. Recorder," September, 1888,) and Kiernan (" Medical Standard," November, 1888), they are based (1) on the fact that bisexual organisation is still found in the lower animal kingdom, and (2) on the supposition that mono- sexuality gradually developed from bisexuality. Kiernan assumes in trying to subordinate the sexual inversion to the category of hermaphrodism that in individuals thus affected retrogression into the earlier hermaphrodisic forms of the animal kingdom may take place at least functionally. These are his own words : " The original bisexuality of the ancestors of the race, shown in the rudimentary female organs of the male, could not fail to occasion functional, if not organic reversions, when mental or physical manifestations were interfered with by disease or congenital defect. It seems certain that a feminily functionating brain can occupy a male body and vice versa.'' Chevalier (op. cit., p. 408) proceeds from the original bisexual life in the animal kingdom, and the original bisexual predisposition in the human foetus. According to him the difference in the gender, with HOMO-SEXUAL FEELING AS ABNORMAL MANIFESTATION. 333 marked physical and psychical sexual character, is only the result of endless processes of evolution. The psycho- physical sexual difference runs parallel with the high level of the evolving process. The individual being must also itself pass through these grades of evolution ; it is originally bisexual, but in the struggle between the male and female elements either one or the other is conquered, and a monosexual being is evolved which corresponds with the type of the present stage of evolution. But traces of the conquered sexuality remain. Under certain circum- stances, these caracteres sexuels latents may gain Darwin's signification, i.e., they may provoke manifestations of inverted sexuality Chevalier does not, however, look upon such processes as a retrogression fatavism), in the sense of Lombroso's opinion and that of others, but rather considers them with Lacassagne as disturbances in the present stage of evolution. If the structure of this opinion is continued, the following anthropological and historical facts may be evolved : — 1. The sexual apparatus consists of (a) the sexual glands and the organs of reproduction ; (b) the spinal centres, which act either as a check or a stimulus upon (a) ; (c) the cerebral regions, in which the psychical processes of the vita sexualis are enacted. Since the original predisposition of (a) is of a bisexual character, the same must be claimed for {b) and (c). 2. The tendency of nature in the present stage of evolution is the reproduction of monosexual individuals, and the law of experience teaches that that cerebral centre is normally developed which corresponds with the sexual glands ("Law of the Sexual Homologous Development ") 3. This destruction of antipathic sexuality is at present not yet completed. In the same manner in which the processus vermiformis in the intestinal tube points to former stages of organisation, so may also be found in the sexual apparatus — in the male as well as in the 334 PSYCHOPATHIA SEXUALIS. female — residua, which point to the original onto- and phylogenetic bisexuality, not to speak of hermaphrodisic malformations, which may be looked upon merely as partial excesses of development, or disturbances in the formation of the sexual organisation, and especially of the external genitals. The residua referred to are, in the male, the utriculus masculinus (remnants of the " Miillersche Gangs ") and the nipple, in woman the paroophoron (remnants of the original renal portions of the Wolftian bodies), and the epoophoron (remnants of Wolff's ganglia, and analogous with the epididymis in the male). Beigel, Klebs, Furst and others have found in the human female suggestions of the Wolffian bodies in the shape of the so-called Gartnerian canals, which in the female ruminants are regularly present in the lateral wall of the uterus. 4. Besides, a long line of clinical and anthropological facts favour this assumption. I will only call attention to the not infrequent cases of individuals with characters of mixed or (in the sense of sexual inversion) predominating physical and psychical sexuality ("female men and male women "), to the appearance of the female character (psychically and physically) in men, consequent upon castration {eunuchs), and of the male character in women after the removal of the ovaries in early yd^h, also to the manifestations of viraginity in climax prcBcox, and even to the development of a second gender. Professor Kaltenhach gives a remarkable instance of such a second (antipathic) vita sexualis, developed upon climax jpracox. On the 17th of February, 1892, he consulted me about " a woman, thirty years of age, married two years, who formerly had irregular menstruations ". Since June, 1891, a sudden series of manifestations which corresponded with the process of masculine puberty, viz., full beard, hair of the head much darker, eyebrows HOMO-SEXUAL FEELING AS ABNORMAL MANIFESTATION. 335 and pubis strongly developed, chest and abdomen covered with hair as in man. Increased activity of the sudoriparous and sebaceous glands. Upon chest, back and face strong miliary and acne developments, whilst formerly the tint was classically white and smooth. Change of voice — formerly rich soprano, now a " lieutenant's voice ". The entire facial expression changed. Complete change of carriage : chest broad, waist gone, abdomen prominent with adipose tissue, short thick-set neck, masculine all over. Lower part of face broad, breasts flat and masculine. Psychical changes : formerly mild and tractable, now energetic, hard to control, even aggressive. From the beginning of marriage no adequate sexual desire, but no traces of inversion. In the sexual organs also highly interesting changes may be found. " Thus this young woman has changed into a man, to all intents and purposes." My explanation of the case : — " Climax prcBcox, loss of former feminine sexuality. Physical and psychical development of male sexuality, hitherto latent. Interesting illustration of the bi-sexual predisposition, and of the possibility of continued existence of a second sexuality in a latent state, under conditions hitherto unknown." Unfortunately, I could obtain no further information about the subsequent metamorphosis of this case, or the presence of probable hereditary taint. Vide also cases 108 and 109, given above. In these severe neurasthenia was the causating element of trans- miitatio sexus, based upon heavy taint ; the change, however, being only psychical, and not affecting the physical sexual character. 5. These manifestations of inverted sexuality are evidently found only in persons with organic taint} In 1 The researches in zoology, by Klaus (" Zoology," 1891, p. 490) show that, in the lower grades of the auiiual world, not only hcrmaplirodisni 336 PSYCHOPATHIA SEXUALIS. normal constitutions the law of mono-sexual development, homologous with the sexual glands, remains intact. That the cerebral centre is developed under other conditions, quite independent from the peripheral sexual organs (in- cluding the sexual glands), is evident from the cases oi hermaphrodism (at least, so far as pseudo-hermaphrodism is concerned), in which the law referred to above remains intact in the sense of mono-sexual development, analogous to the sexual glands. In hcrmaprodismus verus, however, physically as well as psychically, a mutual influence of both centres obtains, and thus also a neutralisation of the vita amoris, assuming even a state of asexuality, and a tendency to physically and psychically combine and put into operation both these sexual characters. But hermaphrodism and sexual inversion stand in no relation to each other. This is clear from the fact that the hermaphrodite (or, practically speaking, the pseudo- hermaphrodite) follows the law of evolution quoted above, and does not offer inverted sexuality, whilst, on the other hand, hermaphrodism has never been anatomically observed in cases of antipathic sexual instinct. This follows, without further argument, from the difference of the conditions under which they originate, for in sexual inversion we must look for the cause in central (cerebral) defects, and in hermaphrodism in the anomalies affecting the peripheral sexual apparatus. The facts quoted seem to support an attempt of a historical and anthropological explanation of sexual inversion. It is a disturbance of the law of the development of the cerebral centre, homologous to the sexual glands (homo - sexuality), and eventually also of the law of exists, but that also (physiological ?) sexual exchange in one and the same individual may take place. Klaus states that the cyniothoidecB (classified under Crustacea) perform in the first part of their life the functions of the male, and in the second part under many, even secondary, changes of the sexual character those of the female. HOMO-SEXUAL FEELING AS AB.NOEMAL MANIFESTATION. 337 the mono-sexual formation of the individual (psychical " hermaphrodism "). In the former case it is the centre of bi-sexual predisposition, antagonistic to the gender represented by the sexual gland, which in a paradoxical manner conquers that originally intended to be superior ; yet the law of mono-sexual development obtains.^ In the other case victory lies with neither centre ; yet an indication of the tendency of mono-sexual development remains, in so far that one is predominant, as a rule the contrary. This is the more remarkable since it has not the support of a corresponding sexual gland — in fact, not even a peripheral sexual apparatus, another proof that the cerebral centre is autonomous, and in its development independent of the sexual glands. In the first case it must be assumed that the centre which by right should have conquered was too weak. This fact may be recognised in the subsequently weak libido in the sexual character, but feebly marked in the physical and psychical conditions. In the second case both centres were too weak to obtain victory and superiority. This defect of the natural laws must, from the anthro- pological and clinical standpoint, be considered as a manifestation of degeneration. In fact, in all cases of sexual inversion a taint of a hereditary character may be established. What causes produce this factor of taint and its activity is a question which cannot be well answered by science in its present stage.^ 1 A mono-sexual psychic apparatus of generation, in a mono-sexual body which belongs to the opposite sex, does, of course, not mean a " feminine soul in a masculine brain," or vice versa — this would simply contradict all monistic and scientific thought ; neither a feminine brain in a masculine body — this contradicts every anatomical fact — but only a feminine psycho-sexual centre in a masculine brain, and vice versa. ^ Joseph Mailer, in a clever brochure (" Uber Gamophagy," Stuttgart, 1892) offers an inducement for further research in this direction. Ho advances the opinion that by a certain law established by necessity, and transcending in normal fashion, a union of the organs and their qualities is 22 338 PSYCHOPATHIA SEXUALIS. There are plenty of analogous cases to be found in tainted individuals. For the symptoms of influences disturbing physical and psychical evolution, and plainly to be found in the germ of procreation, exhibit themselves in many other manifestations of a defective or perverse character (signs of anatomical, functional, somatic and psychical degeneration). The antipathic sexual instinct is only the strongest mark left by a vs^hole series of exhibitions of the partial development of psychical and physical inverted sexual characters (vide supra), and one may be easily permitted to say : The more indistinct the psychical and physical sexual characters appear in the individual, the deeper it is below the present level of perfect homologous mono- sexuality obtained in the evolution of manifold thousands of years. The cerebral centre mediates the psychical and, indirectly, also the physical sexual characters. The various grades of congenital antipathic sexuality will be found to correspond with the intensity of various grades of taint. The same holds good with regard to "acquired" sexual inversion, which exhibits itself only later in hfe. Untainted man will never become sexually inverted through onanism or seduction by persons of the same sex ; for, as soon as the extrinsic influences cease, he returns to normal sexual functions. The tainted individual, however, whose psycho-sexual centre is originally weak, is in a different position. All possible psychical and physical deficiencies, especially neurasthenia, are able to impair his weakened sexuality, homologous though it may have been hitherto effected. This union would explain how, in the struggle of the development of mono- and bi-sexuality, those organs and their qualities suffer the common fate of conquest or defeat which belong together as a whole with regard to their functional capacity. The defect of the elements connecting the organs during the struggle for superiority in beings subject to organic taint could only be explained as a negative result of this hypothetical law. CONGENITAL ANTIPATHIC SEXUAL INSTINCT IN MAN. 339 to the sexual glands. These evil influences may render him furthermost psychically bi-sexual, then invertedly mono - sexual, and eventually may effect even eviratio {defeminatio), by way of producing physical and psychical characters of sexuahty, in the sense of predominating contrary, or the destruction of original, centres. On page '269 I have tried to shov7 in how far neurasthenia may give the impulse for the development of antipathic sexuality. Congenital Antipathic Sexual Instinct in IVIan.i The sexual acts by means of which male urnings seek and find satisfaction are multifarious. There are individuals of fine feeling and strength of will who sometimes satisfy themselves with platonic love, with 1 Cases : (1) Gasper, " Klin. Novellen," p. 36 (" Lohrb. d. gerichtl. Med.," 7 Aufl., p. 176). (2) Westphal, " Archiv f. Psychiatrie," ii., p. 73. (3) Schmincke, ibid., iii., p. 225. (4) Scholz, " Vierteljahrssch. f. gerichl. Med.," xix. (5) Clock, " Arch. f. Psychiatrie," v., p. 564. (6) Servaes, ibid., vi., p. 484. Westphal, ibid., vi., p. 620. (8-10) Stark, " Zeitsch. f. Psychiatrie," Bd. 81. (11) Liman {Casper's " Lehrb. d. gerichtl. Med.," 6 Aufl., p. 509), p. 291. (12) Legrand du Saulle, " Ann. mM. psychol.," 1876, May. (13) Sterz, " Jahrb. f. Psych.," iii.. Heft. 3. (14) Knieg, " Brain," 1884, Oct. (15) Charcot and Magnan, " Arch, de neurol.," 1882, No. 9. (16-18) Ki^n, " Zeitsch. f. Psych.," Bd. 39, p. 216. (19) Rabow, " Erlenmeyer's Centralbl.," 1883, No. 8. (20) Blumer, " Americ. Journ. of Insan.," 1882, July. (21) Savage, "Journ. of Ment. Science," 1884, Oct. (22) Scholz, " Viertelj. f. gerichtl. Med.," N.F., Bd. 43, Heft. 7. (23) Magnan, " Ann. m6d. psych.," 1885, p. 461. (24) Chevalier, " Do I'inversion de I'instinct sexuel," Paris, 1885, p. 129. (25) Morsclli, " La riforma medica," 4 vol., March. (26) Leonpacher, "Friedreich's Blatter," 1888, Heft. 4. (27) Hollander, " Allg. Wiener mad. Zeit.," 1882. (28) Kriese, " Erlenmeyer's Centralbl.," 1888, No. 19. (29-32) v. KraJJt, " Psychopathia Sexualis," 3rd edit., cases 32, 36, 42, and 43. (33) Golcnko, " Euss. Arch. f. Psych.," Bd. ix.. Heft 3. (von Rothe mitgetheilt, in " Zeitsch. f. Psych."). (34) V. Krafft, " Internat. Centralblatt, f. d. Physiol, and Pathol, d. Harn- und Sexualorgane." Bd. i.. Heft 1. (35) Cantarano, " La Psichi- atria," 1887, vol. v., p. 195. (36) Sirieux, " Rcchorches cliniques sur les anomalies d I'instinct sexuel," Paris, 1888, obs. 13. (37-42) Kiernan, " The Med. Standard," 1888, 7 cases. (43-46) Rabow, " Zeitsch. f. Klin. Mod.," Bd. xvii., Suppl. (47-51) v. KrajJt, " Neue Forschungen," Bcob. 1, 3,4, 5, 340 PSYCHOPATHIA SEXUALIS. the risk, however, of becoming nervous (neurasthenic) and insane as a result of this enforced abstinence. In other instances, for the same reasons which may lead normal individuals to avoid coitus, onanism, faute de mieux, is indulged in. In urnings with nervous systems congenitally irritable, or injured by onanism (irritable weakness of the ejacu- lation centre), simple embraces or caresses, with or without contact of the genitals, are sufficient to induce ejaculation and consequent satisfaction. In less irritable individuals, the sexual act consists of manustupration by the loved person, or mutual onanism, or imitation of coitus between the thighs. In urnings morally perverse and potent, quoad erectionem, the sexual desire is satisfied by pederasty, — an 8. (52-61) Idem, " Psychopathia Sexualis," 5th edit. Beob. 53, 61, 64, 66, 73, 75, 78, 84, 85, 87. (62-65) Idem, " Neue Forschuugen," 2nd edit., Beob. 3, 4, 5, 6. (66-67) Hammond, " Sexual Impotence ". (63-71) Gamier, "Anomalies sexuelles," 1889, cases 227, 228, 229, 280. (72) v. Erafft, "Friedreich's Blatter," 1891, Heft 6. (73-87) Idem, "Psych. Sex.," 6th edit., Beob. 78, 81, 82, 84, 85, 86, 87, 89, 93, 94, 96, 97, 98, 101, 102. (88) Frdnhel, " Med. Zeit. d. Vereins f . Heilkunde in Preussen," Bd. 22, p. 102 {homo mollis). (89-91) Bernheim, " Hypnotisme," Paris, 1891, obs. 38, etc. {92) Wetterstrand, " Der Hypnotismus," 1891. (93) Milller, " Hydrotherapie," 1890, p. 309. (94-96) v. Schrenck-Notzing, " Suggestions therapie," 1892, cases 63, 67, 68. (97) Ladame, " Revue de I'hypnotisme," 1889, Sept. 1. (98) v. Krafft, " Internat. Centralblatt f. d. Krankh. d. Harn- Geschlechtsorgane," Bd. i.,Heftl. (99-100) T^acJi/wZz, " Friedreich's Blatter f. gerichtl. Med.," 1892, Heft 6. (101-110) Moll, " Contr. Sexual- empfindung," 2 edit., cases 1-10. (111-123) v. Krafft, " Psych. Sex.," 8 Aufl., Beob. 109, 110, 114, 119, 121, 122, 125, 136, 137, 138, 140, 141, 143. (124-143) Idein, " Jahrb. f. Psych.," xii., 1894. (144) Legrain, "Arch, de Neurologie," 1886, Jan. (145) Dessoir, " Zeitsch. f. Psychiatric," Bd. 50, Heft 5, p. 959. (146-151) v. Krafft, "Psych. Sex.," 9. Aufl., Beob. 109, 110, 128, 129, 131, 133. (152-181) Idem, " Der contrar Sexuale vor dem Strafrichter," 2 Aufl., Wien, 1895, Beob. 21-50. (182) " Laupts, "Arch. d'Authropol. criminelle," 1894 and 1895, p. 320. (183) Snoo, " Psychiatr. Bladen," xii., xiii. (184) Mcyhofer, " Zeitschr. f. Med. Beamte," v., 16. (185) Talbot, " Journ. of Mental Science," 1896, April. (186-218) Moll, " Untersuchungen iiber Libido Sexualis," cases 5, 6, 9, 15-27, 30, 38, 48, 49, 53-55, 63, 64, 67, 69, 71, 72, 74, 75, 77, 78. (219-251) Havelock Ellis, " Bulletin of the Psychol. Section," 1895, Dec, vol. 3, No. iv. (252) Spaink, "Psych. Bladen," 1893, 3. CONGENITAL ANTIPATHIC SEXUAL INSTINCT IN MAN. 311 act, however, which is repugnant to perverted individuals that are not defective morally, much in the same way as it is to normal men. The statement of urnings is remarkable, that the adequate sexual act with persons of the same sex gives them a feeling of great satisfaction and accession of strength, while satisfaction by solitary onanism, or by enforced coitus with a woman, affects them in an unfavourable way, making them miserable and increasing their neurasthenic symptoms. As to the frequency^ of the occurrence of the anomaly, it is difficult to reach a just conclusion, since those affected with it break from their reserve but infrequently ; and in criminal cases the urning with perversion of sexual instinct is usually classed with the person given to pederasty for simply vicious reasons. According to Gasper and Tardieu's, as well as my own, experience, this anomaly is much more frequent than reported cases would lead us to presume. Ulrichs (" Kritische Pfeile," p. 2, 1880) declares that, on an average, there is one person affected with antipathic sexual instinct to every 200 mature men, or to every 800 of the population ; and that the percentage among the Magyars and South Slavs is still greater, — statements ^ That inversion of the sexual instinct is not infrequent is proved, among other things, by the circumstance that it is frequently a subject in novels. Chevalier (op. cit.) points out in French literature, besides the novels of Balzac, like "La Passion au Desert " (treating of bestiality) and " Sarrazine " (treating of the love of a woman for a eunuch), Diderot's " La Religieuse " (a story of one given to amor lesbicus) ; Balzac's " La Fille aux Yeux d'Or " (amor lesbicus) ; Th. Gautier's " Mademoiselle de Maupin " ; Feydeau's " La Comtesse de Clialis " ; Flaubert's "Salammbo," etc. Belot's " Mademoiselle Giraud, ma Femme " may also be mentioned (now translated into English). It is interesting that the heroines of these (Lesbian) novels appear in the character and rdlc of the husband of a lover of the same sex, and that their love is extremely passionate. Moreover, the neuropathic foundation of this sexual perversion does not escape the writers. This theme is treated in German literature in " Fridolin's heimliche Ehe," by Wilbrand ; in "Brick and Brack oder Licbt im Schatten," by Emerich Graf Stadion ; also by Balduin Groller, " Prinz Klotz ". The oldest urning romance is probably that published by Fetronius at Home, under the Empire, under the title " Satyricon ". 342 PSYcnorATHiA sexualis. which may be regarded as untrustworthy. The subject of one of my cases knows personally, at his home (13,000 inhabitants), fourteen urnings. He further declares that he is acquainted with at least eighty in a city of 6(3,000 inhabitants). It is to be presumed that this man, otber- wise worthy of belief, makes no distinction between the congenital and the acquired anomaly. 1. Psychical Hermaphroditism.^ The characteristic mark of this degree of inversion of the sexual instinct is that, by the side of the pronounced sexual instinct and desire for the same sex, a desire toward the opposite sex is present ; but the latter is much weaker and is manifested episodically only, while the homo-sexuality is primary, and, in time and intensity, forms the most striking feature of the vita sexualis. The hetero-sexual instinct may be but rudimentary, manifesting itself simply in unconscious (dream) life ; or (episodically, at least) it may be powerfully exhibited. The sexual instinct toward the opposite sex may be strengthened by the e.xercise of will and self-control ; by moral treatment, and possibly by hypnotic suggestion ; by improvement of the constitution and the removal of neuroses (neurasthenia) ; but especially by abstinence from masturbation. However, there is always the danger that homo-sexual feelings, in that they are the most powerful, may become permanent, and lead to enduring and exclusive antipathic sexual instinct. This is especially to be feared as a result of the influences of masturbation (just as in acquired inversion of the sexual instinct) and its neuras- thenia and consequent exacerbations ; and, further, it is to be found as a consequence of unfavourable experiences * Cf. author's work, " Uebcr psychosexuales Zwittcrthum," in the "Internationales Centralblatt f. d. Physiologic u. Pathologic dor Harn- und Sexualorganc," Bd. i.. Heft 2. PSYCHICAL HERMAPHRODITISM. 343 in sexual intercourse with persons of the opposite sex (defective feeling of pleasure in coitus, failure in coitus on account of weakness of erection and premature ejaculation, infection). On the other hand, it is possible that aesthetic and ethical sympathy with persons of the opposite sex may favour the development of hetero-sexual desires. Thus it happens that the individual, according to the predomi- nance of favourable or unfavourable influences, experiences now hetero-sexual, now homo-sexual, feeling. It seems to me probable that such hermaphrodites from constitutional taint are not infrequent.^ Since they attract very little attention socially, and since such secrets of married life are only exceptionally brought to the knowledge of the physician, it is at once apparent why this interesting and practically important transitional group to the group of absolute inverted sexuality has thus far escaped scientific investigation. Many cases of frigiditas uxoris and mariti may possibly depend upon this anomaly. Sexual intercourse with the opposite sex is, in itself, possible. At any rate, in cases of this degree, no horror sexus alterius exists. Here is a fertile field for the application of medical and moral therapeutics (v. infra). The differential diagnosis from acquired antipathic sexual instinct may present difficulties ; for, in such cases, as long as the vestiges of a normal sexual instinct are not absolutely lost, the actual symptoms are the same {v. infra). In the first degree, the sexual satisfaction of homo- sexual impulses consists in passive and mutual onanism and coitus inter femora. Case 113. Antipathic sexual instinct with sex^tal satis- 1 This idea is supported by the statemonta of an unmarried urning, which Dr. Moll, of Berlin, kindly comraunicatcd to me. lie oould report a number of cases of his acquaintance, in which married men at the same time had " relations " with men. 344 PSYCIIOPATHIA SEXUALIS. faction in heterosexual intercourse. Mr. Z., aged thirty-six, consulted me on account of an anomaly of his sexual feelings, which had become a matter of anxiety to him in connection with an intended marriage. Patient's father was neuropathic, and suffered with nightmare and night-terrors. Grandfather was also neuropathic ; father's brother an idiot. Patient's mother and her family were healthy and normal mentally. The patient had three sisters and one brother, the latter being subject to moral insanity. Two sisters are healthy, and living happy married lives. As a child, the patient was weak, nervous, and subject to night-terrors, like his father ; but he never had any severe illness except coxitis, as a result of which he limps slightly. Sexual impulses were manifested early. At eight, without any teaching, he began to masturbate. From his fourteenth year, ejaculation. He was mentally well endowed, and his principal interest was in art and hterature. He was always weak muscularly, and had no inclination for boyish sports and later for manly occu- pations. He had a certain interest for female toilettes, ornaments, and occupations. From the time of puberty the patient noticed in himself an inexplicable inclination toward male persons. Youths of the lowest classes were especially attractive to him. Cavalry men especially excited his interest. He experienced a lustful desire to press himself against such individuals from behind. Occasionally, in crowds, it was possible for him to do this ; and in such an event an intense feeling of pleasure passed over him. After his twenty-second year, on such occasions, he now and then had an ejaculation. From that time ejaculation occurred when a sympathetic man laid his hand on the patient's thigh. He was now in great anxiety lest he might sometime assault a man sexually People of the lower classes, wearing tight, brown trousers, were especially dangerous for him. His greatest pleasure would be to embrace such a man and PSYCHICAL HEEMAPHRODITISM. 345 press himself to him ; but, unfortmiately, the movahty of his country did not allow such a thing. Pederasty seemed disgusting to him. It gave him great pleasure to gain a sight of the genitals of males. He was always compelled to look at the genitals of every man he met. In circuses, theatres, etc., only male performers interested him. Patient has never noticed any inclination for women. He does not avoid them, even dances with them on occasion, but he never feels the slightest sensual excitation under such circumstances. At the age of twenty-eight the patient was neurasthenic as a result of his excessive masturbation. Then frequent pollutions in sleep occurred, which weakened him very much. It was only occasionally that he dreamed of men when he had pollutions ; and never of women. A lascivious dream-picture (pederasty) had occurred but once. He dreamed of death-scenes, of being attacked by dogs, etc. After these, as before, he suffered with great libido sexualis. Often there came up before him such lascivious thoughts as gloating over the death of animals in the slaughter-house, or allowing himself to be whipped by boys ; but he always overcame such desires, and also the impulse to dress in a military uniform. In order to cure himself of masturbation, and to thoroughly satisfy his libido, he determined to frequent brothels. He first attempted sexual intercourse with a woman when twenty-one, after over-indulgence in wine. The beauty of the female form, and female nudity in general, made no impression on him. However, he was able to enjoy the act of coitus, and thereafter he visited brothels regularly for " purposes of health ". From this time he took great pleasure in hearing men tell stories of their sexual relations with the opposite sex. Ideas of flagellation would also come to him while in a brothel, but the retention of such fancies was not essential for the performance of coitus. He considered 346 PSYCHOPATniA SEXUALIS. sexual intercourse with prostitutes only a remedy against the desire for masturbation and men, — a kind of safety- valve to prevent compromising himself with some man. The patient now wishes to marry, but fears not only that he could have no love for a decent woman, but also that he might be impotent for intercourse with her. Hence his thought and need of medical advice. The patient is very intelligent, and is, in all respects, of masculine appearance. In dress and manner he presents nothing that would attract attention. Gait, voice and frame, — the pelvis especially, — masculine in character. Genitals of normal development. The normal growth of hair for a male is abundant. The patient's relatives and friends have not the slightest suspicion of his sexual anomalies. In his inverted sexual fancies he has never felt himself in the role of a woman toward a man. For some years he has been entirely free from neurasthenic troubles. The question as to whether he considered himself a subject of congenital sexual inversion he could not answer. It seems probable that there was a congenital weak inclination for the opposite sex, with a greater one for the same sex, which, as a result of early masturbation in consequence of the homo-sexual instinct, was still more weakened, but not reduced to nil. With the cessation of masturbation, the feeling for women became in a measure more natural, but only in a coarsely sensual way. Since the patient explained that, for reasons of family and ])usiness, it was necessary for him to marry, it was impossible to avoid this delicate question. Fortunately, the patient limited his inquiries to the question as to , his virility as a husband ; and it was necessary to reply that he was virile, and that he would probably be so in conjugal intercourse with the wife of his choice, — at least, if she were to be in mental sympathy with him ; besides, that he could at all times improve his power by exercising his imagination in the right direction. PSYCHICAL HERMAPHRODITISM. 347 The main thing was to strengthen the sexual inchnation for the opposite sex, which was defective, hut not absolutely wanting. This could be done by avoiding and opposing all homo-sexual feelings and impulses, possibly with the help of the artificial inhibitory influences of hypnotic suggestion (removal of homo-sexual desires by suggestion); by the excitation and exercise of normal sexual desires and impulses; by complete abstinence from masturbation, and eradication of the remnants of the neurasthenic condition of the nervous system by means of hydro- therapy, and possibly general faradisation. I am indebted to a physician, aged thirty, for . the following autobiography, which is also in other respects noteworthy : — Case 114. Psychic hermaphroditism ; abortive antipathic sexual instinct. "In my ancestry I am rather predisposed hereditarily. My grandfather on my father's side was a high-liver and a speculator. My father was a man of character, but for more than thirty years he suffered with folic circulairc, without, however, being much hampered by it in business. My mother, Hke her father before her, suffers with stenocardiac attacks. My mother's father and brother are said to have been sexually hyperaesthetic. My only sister, about nine years older than myself, was twice subject to attacks of eclampsia, and during puberty was religiously exalted, and probably also sexually hyper- a)sthetic. During many years she suffered with severe hysterical neurosis, but she is now quite hardy. " As an only son, and born late, I was the apple of my mother's eye ; and it is due to her indefatigable care that I survived childhood, after having passed througli all the possible diseases of children (hydrocephalus, measles, croup, small -pox, and, at thirteen, chronic intestinal catarrh, which lasted a year). My mother, being herself very religious, raised me, witliout spoiling me, in a religious 348 PSYCHOPATIIIA SEXUALIS. way, and implanted in me, as ihe gaiding moral principle, an unyielding devotion to duty which was further carried to an extreme in me by a teacher whom I still call a friend. Owing to my dehcate health, my childhood, in greater part, was spent in bed. I was given to quiet occupations, especially reading ; and thus as a boy I came to be — if not hlas4 — premature at least. As early as eight or nine the parts of books that excited me most were those where injuries or operations that had to be endured by beautiful girls or ladies were described. Thus I was thrown into great excitement by a story in which was pictured a maiden that had run a thorn into her foot, with a boy taking it out for her. Indeed, every time that I looked upon this picture, which was in nowise lascivious, I had an erection. Whenever possible, I went to see chickens killed ; and if I had missed that, I looked at the spots of blood, and stroked the warm bodies of the birds, with pleasurable shudders. I would emphasise the fact that I have always been a great lover of animals, and have felt disgust and pity while killing larger animals, and even in the vivisection of frogs. " The kiUing of chickens is still a great sexual stimulus for me, and especially holding them, during which I have palpitation of the heart and precordial oppression. It is of interest that my father had a passion for binding to- gether the hands of girls and young women. " I think that another of my sexual abnormalities is attributable to this strain of cruelty. As I shall clearly describe later, one of my favourite games was that of an improvised doll-theatre, where I inspired the parts of my companions. Almost always it was a young girl who, at the command of her papa, whom I represented, had to have a painful operation done on her foot. The more the girl cried, the more it gratified me. How I came to hit upon the foot as the constant object of operation will be seen from the following: When a very young boy, I happened to see my eldest sister change her stockings. PSYCHICAL HERMAPHRODITISM. 3-19 When she hastily hid her feet, my attention was attracted and immediately the sight of her bare feet to the ankles came to be the ideal of my longing. Naturally, this made my sister very careful. This became the occasion for constant quarrels, which, on my part, were kept up with all the wiles of cunning and flattery, and with even ex- plosions of anger, until my seventeenth year. In other respects my sister was to me very indifferent. Indeed, her kiss is repugnant to me. Faute de mleux, I made use of the feet of servants (masculine feet had no effect on me). My greatest desire would have been to cut the nails, or, sit venia verbo, the corns, on the foot of a beautiful woman. My lustful dreams were concerned with these things. Indeed, I applied myself to the study of medicine really in the expectation of gaining an opportunity to satisfy my desires, or cure them. Thank God, I attained the latter. After undertaking the first dissection of the lower extremity of a female, this unhappy desire was removed from me. I was unhappy because I was always deeply ashamed of this impulse. I think I may spare further details concerning it, since this peculiar enthusiasm, which even inspired me to write verses, has been sufficiently described by others. " Now concerning the last phase of my sexual errors : I was about thirteen, and had just begun to mature, when a school-mate, who happened to be our guest, teased me one night by kicking me with his bare feet under the covers. I seized his foot, and immediately became greatly excited, and had a pollution after it — the first that I had. The boy was peculiarly girlish in form, and was also mentally effeminate. Again another comrade who had very small and delicate hands and feet, whom I once saw in a bath, caused unusual excitement in me. I thought it a great piece of good fortune to be in bed with either of these, though any nearer sexual intercourse than embracing them never came into my mind. Moreover, I always thrust such thoughts aside with aversion. Some 350 PSYCHOPATHIA SEXUALIS. years later, when about sixteen or eighteen, I made the acquaintance of two other boys that awakened my sexual feehng. When I played with either of these, I immediately had an erection. Both were very energetic and lively, but delicately formed and child-like. At the occurrence of puberty I lost interest in both of them, though a warm friendship was preserved. I should never have allowed myself to indulge in vicious practices with them. " When I went to the university, I forgot completely these errors of my libido sexualis, and from principle I avoided sexual intercourse until I was twenty-four, despite the contempt of my companions. When pollutions became too frequent, and I began to fear cerebral neurasthenia ex abstinentia, I indulged in normal sexual intercourse, and although doing it in a rather vigorous manner, I derived much benefit from it. " The especial field of work to which I have devoted myself is responsible for the fact that I am almost im- potent with pueltis publicis, and also for the fact that the naked form of a woman disgusts rather than excites me. The act always satisfies me the most, if, during it, I can keep the vision of the face before me ; but since, on the other hand, the idea that the girl near me is enjoyed by another is unbearable, for years I have found it absolutely necessary for my mental comfort, despite the pecuniary sacrifice, to keep a mistress, and, indeed, a virgin. Other- wise the most terrible jealousy made me absolutely in- capable of work. I must also mention that, at thirteen, I fell in love platonically for the first time ; and since then I have often pined in chaste love. What distinguishes my case from all others is the fact that I have never once masturbated in my life. "Some weeks ago, in sleep, I was frightened by a dream of naked boys, from which I awoke with an erection. In conclusion, I venture to undertake the difficult task of describing my present condition : Medium height, grace- fully formed. Skull dolichocephalic, with prominence in PSYCHICAL HEEMAPHRODITISM. 351 the occipital region ; circumference, 59 centimetres; frontal prominence marked ; glance somewhat neuropathic ; pupils medium ; teeth very defective ; muscular structure, strong and tense ; abundant hair, blonde. Varicocele on the left side ; frenum too short, which hindered me in coitus. I severed it myself three years ago. Since then ejaculation is retarded, and pleasurable feeling much diminished. Temperament choleric. Quick of comprehension ; good at drawing conclusions ; energetic ; for one hereditarily predisposed, very persevering. I learn languages easily, and have a good ear for music, but otherwise I have no talent for the arts. I am always ambitious to do my duty, but I am constantly troubled with tadium vitm, and only kept from attempts at suicide by my religion and the thought of my mother. Otherwise I am a typical candidate for suicide. I am ambitious, jealous, have a fear of paralysis ; left-handed. I am filled with socialistic ideas. I like adventures, and I am courageous. I have decided never to marry." Case 115. Psychical hermaphrodism. Hetero-sexual feeling early interfered with by masturbation, but epi- sodically very intense. Homo-sexual feeling ab origine perverse (sexual excitation by men's boots). Mr. X., of high social position, aged .twenty-eight, came to me in September, 1887, in a despairing mood, to con- sult me on account of a perversion of his vita scxualis, which made life seem almost unbearable to him, and which had repeatedly brought him near to suicide. The patient comes of a family in which neuroses and psychoses have been of frequent occurrence. In the father's family there had been marriages between first cousins for three generations. The father is said to have been a healthy man, and to have lived morally in marriage. However, his father's preference for fine-looking servants seems remarkable to the son. The mother's family is described as eccentric. The mother's grandfather and great-grandfather died 352 PSYCHOPATHIA SEXUALIS. melancholic ; her sister was insane ; a daughter of the grandfather's brother was hysterical, and had nympho- mania. Only three of the mother's twelve brothers and sisters married. Of these, one brother was homo-sexual, and always nervous as a result of excessive masturbation. The patient's mother is said to have been a bigot of small mental endowment, nervous, irritable, and inclined to melancholia. Patient has a sister and a brother. The brother is neuropathic and frequently melancholic ; and, though mature has never shown the slightest trace of sexual inclinations. The sister is an acknowledged beauty, and much sought by gentlemen. This lady is married, but childless, as reported, owing to the impotence of her husband. She has always been indifferent to the at- tentions shown her by men, but is charmed by female beauty, and actually in love with some of her female friends. With respect to himself, the patient asserts that when four years old he dreamed of handsome jockeys wearing shining boots. He never dreamed of women when he grew older. His nightly pollutions were always induced by "boot-dreams". From his fourth year he had a peculiar partiality for men, or, more correctly, for lackeys wearing shining boots. At first they only excited his interest, but, with development of his sexual functions, the sight of them caused powerful erections and lustful pleasure. It was only servants' boots that affected him ; the same kind of boots on persons of like social station were without effect on him. In a homo-sexual sense, there was no sexual impulse connected with these situations. Even the thought of such a possibility was disgusting to him. At times, however, he had sensually coloured ideas — like being his servant's servant, and drawing off his boots ; but the idea of being stepped on by him, or of having to blacken his boots, was most pleasing. The pride of the aristocrat rose up against such thoughts. In PSYCHICAL HEEMArHEODITISM. 353 general, these notions about boots were disgusting and painful to him. Sexual instinct was early and powerfully developed. It first found expression in indulgence in sensual thoughts about boots, and, after puberty, in dreams accompanied by pollutions ; otherwise, mental and physical development was undisturbed. Patient was well endowed mentally — learned easily, finished his studies, and became an officer. On account of his distinguished, manly appearance and his high position, he was much sought in society. He characterises himself as a clever, quiet, strong- willed, but superficial man. He asserts that he is a passionate hunter and rider, and that he has never had any inclination for feminine pursuits. In the society of ladies he has always been reserved ; dancing always tired him. He never had an interest in any lady of high social position. As for women, only the buxom peasant girls, such as are the models of painters in Kome, had taken his fancy. He had, however, never felt any sexual interest even in such representatives of the female sex. In the theatre and circus only male performers had attracted him ; but, at the same time, they caused him no sensual feelings. As for men, only their boots excited him, and, indeed, only when the wearers belonged to the servant class and were handsome men. Men of his own position, wearing ever so fine boots, were absolutely indifferent to him. With reference to his sexual inclinations, the patient IS still uncertain whether he feels these more toward the opposite sex or his own. He is inclined to think that originally he had more inclination for women, but that this sympathy was, in any case, very weak. He states with certainty that the sight of a naked man made no impression on him, and that thc3 sight of male genitals was even repugnant to him. In the case of women, this was not exactly the case; but even the most beautiful feminine form did not excite him sexually. When a 23 354 PSYCHOPATHIA SEXUALIS. young officer, he was now and then compelled to accom- pany his comrades to brothels. He was the more easily persuaded to this, since he hoped by this means to get rid of his vile partiality for boots ; but he was impotent unless he brought the thought of boots to his aid. Under such circumstances, the act of cohabitation was normally performed, but without pleasurable feeling. Patient felt no impulse to intercourse with women, always requiring some external cause — i.e., persuasion. Left to himself his vita sexualis consisted in revelling in ideas about boots, and in corresponding dreams with pollutions. Since more and more there became connected with them the impulse to kiss his servant's boots, to draw them off, etc., the patient determined to use every means to rid himself of this disgusting desire, which deeply wounded his pride. At that time, being in his twentieth year, and in Paris, he recalled a very beautiful peasant girl, who lived in his distant home. He hoped, with her assistance, to free himself of his sexual perversion. He went home, and tried to win the girl's favour. He asserts that at that time he was deeply in love with this person, and that the sight of her, or the touch of her dress, gave him sensual pleasure ; and, when she once kissed him, he had a powerful erection. After about a year and a half, the patient succeeded in gaining his desires with this person. He was potent, but ejaculated tardily (ten to twenty minutes), and never had a pleasurable feeling in the act. After about a year and a half of sexual intercourse with this girl, his love for her grew cold, because he did not find her so " fine and pure " as he wished. From this time it was necessary for him to call upon ideas about boots for help, which had been latent, in order to be potent in sexual intercourse with her. In proportion as his power failed, these ideas arose spontaneously. There- after he had coitus with other women. Now and then, especially when the woman was in sympathy with him, the act took place without any assistance of imagination. PSYCHICAL HEEMAPHRODITISM. 355 It once happened that the patient committed a rape. It is remarkable that on this single occasion he had a pleasurable feeling in the (forced) act. Immediately after the deed he had a feeling of disgust. When, an hour after the forced indulgence, he had coitus with the same v/oman, with her consent, he experienced no feeling of pleasure. With the decline of virility — i.e., when it was main- tained only with ideas about boots — libido for the opposite sex decreased. The patient's slight libido and weak inclination for women are evidenced by the fact that, while he still sustained sexual relations with the peasant girl, he began to masturbate. He learned the vice from ^^ Bo^Lsseaii,''s Confessions," the book accidentally falling into his hands. The boot - fancies immediately linked themselves with corresponding impulses. He then had violent erections, masturbated, and ejaculation afforded him a lively feeling of pleasure, which was denied to him in coitus ; and at first he felt himself mentally brighter and fresher, as a result of masturbation. In time, however, symptoms of sexual, and later on of general neurasthenia, with spinal irritation, appeared. He then temporarily gave up masturbation, and sought his first love ; but she was now more than ever indifferent to him. Since he finally became impotent, even when he called ideas of boots to his assistance, he gave up women entirely, and again practised masturbation ; which protected him from the impulse to kiss and blacken, etc., servants' boots. At the same time, he felt his sexual position keenly. He again occasionally attempted coitus, and was successful in it as soon as he thought of blackened boots. After continued abstinence from masturbation, he was at times successful in coitus without any artificial aid. The patient says that his sexual needs are intense. If no ejaculation has taken place for a long time, he becomes congestive, psychically much excited, and tor- 356 PSYCHOPATHIA SEXUALIS. mented by repugnant images of boots, so that he is forced to have coitus, or, preferably, to masturbate. During the past year his moral position became most painfully complicated by the fact that, as the last of a wealthy line of high position, and at the importunate desire of his parents, he must marry. The bride is of rare beaut}^ and mentally in perfect sympathy with him ; but, as a woman, she is as indifferent to him as any other, .^sthetically she satisfies him " as any work of art would " ; in his eyes, she is simply ideal. To honour her in a platonic way would be happiness worth striving for ; but to possess her as a wife is a painful thought. He is certain beforehand that with her he will be impotent, save with the help of ideas of boots. To use such means, however, is in opposition to his respect and his moral and sesthetic feelings for the lady. Were he to soil her with such thoughts, she would lose, in his eyes, all her aesthetic value ; and then he would become impotent for her, and she would become repugnant to him. The patient considers his position one of despair, and confesses that he has of late been repeatedly near suicide. He is a man of much intelligence, and decidedly of masculine appearance, with abundant growth of beard, deep voice, and normal genitals. The eye has a neuro- pathic expression. No signs of degeneration. Symptoms of spinal neurasthenia. It was possible to reassure the patient, and give him hope of his future. The medical advice consisted in means for combatinfj the neurasthenia, and the interdiction of masturbation and indulgence of the fancy in images of boots, in the hope that, with the removal of the neurasthenia, cohabi- tation without ideas of boots would become possible ; and that, in time, the patient would become morally and physically capable of marriage. In the latter part of October, 1888, the patient wrote to me that he had resolutely resisted masturbation and his imagination. In the interval he had had but one dream HOMO-SEXUAL INDIVIDUALS. 357 about boots, and scarcely a pollution. He had been free from homo-sexual inclinations, but, in spite of this, there was often considerable sexual excitement, without any- thing like adequate libido for woman. In this deplorable situation, he was now compelled by circumstances to marry in three months. 2. Homo-Sexual Individuals, or Urnings. In contradistinction from the preceding group of psycho-sexual hermaphrodites, there are here present, ah origine, sexual desires and inclinations for persons of the same sex exclusively ; but, in contrast with the following group, the anomaly is hmited to the vita sexualis, and does not more deeply and seriously affect character and mental personality. The vita sexualis of these urnings, mutatis mutandis, is entirely like that in normal hetero-sexual love ; but, since it is the exact opposite of the natural feeling, it becomes a caricature, and this the more, since these individuals, at the same time, and as a rule, are subject to hyperas- thesia sexualis ; wherefore, their love for their own sex is emotional and passionate. The urning loves and deifies the male object of his affections, just as the normal man idealises the woman he loves. He is capable of the greatest sacrifice for him, and experiences the pangs of unhappy, often unrequited, love ; he suffers from the disloyalty of the beloved object, and is subject to jealousy, etc. The attention of the male-loving man is given only to male dancers, actors, athletes, statues, etc. The sight of female charms is indifferent to him, if not repulsive. A naked woman is disgusting to him, while the sight of male genitals, hips, etc., affords him infinite pleasure. Bodily contact with a sympathetic man induces a thrill of delight ; and, since such individuals are in most cases sexually neurasthenic (congenitally or from onanism 358 PSTCHOPATIIIA SEXUALIS. or enforced abstinence from sexual intercourse), under such circumstances ejaculation is very easily induced, which even in the most intimate intercourse with women cannot be induced at all, or only by mechanical means. The sexual act with a man, in many instances, affords pleasure, and leaves behind a feeling of comfort. Should the urning be able to force himself to coitus, in which, as a rule, disgust has the effect of an inhibitory concept, and makes the act impossible, then his feeling is something like that of a man compelled to take disgusting food or drink. However, experience teaches that not infrequently urnings belonging to this group marry, either from ethical or social considerations. Such unfortunates are relatively potent, in so far that in marital intercourse they incite their imagination, and, instead of thinking of their wives, they call up the image of some loved male person. But for them coitus is a great sacrifice, and no pleasure. It makes them, for days after, nervous and miserable. If such urnings, by means of powerful stimulation of their fancy, or under the influence of alcohoHc drink, or by erections induced by an overfilled bladder, etc., are not enabled to overcome the inhibitory feelmgs and ideas, then they are entirely im- potent ; while the mere touch of a man may induce intense erection, and even ejaculation. Dancing with a woman is unpleasant to an urning, but to dance with a man, especially one with an attractive form, is to him the greatest of pleasures. The male urning, if he possess higher culture, is not opposed to non-sexual intercourse with women, when by mind and refinement they make conversation charming It is only woman in her sexual role that he abhors. In this degree of sexual degeneration, character and occupation correspond with the sex which the individual represents. Sexual perversion remains an isolated anom- aly of the mental benig of the individual, deeply affecting the social existence. In accordance with this, these HOMO-SEXUAL INDIVIDUALS. 359 individuals feel themselves in the sexual act in the same role which would naturally be theirs in hetero-sexual intercourse. However, transitions to group 3 occur, inasmuch as sometimes the passive rdle which corresponds with homo- sexual feeling is thought of or desired, or at least forms the subject of dreams. Moreover, leanings to occupations and tendencies of taste are manifested which do not correspond with the sex of the individual. In many cases one gets the impression that such symptoms are artificial, the result of educational influences ; in other cases, that they represent deeper acquired degenerations of the original anomaly, superinduced by perverse sexual activity (masturbation), and analogous to the signs of progressive degeneration observed in acquired sexual inversion. Regarding the manner of sexual satisfaction, it must be stated that with many male urnings the mere embrace is sufficient to induce ejaculation, subject as they are to irritable weakness of the sexual apparatus. In cases of sexual hypersesthesia, and of paresthesia of the moral sense, great pleasure is afforded by intercourse with persons of the lowest condition. On the same basis, desires to commit pederasty (active, of course) and other similar aberrations occur, though it is but seldom, and apparently only in cases of moral defect, and by reason of libido nimiain individuals especially passionate, that active pederasty is indulged in. The sexual desire of mature urnings, in contradistinction to old and decrepit debauchees, who prefer boys {and indulge in pederasty by preference), seems never to be directed to immature males. Only for want of better material, and in case of violent passion, does the urning become dangerous to boys. Case 116. Mr. A., thirty years of age, artist. Mother heavily tainted psychopathically. Brother sexually in- verted. A. is neuropathic from childhood ; with puberty 360 PSTCHOPATHIA SEXUALIS. neurasthenic. At the age of six he felt extremely happy when it became his lot to sit near a certain chmn in school. With puberty he began to masturbate, thinking during the act of sympathetic playfellows. Pollutions accom- panied by homo-sexual dreams. He does not fancy the passive role towards the male sex. When twenty years of age, but more so at the age of twenty-five, he was very much in love with men fully matured. Woman possessed no charm for him. He made several attempts at coitus cum j^uclUs, succeeded, but derived no pleasure either mentally or physically from it, and soon relinquished all intimate intercourse with the female sex. Only men of manly appearance, of high education and refined manners impress him. He cannot resist such men. A. contends that he is not sensual, but that he takes interest more in the soul than in the body of others. His sexual gratification consists in kisses and em- braces, which produce ejaculation, with intense lust. This prevents masturhatio ynutita, and other immoral actions, which disgust him. Faute de micux, he has at times indulged in masturhatio solitaria. He is of decidedly masculine appearance, without any signs of degeneration. He acknowledges his sexual position to be abnormal, but feels quite happy in it. Case 117. Mr. U., twenty-four years old, technician. Father insane. He has three insane relatives. At the age of seven, during a spell of fever, and even without the slightest knowledge of sexual differences, he began to be interested in the 'posteriora of his male companions. This inclination disappeared at the age of twelve, when he was introduced to the secrets of the vita sexualis. His sexual instinct matured early and strongly. Pollu- HOMO-SEXUAL INDIVIDUALS. 361 tions were always accompanied by homo-sexual dreams. Woman disgusted him. For years he was, at the waning of daylight, impelled with an overruling desire to converse with men. He would follow men in the street for hours until quite exhausted. He burned with the desire to sleep with a man and touch his genitals. Up till now he was unsuccessful in this. As a last remedy, he would resort to auto- masturbation. He feels his position keenly, for fear of succumbing to his degenerate taste. U. gives the impression of being a person of peculiar habits, and wanting in mental equilibrium. Genitals are normal. Personal appearance decidedly masculine. Case 118. D., twenty-four years old, student. Father was emotional, of changeable temperament, irascible, petulant, eccentric in his views and actions, of weak will- power, distracted, and had neuropathic eyes ; in the latter years of his life he was addicted to drink, and died of phthisis at the age of forty ; he possessed no psychopathic qualities of value. D.'s mother was healthy ; but an aunt of hers was psychopathic, and committed suicide, whilst one of her cousins was a drunkard and hypersexual. D. is of lank but manly form, well bearded for a person of his age. Cranium asymetrical, frame masculine. Genitals well formed and normal. D. was always rather delicate, nervous, emotional, excitable, unsteady, but talented and given to flattery. His sexual instinct awoke at an early age. He inclined exclusively to his own sex, but for some time indulged only in auto - masturbation. With the age of sixteen he became markedly cerebro-asthenic, had to interrupt his studies and seek relief from nervous ailments in hydropathic establishments. When arrived at maturity he was more drawn to the urning than to the normally developed man, more to the 362 PSYCHOrATHIA SEXUALIS. youth than the matured male. His fetich was the voice, the higher register of the sympathetic young man's voice enchanted his psycho-sexual feelings, whilst a bass voice simply repulsed him. Fetichism of garments is also indicated, in so far as decidedly masculine dress, such as the military garb, etc., is repulsive to him ; on the contrary, evening dress attracts. D. considers his nature to be that of a female. He takes no interest in virile sports ; although character- ologically or anthropologically he betrays no signs of female character, and even to the eye of the expert he does not present the appearance of an urning. His homo-sexual activity consists in masturbatio mutua, and at times receptio membri alterius in ore. But not even during this act nor in nocturnal pollutions does his fancy assume the feminine role. He has not the slightest interest for women, and never approaches them. During the last three years D. has become a morphia eater to soothe his neurasthenic troubles. Upon my advice he went to a hydropathic institution and had himself also hypnotised. This, however, produced only torpor, but the patient was easily amenable to suggestion. Neurasthenia disappeared ; he began to master his weak- ness for masturbation, and to have erotic dreams of women, but, trying to have sexual intercourse with them, he was impotent, and succeeded only in passive masturbation by female hands, which gave him a sort of gratification. For some months after protracted treatment improve- ment continued, but then the patient relapsed into the practice of masturbation, became again neurasthenic, yielded to morphinism, and his whole sexual intercourse was directed to homo-sexual acts. Case 119. Mr. G., twenty-three years. Came to consult me on account of constitutional neurasthenia, coupled with insomnia which had been very acute for several months past. HOMO-SEXUAL INDIVIDUALS. 363 He comes of a family personally well known to me, most members of which are affected with neuroses, and other conditions of psychical degeneration. He confesses to being an urning. Had even at the age of seven erections when bathing with other boys. He repeatedly fell in love with school-mates! With puberty masturbation, and pollutions accompanied by homo-sexual dreams. Since the age of eighteen repeated attempts at coitus cum muliere were abortive on account of impotence, ex horrore fcmmcB. For the last two years he has given up women's society, and practised exclusively homo-sexual intercourse. He prefers men of the age of twenty to thirty. He plays the role of the man. His passions and courtings are those of the male. He asserts that he feels himself refreshed mentally and bodily by homo-sexual intercourse, which he practises inter femora. Once he tried active pederasty, but desisted on the ground of ethical sentiments. For the last few months he has maintained permanent intercourse with a man of his own proclivities. Previously he was often impotent in the homo-sexual act. This was caused by want of cleanliness on the part of his companion, or because of the thought that he had to pay money for the privilege ; in other cases bashfulness, on account of the high position held by the other party. G. understands that his sexual instinct is abnormal, but he finds gratification in it, and seeks no change. Anatomically and anthropologically G. presents decid- edly the appearance of a man ; his genitals are normal. Case 120. Mr. Z., aged fifty years, married, in the Civil Service. P. Father psychopathic, whose sister was an inmate of an asylum for the insane until, her death. Z., whose sister was also a patient in a lunatic asylum, suffered up to his eighth year from convulsions, and since pubescence from cephalalgia ; at school he was highly eccentric and intractal le. 364 PSTCHOPATHIA SEXUALIS. At the age of sixteen, whilst at a Jesuit college, he was one night assaulted by a school-mate, who explained to him the sexual functions, and persuaded him to consent to coitus inter femora. Z. took pleasure in the act, and in his dreams and when awake revelled in the memory of this nocturnal adventure, always imagining that he was taking the passive role, forced upon him by superior strength. The intercourse with the youthful seducer developed into a relation such as only exists between husband and wife, and consisted in mutual masturbation for a period of twelve months. This time Z. considers the happiest of his life. Death severed the connection in 1864, the friend succumbing to cerebral paralysis. Z. bemourned his loss as only a wife can that of her husband. In the autumn of 1864 Z. approached another school- mate, who, however, proved unsympathetic and refused him. At the university Z. affected feminine coquetry, wore patent leather shoes, parted his hair in the middle, had various love affairs with young men, and was unspeakably happy when at some private theatricals he could appear in the role of a woman. He had at that time a great weakness for pomatums, strong scents and jewellery. The gentle sex never attracted him. When upon one occasion he was induced to go with others to a brothel the girl that fell to bis lot appeared to him like a wooden statue, and he could not accomplish coitus. This experience aroused in him doubts as to his future. But soon he persuaded himself again that his homo-sexual instinct and actions contained no unnatural elements. In 1872 he entered upon matrimony, based upon respect and self-interest. He succeeded in performing his conjugal duties, imagining the wife to be a handsome young man. This sexual intercourse was, however, of rare occurrence, since it gave him no mental pleasure, HOMO-SEXUAL INDIVIDUALS, 365 and he again sought compensation in homo-sexual acts, consisting merel}' in mutual masturbation. During the last seven years Z. has had no sexual connection with his wife ; but from this union sprang two sons (now grown up), whom he declares to be perfectly sound and sexually normal. Z. states that his homo - sexual inclinations have caused him much worry, and that, though in vain, he resisted them with all his will-power, in order to be true to his wife. The very sight of a young man clad in close-fitting trousers was suliicient to overcome him. On such occasions, especially after partaking of wine, which he never liked, congestions to the head and hallucinations of a sexual character took place. He fancied he beheld naked young men approach him with penis erect, grasp his genitals, masturbate him, and perform coitus mter femora with him. He yielded to it in thought, had orgasm, but rarely ejaculation. This happened to him at times also before he fell asleep. In 1895 Z. was sentenced to six months' imprisonment on account of immoral acts with a young navvy of seven- teen years of age. His examination at the clinic showed him to be neurotically much tainted and wanting in mental balance. Cranium asy metrical ; typical instance of neurasthenia cerehralis ; genitals normal. Case 121. On a summer evening, at twilight, X. Y., a physician of a city in North Germany, was detected by a watchman while committing a misdemeanour with a countryman in a field. He was practising masturbation on him, and then inontulam alius in os suum immisit. X, escaped legal prosecution by flight. The authorities dis- missed the complaint, because there had been no publicity, and because immissio memhri in anum had not taken place. Among X.'s effects was found an extensive correspond- ence of a perverse sexual character, which showed that 366 PSYC HOPATHIA SEXUALIS. he had had perverse intercourse for years with all classes of people. X. came of a neurotic family. His paternal grand- father died by suicide while insane. His father was a weak, peculiar man. One brother masturbated at the age of two. A cousin was sexually perverse, and practised perverse acts, similar to those of X., while a youth ; he became weak-minded, and died of spinal disease. A paternal great-uncle was an hermaphrodite. His mother's sister was insane. His mother is said to have been healthy. X.'s brother is nervous and irascible. X., hkewise, was nervous as a child. The mewing of a cat would create great fear in him ; and if one but imitated the voice of a cat he would cry bitterly, and run to others for protection. Shght physical disturb- ance caused violent fever. He was a quiet, dreamy child, of excitable imagination, but of slight mental capabilities. He did not indulge much in boyish games ; he preferred feminine pursuits. It gave him especial pleasure to curl the hair of the housemaid or of his brother. At thirteen X. went to an institute. There he prac- tised mutual masturbation, seduced his comrades, and his cynical conduct made him unmanageable ; so that he bad to be taken home. At that time the parents found love-letters with lascivious contents, showing perverse sexuality. From the age of seventeen he studied under the strict surveillance of a professor in a gymnasium. He made but sad progress in learning. He had only a talent for music. After finishing his studies, the patient entered the university at the age of nineteen. There he attracted attention by his cynical character and his association with young persons who were thought to be given to mascuhne love. He began to be dandified ; wore striking cravats, and low cut shirts ; he forced his feet into narrow shoes, and curled his hair in a remarkable way. This HOMO-SEXUAL INDIVIDUALS. 367 peculiarity disappeared when he left the school and returned home. At the age of twenty-four he was for a long time neurasthenic. From that time until his twenty-ninth year he was earnest and skilful in his profession ; but he avoided the society of the opposite sex, and constantly associated with men of doubtful character. The patient would not allow a personal examination. In writing, he made the excuse that this would be of no use, because his impulse to his own sex had existed from his earliest childhood, and was congenital. He had always had horror femince, and had never been inclined to avail himself of the charms of women. Toward men he felt himself in the role of a man. He recognised his impulse toward his own sex as abnormal, and excused his sexual indulgence as being the result of an abnormal natural condition. Since his flight X. lives out of Germany, in Southern Italy, and, as I learned from a letter, now, as before, he indulges in perverse love. X. is an earnest, stately man, of masculine features, well-grown beard, and normally developed genitals. Dr. X. furnished me a short time ago with his autobiography, of which the following is worthy of mention : — " When, at the age of seven, I entered the private school, I felt very uncomfortable, and found very little sympathy with my companions. Only toward one of them, who was a very handsome child, did I feel attracted, and I loved him wildly. In childish games I always knew how to arrange it so that I could appear in feminine attire ; and my greatest pleasure was to form intricate coiffures for our servant-girls. I often regretted that I was not a girl. "My sexual instinct awakened when I was thirteen, and from the moment of its appearance it was directed toward youthful, strong men. At first I was not really certain that this was abnormal, but consciousness of it 368 PSYCHOPATHIA SEXUALIS. came when I saw and heard how my companions were characterised sexually. I began to masturbate at the age of thirteen. At seventeen I left home and went to the gymnasium of a large capital, where I was put to board with a married professor of the gymnasium, with whose son I afterward had sexual relations. It was with him that I first had sexual satisfaction. Thereafter I made the acquaintance of a young artist, who very soon noticed that I was abnormal, and confessed to me that he was in the same condition. I learned from him that this abnormality was very frequent ; and this knowledge over- came the trouble that I had had in supposing that I was alone in my abnormality. This young man had an extensive acquaintance with persons in like condition, to which he introduced me. There I became the object of general attention, for on all sides I was declared to be very attractive physically. I soon became insanely loved by an old gentleman ; but, not finding him to my taste, I endured him but a short time, and then gave ear to a young and handsome officer who lay at my feet. He was really my first love. " After passing my final examination, at the age of nineteen, free from the discipline of school, I made the acquaintance of a great number of people like myself, and among them Karl Ulrichs {Numa Numantinus). " When, later, I took up the study of medicine, and associated with many normal youths, I was often in a position where I was compelled to visit public prostitutes. After having consorted to no purpose with various pros- titutes, some of whom were very beautiful, the opinion was spread among my acquaintances that I was impotent, and I strengthened this by telling of previous sexual excesses. At that time I had numerous external relations wdth persons who prized my physical peculiarities, which were considered very beautiful. The result of this was, that I was exciting somebody all the time ; and I received such a mass of love-letters that I was often in embarrass- HOMO-SEXUAL INDIVIDUALS. 369 ment. The acme of this was reached later when, as a physician, I hved in the hospital. There I moved about like a celebrated person, and the scenes of jealousy that took place on my account almost led to the discovery of the whole thing. Shortly after this, I fell ill with an inflammation of my shoulder-joint, from which I recovered after three months. During this illness I received sub- cutaneous injections of morphine several times daily, which were suddenly discontinued, and which I practised thereafter secretly after my recovery. For the purpose of special study, I spent some months in Vienna, before entering into ]Drivate practice, and there, by means of some recommendations, I gained entrance to various circles of people like myself. I there learned that the abnormality in question, in its various forms, is spread through the lower classes as well as the higher, and that those who are approachable for money are not infrequently met among the higher classes. " When I established myself in the country, I hoped to cure myself of the morphine habit by means of cocaine ; and then I became a victim of cocaine, of which, only after three relapses, I was able to rid myself (about two years ago). In my position, it was impossible for me to find sexual satisfaction, and I noticed with pleasure that the use of cocaine had overcome my desire. When, on the first occasion, at the urgent request of my aunt, I had emancipated myself from cocaine, I travelled for a few weeks in order to improve my health, the perverse im- pulses were again awakened in their old strength, and, one evening, while out in the fields by the city amusing myself with a man, I noticed that I had been detected by the authorities and advertised ; but that the act of which I was accused was not punishable, in accordance with the opinion expressed by the highest court of the G-erman kingdom. I had, therefore, to be careful ; for already the announcement of the crime had been heralded on all sides. I saw that after this I should be compelled to 24 o70 PSYCHOPATHIA SEXUALIS. leave Germany, and find a new home where neither the law nor public opinion would be opposed to that impulse, which, like all abnormal instincts, could not be overcome by the will. Since I was never deceived for a moment about the matter, in recognising my impulses as opposed to social usages, I repeatedly attempted to become master of them ; but by these efforts they were increased in power. This same observation has been communicated to me by acquaintances. Since I was exclusively drawn toward strong, youthful and masculine individuals, and they were very seldom inclined to yield to my wishes, I was compelled to buy them. Since my desire was limited to persons of the lower classes, I was always able to find such as were purchasable with money. I hope that the following statements will not awaken your repugnance. At first I intended to omit them ; but, for the completeness of this communication, I may include them, since they serve to enrich the clinical material. I am compelled to perform the sexual act in the following way : — " Pene juvenis in os recepto, ita ut commovendo ore meo effecerim, ut is quem cupio, semen ejaculaverit, sperma in perinaeum exspuo, femora comprimi jubeo et penem meum adversus et intra femora compressa immitto. Dum haec fiunt, necesse est, ut juvenis me, quantum potest, amplectatur. Quae prius me fecisse narravi, eandem mihi afferunt voluptatem, acsi ipse ejaculo. Ejaculationem pene in anum immittendo vel manu terendo assequi, mihi nequaquam amoenam est. " Sed inveni, qui penem meum receperint atque ca facientes, quae supra exposui, effecerint, ut libidines mete plane sint saturata?. "Concerning my person, I must still mention the following : I am 186 centimetres tall, of masculine appear- ance, and, with the exception of abnormal irritability of the skin, healthy. My hair and beard are black and thick. My genitals are of medium size and normally formed. I am able, without any trace of fatigue, to per- HOMO-SEXUAL INDIVIDUALS. 371 form the sexual act from four to six times in twenty-four hours. My Hfe is very regular. I use alcohol and tobacco very sparingly. I play the piano quite well, and some of my unpretentious compositions have been much ap- plauded. I have lately finished a novel, which, as my first work, has been very favourably criticised by my friends. The story has several problems taken from the life of urnings in the subject-matter. "Among the large number of fellow-sufferers that are personally known to me, I have naturally been in a posi- tion to make observations concerning the condition and the degrees of abnormality ; and, perhaps, the following communications may be of service to you : — " The most abnormal thing that I am acquainted with was the impulse of a gentleman who lived in Berlin. He preferred, above all others, young fellows with unwashed feet, which he would lick passionately. A gentleman in Leipzig was similar to him ; who, where it was possible, would linguam in anum immittere, preferring the parts to be uncleaned. Several have assured me that the sight of riding-boots or of parts of military uniforms induced such excitement in them that spontaneous ejaculation resulted. A man in Paris compelled a friend ut in os ei mingat. " With reference to the degree in which many feel themselves as women, which is with me not the case, two persons in Vienna are examples. They bore feminine names. One is a barber who calls himself ' French Laura'; the other was formerly a butcher, who calls himself ' Selcher-Fanny '. Both of them never missed an opportunity, during the carnival time, to show themselves in very fantastic feminine masks. In Hamburg there is a person that many people believe to be a woman, because he always goes about the house in feminine attire, and only occasionally leaves the house, and always in such clothing. This man wished to stand as godmother at a christening, and, as a result of it,- gave rise to great scandal. 372 PSYCHOPATHIA SEXUALIS. " Feminine timidity, frivolity, obstinacy and weakness of character are the rule in such individuals. " Several cases of perverse sexuality are know^n to me where epilepsy and psychoses are present. Hernias are remarkably frequent. In practice many persons come to me to be treated for diseases of the anus, because of recom- mendation by friends. I saw two syphilitic and one local chancre, and several fissures ; and at present I am treating a gentleman for condylomata of the anus, which form a rounded tumour as large as a fist. One case of primary affection of the soft palate I saw in Vienna, in a young man who used to frequent fancy-dress balls in girl's attire, and entice young men ; he would then pretend that he was menstruating, and thus induce the others to use him per os. The assertion was made that in this way he had deceived fourteen men in one evening. Since, in none of the pubhcations concerning antipathic sexuality that I have seen, I have found anything concerning the intercourse of pederasts among themselves, I venture to communicate something concerning it in conclusion : — "As soon as individuals that are affected with in- verted sexuality become acquainted, there is a detailed narration of their experiences, loves and seductions, as far as the social difference between them allows such entertainment. Only in very few cases is this amusement uncommon with new acquaintances. Among themselves, they call themselves ' aunts ' ; in Vienna, ' sisters ' ; and two very masculine public prostitutes in Vienna, whom I accidentally became acquainted with, and who lived in a perverse sexual relation with each other, told me that for the corresponding condition in women the name ' uncle ' was used. Since becoming conscious of my abnormal instinct I have met thousands of such individuals. " Almost every large city has some meeting-place, as well as a so-called promenade. In smaller cities there are relatively few ' aunts,' though in a small town of 2300 inhabitants I found eight, and in one of 7000 eighteen of EFFEMINATION. 373 whom I was absolutely sure, — to say nothing of those whom I suspected. In my own town of 30,000 inhabitants I personally know about 120 ' aunts '. The greater number of them, and I especially, possess the capability of judging another immediately as to whether they are alike or not, which, in the language of the ' aunts,' is called ' reason- able ' or * unreasonable '. My acquaintances are often astounded at the certainty of my judgment. Individuals that are apparently absolutely masculine I recognise as ' aunts ' at the first sight. On the other hand, I am able to behave myself in such a masculine way that, in circles to which I have been introduced by acquaintances, there is a doubt as to my genuineness. When I am in the mood, I can act exactly like a girl, " Since the majority of * aunts,' like myself, in no way regret their abnormality, but would be sorry if the con- dition were to be changed ; and, moreover, since the congenital condition, according to my own and all other experience, cannot be influenced, all our hope rests upon the possibility of a change of the laws with reference to it, so that only rape or the commission of public offence, when this can be proved at the same time, shall be punishable." 3. Effemi nation. There are various transitions from the foregoing cases to those making up this category, characterised by the degree in which the psychical personahty, especially in general manner of feehng and inclinations, is influenced by the abnormal sexual feeling. In this group are fully developed cases in which males are females in feeling ; and vice versa women, males. This abnormality of feeling and of development of the character is often apparent in childhood. The boy likes to spend his time with girls, play with dolls, and help his mother about the house ; he likes to cook, sew, knit ; he develops tastes in female 374 psYcnorATiiiA sexualis. toilettes, and even becomes the adviser of his sisters. As he grows older he eschews smoking, drinking and manly sports, and, on the contrary, finds pleasure in adornment of person, art, belles-lettres, etc., even to the extent of giving himself entirely to the cultivation of the beautiful. Since woman possesses parallel inclinations, he prefers to move in the society of women. If he can assume the rSle of a female at a masquerade it is his greatest delight. He seeks to please his lover, so to speak, by studiously trying to represent what pleases the female-loving man in the opposite sex — modesty, sweetness, taste for aesthetics, poetry, etc. Efforts to approach the female appearance in gait, attitude and attire are frequently seen. With reference to the sexual feeling and instinct of these urnings, so thoroughly permeated in all their mental being, the men, without exception, feel themselves to be females. Thus they feel themselves to be antagonistic to persons of their own sex constituted like themselves, as of course, they are like them in form. But, on the other hand, they are drawn toward those of their own sex that are homo-sexual or sexually normal. The same jealousy which occurs in normal sexual life also occurs here, when rivalry is threatened ; and, indeed, since they are, as a rule, hyperffisthetic sexually, this jealousy is often bound- less. In cases of completely developed inverted sexuality, hetero-sexual love is looked upon as a thing absolutely incomprehensible; sexual intercourse with a person of the opposite sex is unthinkable, impossible. Such an attempt brings on the inhibitory concept of disgust or even horror, which makes erection impossible. Only two of my cases transitional to the third category were able, with the aid of imagination which made the female in question assume the role of man, to have coitus for the time being ; but the act, which yielded no gratification, was a great sacrifice, and afforded no pleasure. EFFEMINATION. 375 In homo-sexual intercourse effeminated men feels himself in tlie act always as a woman. The means of indulgence, where there is irritable weakness of the ejaculation centre, are simply succuhus, or passive coitus inter femora; in other cases, passive masturbation, or ejaculatio viri dilecti in ore. Some have a desire for passive pederasty ; occasionally a desire for active pederasty occurs. In one attempt of this kind, the man desisted because of the disgust which seized him when the act reminded him of coitus. There tvas never inclination for immature persons {hoy -love). Not infrequently there were only platonic desires. Case 1 22. Autobiography. In the subsequent pages you will find a description of the character as well as the psychic and sexual feelings of an urning, i.e., of an individual who, despite of mascuHne anatomy, has the feelings of a woman, and who is not in the least attracted by women, but whose entire sexual instinct is directed towards men. " I am convinced that the enigma of our existence can only be solved by the impartial scientist (or, at any rate, that hght can be thrown upon it by him). For which reason I give this description of my life for the sole purpose of elucidating this cruel error of nature, and thus to benefit in all possible manner such fellow-beings as are afflicted in a similar way. Urnings there will be as long as the human race endures, for there were such ever since humanity began. But as science progresses, men will look upon the like of myself as subjects worthy rather of compassion than of disdain. I shall confine myself to brevity, avoiding personaHties and adopting rather a cynical style, for I aspire to truth. " I am thirty-four and a half years of age, a merchant with moderate income, of medium size, slender, but not muscular ; I have a well-bearded, but very common face 376 PSYCHOPATHIA SEXUALIS. and make at first the impression of being an ordinary man. But my gait is feminine, my movements are awkward and devoid of elegance and manly bearing. My voice is neither feminine nor shrieking, but rather of bari- tone resonance. This much for my external appearance. " I do not smoke or drink, neither can I whistle, ride, perform gymnastics, fence or shoot. I do not fancy horses or dogs, and have never held a gun or sword in my hand. My intrinsic feelings and sexual desires are feminine all through. I can lay no claim to higher education — I only went as far as the fifth form of the gymnasium — nevertheless I am intelligent, and love to read good literature ; am of sound judgment, but am easily moved by spontaneous emotions, and readily yield to the influence of others who understand me and know how to prey upon my weaknesses. I form for ever resolutions, but never have the energy to carry them through. Like unto woman, I am petulant and nervous, irritable without cause, at times vicious, and towards persons not present and against whom I have a grudge, arrogant and unjust, even to a degree insulting. "In all my doings I am superficial, even careless, and am devoid of real moral sentiment, of tender feelings towards my parents, brothers and sisters ; but I am not egotistical, but rather inclined to self-sacrifice, cannot resist tears, and am easily won over by cordial, depre- catory manners, as is common in woman. " At an early age I took a dislike to the manly sports practised by my companions ; liked to play with little girls, who suited my character better than boys ; was shy, and easily blushed. " At the age of twelve-thirteen the close-fitting uniform of a soldier caused in me peculiar emotions ; and, whilst during the subsequent years my school-mates always talked about girls, and even entered upon love affairs, I was never able to resist the influence which a well- formed man, especially with well-pronounced j^osteriora, EFFEMINATION. 377 made upon my senses. I would follow him for hours, and simply revel in the sight of him. " Although I never reflected much upon these impres- sions — so totally different from those of my companions — I began to practise onanism, always thinking of manly heroic forms, until a friend, when I was seventeen, explained matters to me. Since that time I have been with girls about eight or ten times ; but, in order to produce erection, I had to call to aid the thought of some handsome man known to me, and I am convinced that even now I could not go with a woman without the assistance of my fancy. Soon after I discovered my anomaly I preferred to go with well-matured and well- built urnings, for at that time I did not have opportunity or sufficient knowledge to have intercourse with real men. " But my taste has completely changed, so that only men of fine, supple and muscular form attract me sensually. Their charms excite me as if I were a real woman. Thus it has happened that in the course of time I have made the intimate acquaintance of at least a dozen men who, for a consideration of one or two florins, serve my purpose. When alone with such a fine fellow in my room, I derive the utmost pleasure from membrum ejus vel maxime si magnum atque crassum est, manibus capere et apprehendere et premere, turgentes nates femoraque tangere atque totum corpus manibus contrectare et, si conceditur, os, faciem atque totum corpus, immovero nates, ardentibus osculis obtegere. Quodsi membrum magnum purumque est, dominusque ejus mihi placet, ardente libidine mentulam ejus, in os meum receptam complures horas sugere possum, neque autem delector, si semen in os meum ejaculatur, cum maxime eorum qui, * urninge ' nominantur pars hac re non modo delectatur, sed etiam semen nonnunquam devorat. " But the height of pleasure I experience when such a man vievibrum meum in os recipit et erectionem in ore suo concedlt. 378 PSYCHOPATIIIA SEXUALIS. " It may sound strange but I can alwa3^s find fellows whom I may use in this manner for a consideration. They learn about this at the barracks, for the urnings know fully well that the soldier will do almost anything for money. In fact these young fellows when once trained to it will continue the practice whilst at the same time indulging in their passion with woman. " Urnings as a rule do not attract me, for everything that smacks of the feminine is repulsive to me. Still I have come across some who can enchant me the same as the real man does. In fact I rather go with them because they requite passionately my burning love. When alone with such a being I give my emotions free play and revel to the utmost in my animal instinct. Osculor, premo, amplector eum, linguam meam in os ejus immitto ; ore cupiditate tremente ejus labrum superius sugo, faciem meam ad ejus nates adpono et odore voluptari e nati])us omanente voluptate obstupescor. Genuine men in close fitting uniforms make the deepest impression upon me, and should I have the chance of throwing my arms around such a fellow and of kissing him it produces immediate ejaculation, a circumstance which I ascribe to frequent auto-masturbation. For I often did this in former years well-nigh every time when I beheld such a fine fellow whose image was ever present before me during the act. My taste in this regard is by no means very refined, but more like that of a servant girl who sees her ideal in a stalwart dragoon. A pretty face may be a pleasant attribute, but by no means indispensable for kindling my sensual fire ; the main thing always is : vir inferiore corporis parte robusta et bene firmosa, turgidis femoribus durisque natibus thorax qualibet forma. A prominent abdomen disgusts me ; a sensual mouth and white teeth simply makes me tingle and if such a man has also a membrum pulchrum magnum et a^qualiter formatum, all my demands, even the most exorbitant, are quite satisfied. EFFEMINATION. 379 "When men sensually excited me in former years I would have five to eight ejaculations during the night (even now four to six), for I am uncommonly sensual; the very clanking of the sword of a cavalry man on the pavement excites me. My imagination is very vivid ; during all hours of the day I think of handsome men with muscular limbs and could derive the utmost pleasure from witnessing how a strong powerful fellow magna mentula prffiditus me prrosente puellam futuat ; mihi persuasum est, fore ut hoc adspectu sensus mei vehementissima per- turbatione afficiantur et dum futuit corpus adolescentis pulchri tangam et, si liceat, ascendam in eum dum cum puella concumbit atque idem cum eo faciam et membrum meum in ejus anum immittam. The only thing that has prevented me from carrying out this idea, which fills my thoughts frequently, is the want of means. " Most of all I am enchanted by soldiers, but I have also a great weakness for butchers, cabdrivers, carmen, circus riders and ship's captains, but they must be of elastic and muscular build. I hate intimacy with urnings, in fact for them I have a great aversion which I can neither explain nor justify. With the exception of one I have never had intimate relations with such. But I have cordial relations of many years' standing with several urnings whose company I enjoy, but sexual intercourse has never taken place between us, in fact they are in no wise aware of my anomaly. " I detest conversing about politics, state-economy, or any other serious topic, but I love to chat with fair knowledge and especial preference about the theatre. At the opera I live, so to speak, upon the stage and feel as though the audience were applauding me. There is nothing I should like better than to play the role of the heroine or some other important female character. " The most interesting and all-absorbing topic of con- versation with my companions is for ever ' our men ' ; this theme is inexhaustible ; their most secret charms are 380 PSYCHOPATHIA SEXUALIS. described to the minutest details, mentulae sestimantur quanta sint magnitudine, quanta crassitudine ; de forma eorum atque rigiditate conferimus, alter ab altero cog- noscit cujus semen celerius, cujus tardius ejaculetur. I may mention here that one of my four brothers allowed himself to be used for homo-sexual purposes without being an urning himself. All four of them are passionate devotees of the gentle sex and are for ever given to sexual excess. The genitals of the male members of our family are all abnormally well developed. " I again repeat the words with which I started these lines. I could not choose my expressions as my intention was to place in your hands certain material for the study of an urning's life, and absolute truth is in this regard imperative. Kindly ascribe to this effort the many cyni- cisms I have uttered." In the month of October, 1890, the writer of this epistle came to me personally. His appearance tallied with the description given by himself. Genitals very large with alfundant growth of hair. He claims that his parents had sound nerves, but a brother had committed suicide by shooting himself on account of some nervous disorder ; the other three, he says, are highly neurasthenic. This man was in a most despondent frame of mind. He could suffer such a life no longer, for he was entirely reduced to the intercourse with mercenary men, could not practise abstinence on account of his extreme sensuality. Neither could he perceive how he could be made hetero-sexual and capable of enjoying the nobler pleasure of man, as for thirteen years his instinct had been homo-sexual. He feels as a woman does, and, like her, seeks conquests among men who are not urnings. When he converses with an urning it is the same as if two women were to- gether. He should prefer to be sexless. Would castration liberate him ? Attempts at hypnotism had but weak effects on this so highly excitable patient. EFFEMINATION. 381 Case 123. B., writer, forty-two years of age, un- married, was sent to me by his own physician (with whom he had fallen in love), as a case of sexual inversion. B. gave readily in modest language an account of his vita anteacta and especially sexualis. He seemed pleased to obtain at last an authentic explanation of his abnormal state which he had always considered a disease. B. possesses no knowledge of his grandparents. The father was of an irascible, excitable nature, a drinker, and of strong sexual wants. After begetting twenty-four children with the same woman, he obtained a divorce, and after that had three children by his housekeeper. The mother was a healthy woman. Of the twenty-four chil- dren only six are now among the living, several of whom suffer from nervous affections, but are sexually normal, except one sister who for ever runs after the men. B. claims to have always been delicate and sickly. His vita sexualis awoke at the age of eight. He began to masturbate and derived much pleasure from pencm aliorum pueromm in os arrigere. At the age of twelve he began to fall in love with men, preferring those in the thirties and with moustache. His sexual needs at that period were extraordinary and erections and pollutions were frequent. He masturbated daily, thinking of some man whom he loved. His ambition was always penem viri in os arrigere, which thought caused ejaculation accompanied by the utmost lust. But only twelve times thus far had he been successful in this. He never felt nausea at the penis of others if they were sympathetic ; on the contrary. Active as well as passive pederasty disgusted him thoroughly and he never accepted such offers. During the perverse act he played the role of woman. His love for sympathetic men is boundless. He could do anything for the man whom he thus loved, and when beholding him he trembled with excitement and lustful feelings. When nineteen he was several times lured by his 382 PSYCHOPATHIA SEXUALIS. companions to a brothel, but coitus did not please him and only at the moment of ejaculation did he experience a sort of gratification. He could only be virile with woman when he thought of her during the act as the man whom he loved. He much rather would have preferred the woman to allow him immissio 2icnis in os ; but she refused. Faute de mieux he indulged in coitus ; twice even he was a father. The younger of the two children, now a girl of eight, has already begun masturbation and mutual onan- ism, which fact troubled him very much. Was there no remedy for this ? Patient says that towards men he always feels himself to be of feminine type (this also during sexual intercourse). His idea is that this sexual perversion originated from the fact that his father when begetting him wished to beget a girl. The other children of the family always teased him on account of his girlish ways and manners. To sweep the rooms and wash the dishes were ever pleasant oc- cupations for him. His housework was always much admired and praised because he was cleverer than the girls. Whenever he could he would don girl's attire. At the Mardi-gras balls he always wore the female mask. He made a capital coquette on account of his female nature. Drinking, smoking, manly sports and occupations never suited him, but he was passionately fond of sewing and was often upbraided on account of his weakness for dolls when a boy. When at the circus or the theatre his attention was only drawn to the male performers. He had an irresistible desire to loiter about W. C's. in order to get a look at the men's genitals. Female charms never attracted him. Coitus was only possible when aided by the thought of a beloved man. Nocturnal pollutions were always produced by lascivious dreams about men. Despite numerous sexual excesses B. has never suffered from neurasthenia sexualis ; neither are there symptoms of neurastlunia of any kind. EFFEMINATION. 383 Features delicate ; sparse side whiskers and moustacbe, which began to grow only when he was twenty-eight. His external appearance, excepting a light, swinging gait, does not indicate female nature. He observes that he is often teased on account of his womanish carriage. His manners are highly modest. Genitals large, well developed, quite normal, with abundance of hair ; pelvis masculine. Cranium rachitic, shghtly hydrocephalic ; parietal bones rather bulging. Countenance exceptionally small. Patient says he is easily provoked to wrath. Case 124. Taylor had occasion to examine a certain ■Ehza Edwards, aged twenty-four. It was discovered that she was of masculine sex. E. had worn female clothing from her fourteenth year, and had also been an actress. The hair was worn long, after the manner of females, and parted in the middle. The form of the face was feminine, but otherwise the body was masculine. The beard was carefully pulled out. The masculine, well - developed genitals were fixed in an upward position by an artful bandage. The condition of the anus indicated passive pederasty {Taylor, " Med. Jurisp.," 1873, ii., p. 286, 473). Case 125. An official of middle age, who for some years had been happy in family life, and was married to a virtuous woman, presented a pecuhar manifestation of antipathic sexual feeling. One day, through the indiscretion of a prostitute, the following scandal became public : About once a week X. would appear in a house of prostitution, and there dress himself up as a woman, always requiring, as a part of his costume, a coiffure. When his toilet was completed, he would lie down on the bed, and have the prostitute perform manustupration. But he very much preferred to have a male person (a servant of the house). This man's father was hereditarily tainted, had been insane several times, and was afflicted with hypcroesthesia and parcesthesia sexualis. 384 PSYCHOPATHIA SEXUALIS. 4. Androgyny. Forming direct transitions from the foregoing groups are those individuals of antipathic sexuahty in whom not only the character and all the feelings are in accord with the abnormal sexual instinct, but also the frame, the features, voice, etc. ; so that the individual approaches the opposite sex anthropologically, and in more than a psychical and psycho-sexual way. This anthropological form of the cerebral anomaly apparently represents a very high degree of degeneration ; but that this variation is based on an entirely different ground than the teratological manifestation of hermaphrodism, in an anatomical sense, is clearly shown by the fact that thus far, in the domain of inverted sexuality, no transitions to hermaphroditic malformation of the genitals have been observed. The genitals of these persons always prove to be fully differen- tiated sexually, though not infrequently there are present anatomical signs of degeneration (epispadiasis, etc), in the sense of arrests of development in organs that are otherwise well marked. There is yet wanting a sufficient record of cases belonging to this interesting group of women in masculine attire with masculine genitals. Every experienced observer of his fellow-men remembers masculine persons that were very remarkable for their womanish character and type (wide hips, form rounded by abundant development of adipose tissue, absence or insufficient development of beard, feminine features, deHcate complexion, falsetto voice, etc). In persons belonging to the fourth group, and in certain ones in the third, forming transitions to the fourth, there seems to be a feeling of shame (sexual) toward persons of the same sex, and not toward those of the opposite sex. Case 1 26. Androgyny. Mr. v. H., aged thirty, single ; ANDROGYNY. 385 of neuropathic mother. Nervous and mental diseases are said not to have occurred in the patient's family, and his only brother is said to be mentally and physically com- pletely normal. The patient developed tardily physically, and, therefore, spent much of his time at the sea-shore and climatic resorts. From childhood he was of neuro- pathic constitution, and, according to the statements of his relatives, unlike other boys. His disinclination for masculine pursuits and his preference for feminine amusements were early remarked. Thus he avoided all boyish games and gymnastic exercises, while doll-play and feminine occupations were particularly pleasing to him. Subsequently he developed well physically, and escaped severe illnesses, but he remained mentally abnormal, incapable of an earnest aim in life, and decidedly feminine in thought and feeling. In his seventeenth year pollutions occurred, became more frequent, and finally took place during the day ; so that the patient grew weak, and manifested various ner- vous disturbances. Symptoms of neurasthenia spinalis made their appearance, and have lasted up to the last few years, but they have become milder with the decrease in the number of pollutions. Onanism is denied, but is very probable. An indolent, effeminate, dreamy habit of thought has become more and more noticeable ever since puberty. All efforts to induce the patient to take up an earnest pursuit in life were vain. His intellectual functions, though formally quite undisturbed, were never equal to the motive of an independent character, and the higher ideals of life. He remained dependent, an over- grown child ; and nothing more clearly indicated his original abnormal condition than an actual incapability to take care of money, and his own confession that he had no ability to use money reasonably ; that as soon as he had money he wasted it for curios, toilet-articles, and the like. Incapable as he was of a reasonable use of money, the 25 386 PSYCHOPATHIA SEXUALIS. patient was no more capable of leading a social existence, indeed, he was incapable of gaining an insight into its significance and value. He learned very poorly, spending his time in toilettes and artistic nothings, particularly in painting, for which he evinced a certain capability ; but in this direction he accomplished nothing, since he was wanting in persever- ance. He could not be brought to take up any earnest thought ; he had a mind only for externals, was always distracted, and serious things quickly wearied him. Pre- posterous acts, senseless journeys, waste of money and debts repeatedly occur throughout the course of his later life ; and even for these positive faults in his life he was wanting in understanding. He was self-willed and in- tractable, and never did well as soon as an attempt was made to put him on his feet and point out to him his own interests. With these manifestations of an original abnormal and defective mind, there were notable indications of perverse sexual feeling, which were also indicated in the somatic habitus of the patient. Sexually, the patient felt like a woman toward men, and had inclinations toward people of his own sex, with indifference, if not actual disinclin- ation, for females. In his twenty-second year it is asserted that he had sexual intercourse with women, and was able to perform the act of coitus normally ; but, partly on account of increase of neurasthenic symptoms which was occa- sional after coitus, and partly on account of fear of infection — but really by reason of a want of satisfaction — he soon ceased to indulge in such intercourse. Concerning his abnormal sexual condition, he is not quite clear ; he is conscious of an inclination toward the male sex, but confesses, only in a shame-faced way, that he has certain pleasurable feehngs of friendship for mascuhne individuals, which, however, are not accompanied by any sensual feelings. The female sex he does not exactly abhor ; he ANDROGYNY. 387 could even bring himself to marry a woman who could have an attraction for him, by means of similarity in artistic tastes, if he could but be freed from conjugal duties, which were unpleasant to him, and the performance of which made him tired and weak. He denied having had sexual intercourse with men, but his blushing and embarrassment, and, still more, an occurrence in N., where the patient some time before provoked a scandal by attempting to have sexual intercourse with youths, gave him the lie. His external appearance also, habitus, form, gestures, manners and dress are remarkable, and decidedly recall the feminine form and characteristics. The patient, however, is over middle height, but thorax and pelvis are decidedly of feminine form. The body is rich in fat ; the skin is well groomed, delicate and soft. This impression of a woman in masculine dress is further increased by a thin growth of hair on the face, which is shaven, with the exception of a small moustache ; by the mincing gait ; the shy, effeminate manner ; the feminine features ; the swimming, neuropathic expression of the eyes ; the traces of powder and paint ; the curtailed cut of the clothing, with the bosom-like prominence of the upper garments ; the fringed, feminine cravat ; and the hair brushed down smoothly from the brow to the temples. The physical examination makes undoubted the feminine form of the body. The external genitals are well developed, though the left testicle has remained in the canal ; the growth of hair on the mons veneris is thin, and the latter is unusually rich in fat and prominent. The voice is high, and without masculine timbre. The occupation and manner of thought of v. H. are decidedly feminine. He has a boudoir and a well-supplied toilet-table, at which he spends many hours in all kinds of arts for beautifying himself. He abhors the chase, practice with arms, and such masculine pursuits, and calls himself an cesthete ; speaks with preference of his 388 PSYCHOPATHIA SEXUALIS. paintings and attempts at poetry. He is interested in feminine occupations, in which — e.g., embroidery — he engages, and calls his greatest pleasure. He could spend his life in an artistic and aesthetic circle of ladies and gentlemen, in conversation, music and aesthetics. His conversation is preferably about feminine things, — fashions, needlework, cooking and household work. The patient is well nourished, but anaemic. He is of neuropathic constitution, and presents symptoms of neurasthenia, which are maintained by a bad manner of of life, lying abed, living in-doors, and effeminateness. He complains of occasional pain and pressure in the head, and has habitual constipation. He is easily frightened ; complains of occasional lassitude and fatigue, and drawing pains in the extremities, in the direction of the lumbo- abdominal nerves. After pollutions, and regularly after eating, he feels tired and relaxed ; he is sensitive to pressure over the spinous processes of the dorsal vertebrae, as also to pressure along accessible nerves. He feels pecuhar sympathies and antipathies towards certain persons, and, when he meets people for whom he has an antipathy, he falls into a condition of peculiar fear and confusion. His pollutions, though now they occur but seldom, are pathological, in that they occur by day, and are unaccom- panied by any sensual excitement. Opinion. 1. Mr. V. H., according to all observations and reports, is mentally an abnormal and defective person, and that, in fact, ah origine. His antipathic sexual instinct repre- sents a part of his abnormal physical and mental condition. 2. This condition, in that it is congenital, is incurable. There exists defective organisation of the highest cerebral centres, which renders him incapable of leading an in- dependent life, and of obtaining a position in life. His perverse sexual instinct prevents him from exercising ANDROGYNY. 389 normal sexual functions ; and this is attended by all the social consequences of such an anomaly, and the danger of satisfaction of perverse impulses arising out of his abnormal organisation, with consequent social and legal conflicts. Fear of the latter, however, cannot be great, since the (perverse) sexual impulse of the patient is weak. 3. Mr. V. H., in the legal sense of the word, is not irresponsible, and neither fit for, or in need of, treatment in a hospital for the insane. It is possible for him — though but an overgrown child, and incapable of personal independence — to live in society, even under the care and guidance of normal individuals. To a certain extent, it is possible for him to respect the laws and restrictions of society, and to judge his own acts ; but, with respect to possible sexual errors and conflicts with criminal laws, it must be emphasised that his sexual instinct is abnormal, having its origin in organic pathological conditions ; and this circumstance should eventually be used in his favour. On account of his notorious lack of independence, he cannot be dis- charged from parental care or guardianship, inasmuch as otherwise he would be ruined financially. 4. Mr. V. H. is also physically ill. He presents signs of slight anaemia and of neurasthenia spinalis. A rational regulation of his manner of life and a tonic regimen, and, if possible, hydro-therapeutic treatment, seem necessary. The suspicion that this trouble has its origin in early masturbation should be entertained, and the possibility of the existence of spermatorrhoea, that is of importance etiologically and therapeutically, is probable. (Personal case. Zeitschr. /. Psychiatrie.) ^90 psychopathia sexualis. Sexual Inveksion in Woman.^ Science in its present stage has but few data to fall back on, so far as the occurrence ^ of homosexual instinct in woman is concerned as compared with man. It would not be fair to draw from this the conclusion that sexual inversion in woman is rare, for if this anomaly is really a manifestation of functional degeneration, then degenerative influences will prevail ahke in the female as well as in the male. The causes of apparent infrequency in woman may be found in the following facts: (1) It is more difficult to gain the confidence of the sexually perverse woman ; (2) this anomaly, in so far as it leads to sexual intercourse, inter feminas, does not fall (in Germany at any rate) under the criminal code, and therefore remains hidden from public knowledge ; (3) sexual inversion does not affect woman in the same manner as it does man, for it does not render woman impotent ; (4) because woman (whether sexually inverted or not) is by nature not as sensual and certainly not as aggressive in the pursuit of sexual needs as man, for which reason the inverted sexual intercourse among women is less noticeable, and by outsiders is considered mere friendship. Indeed, there are cases on record (psychical hermaphrodism, even homosexuality) in which the causes of frigiditas uxoris remain unknown even to the husband. 1 Literature : Havelock Ellis, " Alienist and Neurologist," April, 1895 ; Moll, " Contriire Sexualempfindung," second edition, p. 322. 2 Observations : (1) Wcstphal, " Arch. f. Psych.," ii., p. 73 ; (2) Gock, op. cit, No 1. ; (3) Wise, " The Alienist and Neurologist," January, 1883; (4) Cantarano, " La Psichiatria, 1883," p. 201 ; (5) Serieux, op. cit., obs. 14 ; (6) Kiernan, op. cit. ; (7) Milller, Friedreich's " Bliiicer f. ger. Med.," 18al, Heft 4. ; (8-13) Moll, " Contrare Sexualempfindung, 2 Aufl. Beob., 18, 19, 20, 21, 22, 23 ; (14) Meijhofer, " Zeitsch. f. Medicinalbeamte," v., 16 ; (15- 16) Zuccarelli, " Inversione congenita in due donne," Napoli, 1888 ; (17- 27) Moll, " Untersuchungen iiber Libido sexualis," FaUe 10-12, 40-44, 47, 56, 57; (28-29) Havelock Ellis, op. cit.; (30) Penta e Ursa, " Archiv. delle psichopatie sexuali," p. 33 ; (31) Penta, ibid., p. 94. SEXUAL INVERSION IN WOMAN. 391 Certain passages in the Bible/ the history of Greece ("Sapphic Love")» the moral history of ancient Eome and of the Middle Ages,''' offer proofs that congressus intersexualis feminarum took place at all times, the same as it is practised now-a-days in the harem, in female prisons, brothels and young ladies' seminaries {vide infra, amor lesbicus). Still it must be admitted that many of these cases are to be reduced to causes of perversity and not per- version.^ So far as the clinical aspect is concerned I may be brief, for this anomaly shows the same qualifications alike in man and woman, mutatis mtitaiidis, and runs through the same grades. Psychico-hermaphrodisic and many homo- sexual women do not betray their anomaly by external appearances nor by mental (masculine) sexual characteris- tics. Remarkable, however, it is that Dr. Flatau {Moll, op. cit., p. 334) in examining the larynx of twenty-three homosexual women found in several of them a decidedly masculine formation. In the transition to the subsequent grade, i.e., that of viraginity (analogous to ejfemhiatio in the male) strong preference for male garments will be found. In dreams, but also in the ideal or real homosexual function, the individual in question plays an indifferent sexual role. 1 Paul, Epist. ad Rom. ^ Floss, op. cit. 3 It is a remarkable fact that in fiction, lesbic love is frequently used as the leading theme, viz., Diderot, '• La Beligieuse " ; Balzac, " La fille aux yeux d'or"; Th. Gautier, "Mademoiselle de Maupin " ; Feydeau, " La Comtesse de chalis " ; Flaubert, " SalammbO " ; Belot, " Mademoiselle Giraud, ma femme," etc. The heroines of these (lesbic) novelles appear to the beloved persons of the same sex in the character and the rSle of a man ; their love is most intense. The oldest case of sexual inversion recorded thus far in Germany ia one of viraginity dating as far back as the beginning of the eighteenth century. It is that of a woman vyho was married to another woman cohabiting with the consort by means of a leathern priapus. Vide Dr. Mullej- in Friedreich's " Blatter f. ger. Med." 1891, Heft 4. 392 PSYCHOPATHIA SEXUALIS. Where viraginity is fully developed, the woman so acting assumes definitely the masculine role. In this grade modesty finds expression only towards the same but not the opposite sex. In such cases the sexual anomaly often manifests itself by strongly marked characteristics of male sexuality. The female urning may chiefly be found in the haunts of boys. She is the rival in their play, preferring the rocking-horse, playing at soldiers, etc., to dolls and other girlish occupations. The toilet is neglected, and rough boyish manners are affected. Love for art finds a sub- stitute in the pursuit of the sciences. At times smoking and drinking are cultivated even with passion. Perfumes and sweetmeats are disdained. The con- sciousness of being a woman and thus to be deprived of the gay college life, or to be barred out from the military career, produces painful reflections. The masculine soul, heaving in the female bosom, finds pleasure in the pursuit of manly sports, and in manifestations of courage and bravado. There is a strong desire to imitate the male fashion in dressing the hair and in general attire, under favourable circumstances even to don male attire and impose in it. Arrests of women in men's clothing are by no means of rare occurrence. A case of a woman who for years successfully posed as a man (hunter, soldier, etc.,) is related by Mailer in Friedreich's "Blattern"; another by Wise {op. cit.) and others. The ideals of such viragines are certain female characters who in the past or the present have excelled by virtue of genius and brave and noble deeds. Gynandry represents the extreme grade of degenerative homosexuahty. The woman of this type possesses of the feminine quahties only the genital organs ; thought, senti- ment, action, even external appearance are those of the man. Often enough does one come across in life such SEXUAL INVEESION IN WOMAN. 393 characters, whose frame, pelvis, gait, appearance, coarse masculine features, rough deep voice, etc., betray rather the man than the woman Moll (op. cit. p. 331) has given many interesting items about the mode of life led by these men-women, and about the way in which they satisfy their sexual needs. Mutatis mutandis, the situation is the same as with the man-loving man. These creatures seek, find, recognise, love one another, often hve together as "father" and "mother" in pseudo marriage. Suspicion may always be turned towards homosexuality when one reads in the advertisement columns of the daily papers : " Wanted, by a lady, a lady friend and companion ". Numerous psychical hermaphrodites of the female gender, and even homosexualists, enter upon matrimony with men partly on account of being ignorant of their own anomaly, and partly because they wish to be pro- vided for. Some of these marriages linger on in a way, the husband, perhaps, being psychically sympathetic, thus rendering the marital act possible to the unhappy wife. But in most cases, when one or two children have been born, she seeks under all kinds of pretexts to avoid the connubial duty. More frequently, however, incompatibihty wrecks these unions. Homosexual intercourse continues after marriage just the same as with the homosexual man. When viraginity prevails marriage is impossible, for the very thought of coitus cum viro arouses disgust and horror. The intersexual gratification among these women seems to be reduced to kissing and embraces, which seems to satisfy those of weak sexual instinct, but pro- duces in sexually neurasthenic females ejaculation. Automasturbation, faute de miciix, seems to occur in all grades of the anomaly the same as in men. Strongly sensual individuals may resort to cunnilingas or mutual masturbation. 394 PSYCHOPATHIA SEXUALIS. In grades 3 and 4 the desire to adopt the active role towards the beloved person of the same sex seems to invite the use of the priapus. Case 1 27. Psychical hermaphrodism. Mrs. X., twenty- six years of age, suffers from neurasthenia. She is heredi- tarily tainted, suffers periodically from delusions. She has been married seven years, has two healthy children, a boy of six and a girl four years old. Success in gaining the confidence of the patient. . She confesses that she always inclined more to persons of her own sex, and that, although she esteems and Hkes her husband, sexual inter- course disgusts her. Since the birth of the younger of the two children she has prevailed upon him to give it up altogether. When at the seminary she interested herself in other young ladies in a manner which she can only describe as love. At times, however, she also found her- self drawn to certain gentlemen, and especially of late her virtue had been sorely tried by an admirer to whose advances she was afraid she might succumb, for which reason she avoided being alone with him. But such episodes were only of a quite transient character as com- pared with her passionate liking for persons of her own sex. Her whole desire was to be kissed and embraced by them and have the most intimate intercourse with them. She suffered much from nervousness because she could not always reahse these desires. The patient is not aware of this inclination to persons of the same sex being of a sexual character, for beyond kissing, embracing, or fondhng them she would not know what to do with them. Patient thinks herself to be of a sensual nature. It is likely that she is addicted to masturbation. She considers her sexual perversion as "unnatural, morbid ". There is nothing in the behaviour or the manners or the external appearance of this lady which in the least betrays her anomaly. SEXUAL INVERSION IN WOMAN. 395 Case 128. Psychical hermaphrodism. Mrs. M., forty- four years of age, claims to be an instance illustrating the fact that in one and the same human being, be it man or woman, the inverted as well as the normal direction of sexual life may be combined. The father of this lady was very musical, generally possessed considerable talents for art, was a great admirer of the gentle sex, and himself of exceptional beauty. He died, after repeated apoplectic attacks, with dementia in an asylum. His brother was neuropsychopathic, as a child was afflicted with somnam- bulism, and later on with hypercesthesia sexualis. Although married and father of several married sons, he fell despe- rately in love with Mrs. M., then eighteen years of age, and attempted to abduct her. Her grandfather (on the paternal side) was very eccen- tric and a well-known artist, who had originally studied theology, but for love of the dramatic art became a mimic and singer. He was given to excess in Baccho et Venere, extravagant and fond of splendour, and died at the age of forty-nine from apoplexia cerebri. Her mother's father and her mother both died of pulmonary phthisis. She had eleven brothers and sisters, of whom only six are alive now. Two brothers died at the age of sixteen and twenty of tuberculosis. One brother is suffering from laryngeal phthisis. Four living sisters the same as Mrs. M. are physically like unto the father, very nervous and shy. Two younger sisters are married and in good health, and both have healthy children. Another one, a maiden, is suffering from nervous affection. Mrs. M. is the mother of four children, several of whom are rather delicate and neuropathic. There is nothing of importance in the history of the patient's childhood. She learned easily, had gifts for poetry and aesthetics, was somewhat affected, loved to read novels and sentimental literature, was of neuropathic constitution and very sensitive to changes of temperature, the slightest draught would make her flesh creep. It is 396 PSYCHOPATHIA SEXUALIS. noteworthy, however, that one day when ten years of age she fancied her mother did not love her. Thereupon she put a lot of sulphur matches in her coffee and drank it to make herself ill, in order to draw her mother's love to herself. Puberty began without difficulty at the age of eleven, with subsequent regular menses. Even previous to that period sexual life had awakened, which ever since was very potent. The first sentiments and emotions lay in the homosexual direction. She conceived a passionate, though platonic, affection for a young lady, wrote love- songs and sonnets to her, and never was happier than when, upon one occasion, she could admire the " charms of her beloved" in the bath, or when she could gaze upon the neck, shoulders and breasts of this lady whilst dressing. She could resist only with difficulty the desire to touch these physical charms. When a girl she was deeply in love with Raphael's and Guido Eeni's Madonnas. She was irresistibly impelled to follow pretty girls and ladies by the hour, no matter how inclement the weather might be, admiring their air of refinement and watching for a chance of showing them a favour, giving them flowers, etc. The patient asserts that up to her nineteenth year she had not the slightest knowledge of the difference of sexes, since she had been brought up by a prudish old maiden aunt like a nun in a cloister. In consequence of this crass ignorance she fell a victim to a man who loved her passionately and insidiously betrayed her virtue. She became the wife of this man, gave birth to a child, and led an "eccentrically" sexual hfe with him, but felt satisfied with the sexual intercourse. A few years later she became a widow. Since then her affections again turned to persons of her own sex, the principal reason for which was, the patient thinks, the fear of the results of sexual intercourse with man. At the age of twenty-seven she entered upon a second marriage with a man of infirm constitution. It was not SEXUAL INVERSION IN WOMAN. 397 a love match. Thrice she became a mother, and fulfilled all the conditions of maternity ; but her health ran down, and during the latter years her dislike for coitus ever increased, chiefly on account of her husband's infirmity, although her desire for sexual gratification remained strong. Three years after her second husband's death, she discovered that her daughter by the first husband, now nine years of age, was given to masturbation and going into decline. She read an article about this vice in the EncydopcBdia, and now could not resist the temptation to try it herself, and thus became an onanist. She hesitates to give a full account of this period of her life. She states, however, that she became sexually so excited that she had to send her two daughters away from home in order to preserve them from something " terrible ". The two boys could remain at home. Patient became neurasthenic ex masttirbatione (spinal irritation, pressure in the head, languor, mental constipa- tion, etc.) at times even dysthymic, with worrying tadium vita. Her sexual inclinations turned now to woman, now to marl. But she controlled herself, suffered much from her abstinence, especially since she resorted to mastur- bation on account of her neurasthenic afflictions only at the last instance. At present the patient — now forty- four years of age, but still having regular periods —suffers from a violent passion for a young man with wliom, on account of her avocation, she is bound to be in constant contact. The patient does not offer anything extraordinary in her external appearance, though graceful of Iniild, she is slight of form. Pelvis decidedly feminine, but arms and legs large, and of pronounced mascuHne type. Female boots do not reall}' fit her, and she has quite crippled and malformed her feet by forcing them into narrow shoes. Genitals quite normal. Excepting a descensus uteri 398 PSYCHOPATHIA SEXUALIS. with hypertrophy of the vaginal portion, no changes are noticeable. She still claims to be essentially homosexual, and declares that her inclination and desire for the opposite sex are only periodical and grossly sensual. Although she has strong sexual feelings towards the man aforementioned, yet her greatest and noblest pleasure she finds in pressing a kiss upon the soft cheek of a sweet girl. This pleasure she enjoys often, for she is the " favourite aunt " among these " dear creatures," to whom she renders the services of the " cavalier " un- stintingly, always feeling herself in the role of the man. Case 129. Homosexuality. Miss L., fifty-five years of age. No information about her father's family. The parents of her mother are described as irascible, capricious and nervous. One brother of her mother is an epileptic, another eccentric and mentally abnormal. Mother was sexually hypersesthetic, and for a long time a messalina. She was considered to be psychopathic and died at the age of sixty-nine of cerebral disease. Miss L. developed normally, had only slight illnesses in childhood, and was mentally well endowed, but of a neuropathic constitution, emotional, and troubled with numerous fads. At the age of thirteen, two years previous to her first menstruation, she fell in love with a girl-friend (" a dreamy feeling, quite pure of sensuality "). Her second love was for a girl older than herself who was a bride ; this was accompanied by tantalising sensual desires, jealousy, and an "undefined consciousness of mystical impropriety ". She was refused by this lady and now fell in love with a married woman, who was a mother and twenty years lier senior. As she controlled her sensual emotions, this lady never even divined the true reason of this enthusiastic friendship which lasted for twelve years. Patient describes this period as a veritable martyrdom. SEXUAL INVERSION IN WOMAN. 399 Since she was twenty-five she had begun to mastur- bate. Patient seriously thought that, perhaps, by marriage she might save herself, but her conscience objected, for her children might inherit her weakness, or she might make a sincere husband unhappy. At the age of twenty-seven she was approached with direct proposals by a girl who denounced abstinence as absurd, and plainly described the homosexual instinct which ruled her and was very impetuous in her demands. She suffered the caresses of the girl, but would not con- sent to sexual intercourse, as sensuality without love disgusted her. Mentally and bodily dissatisfied the years fled by, leaving the consciousness of a spoiled life. Now and then she became enthusiastic about ladies of her acquamtance, but controlled herself. She also rid herself from mastur- bation. When she was thirty-eight years of age she became acquainted with a girl nineteen years her junior, of ex- ceptional beauty, who came from a demoralised family, and had been at an early age seduced by her cousins to mutual masturbation. It cannot be ascertained whether this girl A. was a case of psychical hermaphrodism or of acquired sexual inversion. The former hypothesis seems the likelier of the two. The following is taken from an autobiography of Miss L. :— " Miss A., my pupil, began to show me her idolatrous love. She was sympathetic to the highest degree. Since I knew that she was entangled in a hopeless love afi"air with a dissolute fellow and continued intimate intercourse with demoralised female cousins, I decided not to repulse her. Compassion and the conviction that she was surely drifting into moral decay determined me to suffer her advances. " I did not consider her affection as dangerous, as I did not think it possible that (considering her love affair) in 400 PSYCHOPATHIA SEXUALIS. ONE soul two passions (one for a man and another for a woman) could exist simultaneously. Moreover, I was certain of my power of resistance. I kept, therefore, Miss A. about me, renewed my moral resolutions, and con- sidered it to be my duty to use her love for me for ennobling her character. The folly of this I soon found out. One day whilst I lay asleep Miss A. took occasion to satisfy her lust on me. Although I woke up just in time, I did not have the moral strength to resist her. I was highly excited, intoxicated as it were — and she prevailed. " What I suffered immediately after this occurrence beggars description. Worry over the broken resolutions, which to keep I had made such strenuous efforts, fear of detection and subsequent contempt, exuberant joy at last to be rid of the torturing watchings and longings of the single state, unspeakable sensual pleasure, wrath against the evil companion, mingled with feelings of the deepest tenderness towards her. Miss A. calmly smiled at my excitement, and with caresses soothed my anger. " I accepted the situation. Our intimacy lasted for years. We practised mutual masturbation, but never to excess or in a cynical fashion. "Little by little this sensual companionship ceased. Miss A.'s tenderness weakened ; mine, however, remained as before, although I felt no longer the same sensual cravings. Miss A. thought of marriage, partly in order to find a home, but especially because her sensual desires had turned into the normal paths. She succeeded in finding a husband. I sincerely hope she will make him happy, but I doubt it. Thus I have the prospect before me to linger on the same joyless, peaceless life as it ever was in youthful days. " It is with sadness that I remember the years of our loving union. It does not disturb my conscience to have had sexual intercourse with Miss A., for I succumbed to her seduction, having honestly endeavoured to save her SEXUAL INVERSION IN WOMAN. 401 from moral ruin and to bring her up an educated and moral being. In this I honestly think I have succeeded after all. Besides, I rest in the thought that the moral code is established only for normal humans, but is not binding for anomalies. Of course, the human being who is endowed by nature with sentiments of refinement, but whose constitution is abnormal and outside the conven- tionalities of society, can never be truly happy. But I experienced a sad tranquillity and felt happy when I thought Miss A. to be so too. " This is the history of an unhappy woman who, by the fatal caprice of nature, is deprived of all joy of hfe and made a victim of sorrow." The author of this woeful story is a lady of great refine- ment. But she has coarse features, a powerful but through- out feminine frame. A few years ago she passed through the climacterium without trouble, and since then has been entirely free from sensual worry. Sexually she has never played a defined role towards the woman she loved ; for men she never felt the shghtest inclination. Her statements about the family relations and the health of her paramour, Miss A., estabhsh a heavy taint beyond doubt. The father died in an insane asylum, the mother was deranged during the period of her climac- terium, neuroses were of frequent occurrence in the family, and Miss A. herself suffered at times heavily from hysteropathy, with hallucinations and delirium. Case 130. Homosexuality. S. J., age thirty-eight, governess. Came to me for medical advice on account of nervous trouble. Father was periodically insane, and died from cerebral disease. Patient is an only child. She suffered early from anxiety and alarming fancies, e.g., that she would wake up in a coffin after it had been fastened down ; that she would forget something when going to confession, and thus receive holy communion unworthily. Was often troubled with headaches, very 402 PSYCHOPATHIA SEXUALIS. excitable, easily startled, but notwithstanding had a great desire to see exciting things such as funerals, etc. From the earliest youth she was subject to sexual excitement, and spontaneously practised masturbation. At the age of fourteen she began to menstruate. Her periods were often accompanied by colicky pains, intense sexual excitement, neuralgia and mental depression. With the age of eighteen she gave up masturbation success- fully. The patient never experienced an inclination towards a person of the opposite sex. Marriage to her only meant to find a home. But she was mightily drawn to girls. At first she considered this affection merely as friendship, but she soon recognised from the intensity of her love for girl friends and her deep longings for their constant society that it meant more than mere friendship. To her it is inconceivable that a girl could love a man, although she can comprehend the feeling of man toward woman. She always took the deepest interest in pretty girls and ladies, the sight of whom caused her intense excitement. Her desire was ever to embrace and kiss these dear creatures. She never dreams of men, always of girls only. To revel in looking at them was the acme of pleasure. Whenever she lost a " girl friend " she felt in despair. Patient claims that she never felt in a defined role, even in her dreams, towards her girl friends. In appear- ance she is thoroughly feminine and modest. Feminine pelvis, large mammae, no indication of beard. Case 131. Homosexuality. Mrs. E., aged thirty-five, of high social position, was brought to me in 1886 by her husband for advice. Father was a physician ; very neuropathic. Paternal grandfather was healthy and normal, and reached the age of ninety-six. Facts concerning paternal grandmother are wanting. All the children of father's family are said SEXUAL INVERSION IN WOMAN. 403 to have been- nervous. The patient's mother was nervous, and suffered with asthma. The mother's parents were healthy. One of the mother's sisters had melanchoha. From her tenth year patient has been subject to habitual headache. With the exception of measles, she has had no illness. She was gifted, and enjoyed the best of training, having especial talent for music and languages. It became necessary for her to prepare her- self for the work of a governess, and during her earlier years she was mentally overworked. She passed through an attack of melancholia sine delirio, of some months' duration, at seventeen. The patient asserts that she has always had sympathy only for her own sex, and found only an aesthetic interest in men. She never had any taste for female work. As a Httle girl, she preferred to play with boys. She says she remained well until her twenty-seventh year. Then, without external cause, she became depressed and considered herself a bad, sinful person, had no plea- sure in anything, and was sleepless. During this time of illness she was also troubled with delusions : she must think of her death and that of her relatives. Kecovery after about five months. She then became a governess, was overworked, but remained well, except for occasional neurasthenic symptoms and spinal irritation. At twenty-eight she made the acquaintance of a lady five years younger than herself. She fell in love with her, and her love was returned. The love was very sensual, and satisfied by mutual masturbation. " I loved her as a god ; hers is a noble soul," she said, when she mentioned this love-bond. It lasted four years and was ended by the (unfortunate) marriage of her friend. In 1885, after much emotional strain, the patient became ill with symptoms of hystero-neurasthenia (dys- pepsia, spinal irritation, and tonic spasmodic attacks ; attacks of hemiopia with migraine and trausitory aphasia; 404 PSYCHOPATHIA SEXUALIS. pruritus pudendi et ani). In February, 1886, these symp- toms disappeared. In March she became acquainted with her present husband, whom she married without taking much time for reflection ; for he was rich, much in love with her, and his character was in sympathy with her own. On 6th April, she read the sentence, " Death misses no one ". Like a flash of lightning in a clear sky, the former delusions of death returned. She was forced to meditate on the most horrible manner of death for herself and those about her, and constantly imagined death-scenes. She lost rest and sleep, and took no pleasure in anything. Her condition improved. Late in May, 1886, she was married, but was still troubled by painful thoughts at that time : that she would bring misfortune on her husband and those about her. First coitus on 6th June, 1886. She was deeply de- pressed morally by it. She had had no such conception of matrimony. The husband, who really loved his wife, did all he could to quiet her. He consulted physicians, who thought all would be well after pregnancy. The husband was unable to explain the peculiar behaviour of his wife. She was friendly toward him, and suffered his caresses. In coitus, which was actually carried out, she was entirely passive, and after the act she was tired, exhausted all day long, nervous, and troubled with spinal irritation. A bridal tour brought about a meeting with her old friend, who had lived in an unhappy marriage for three years. The two ladies trembled with joy and excitement as they sank into each other's arms, and became insepar- able. The husband saw that this friendly relation was a peculiar one, and hastened their departure. He had an opportunity of ascertaining, through the correspondence of his wife with this friend, that the letters interchanged were like those of two lovers. Mrs. R. became pregnant. During pregnancy the SEXUAL INVERSION IN WOMAN. 405 remains of depression and delusions disappeared. In September, during about the ninth week of pregnancy, abortion took place. After that, renewed symptoms of hystero-neurasthenia. In addition to this, there were anteflexio et latero-positio dextra uteri, ancsmia, et atonia ventriculi. At the consultation the patient gave the impression of a very neuropathic, tainted person. The neuropathic expression of the eyes cannot be described. Appearance entirely feminine With the exception of a very narrow, arched palate, there was no skeletal abnormahty. With difficulty the patient could be brought to give the details of her sexual abnormality. She complained that she had married without knowing what marriage between men and women was. She loved her husband dearly for his mental qualities, but marital intercourse was a pain to her ; she did it unwillingly, without ever finding any satisfaction in it. Post actum, all day long she was weary and exhausted. Since the abortion and the interdiction of sexual intercourse by the physicians, she had been better ; but she thought of the future with horror. She esteemed her husband, and loved him mentally ; but she would do anything for him, if he would but avoid her sexually in the future. She hoped to have sexual feeling for him in time. When he played the violin, she seemed to feel the beginning of an inclination for him that was sometbing more than friendship ; but it was only tran- sitory, and she could get no assurance for the future in it. Her greatest happiness was in correspondence with her former lover. She felt that this was wrong, but she could not give it up ; for to do so made her miserable. Case 132. Homosexuality. Miss X. belongs to the middle class in a large city. At the end of my observa- tions she was twenty-two years of age. She is considered a beauty ; much admired by men ; decidedly sensual ; a born Aspasia ; refused all proposals 406 PSTCHOPATHIA SEXUALIS. of marriage. She reciprocated, however, the advances of one admirer, a youthful scholar, entertained relations with him, that is to say, she allowed him to kiss her, but not as a lover. "When on one occasion Mr. T. thought he had obtained the aim of his attentions, she begged him under tears to desist, alleging that her refusal was not based upon moral principles, but rooted in deeper psychical reasons. Subsequent epistolary correspondence between the two disclosed the existence of sexual inversion. Her father was given to drink, her mother hystero- pathic. She herself is of neuropathic constitution, has a large bust and the appearance of an exceptionally hand- some woman, but is strikingly mannish in her manners, has masculine tastes, loves gymnastics and horseback exercise, smokes, and has masculine carriage and gait. She would like to go on the stage. Recently she caused much talk on account of her enthusiastic friendships with young ladies. One young lady lives with her. They sleep in the same bed. Up to her puberty Miss X. claims to have been sexually indifferent. At the age of seventeen, whilst at a spa, she made the acquaintance of a young foreigner whose " royal " appear- ance fascinated her. She was happy when, on a certain occasion, she could dance with him the whole evening. The next evening at twiHght she happened to witness the revolting scene of this charming young man right opposite from her window in the shrubbery of the gardens futuare more bestiarum mulierem quondam inter menstruationem. Aspectu sanguinis currentis et libidinis quasi bestialis viri Miss X. was horrified, almost annihilated, and felt it difficult to recover her mental balance. For a long time she lost her sleep and appetite, and from that time she has seen in man only the embodiment of coarse vulgarity. Two years later, in a public park, she was approached by a young lady who smiled and looked upon her in such a peculiar fashion that she felt a thrill through her soul. SEXUAL INVERSION IN WOMAN. 407 The day after, Miss X. was irresistibly impelled to go to the park again. The young lady was already there, and seemed to be waiting for her. They greeted each other like old acquaintances ; talked and joked together, made fresh appointments, and when the weather became too inclement they met at the boudoir of the young lady. " One day," Miss X. relates in her confidential revela- tions, " she led me to her divan, and whilst she was seated I knelt down at her feet. She fastened her timid eyes upon me, stroked away the hair from my forehead, and said, 'Ah ! if I only could love you once really ! May I ?' I consented, and whilst we thus sat together, gazing into each other's eyes, we drifted into that current which allows of no retreat. . . . She was enchantingly beauti- ful. All I wished was to possess the power of the artist to immortalise that form upon the canvas. To me it was a novel experience. I was intoxicated. We abandoned ourselves to each other without restriction, drunk with the ravages of sensual feminine pleasure. I do not believe that man can ever grasp the exuberance of such piquant tenderness ; man is not sufficiently refined ; he is much too coarse. . . . Our wild orgy lasted until I sank down exhausted, powerless, unnerved. I fell asleep on her bed. Suddenly I awoke with an unspeakable thrill, hitherto unknown to me, running through my whole being. She was upon me — cunnilingum perficiens — the highest pleasure for her, tandem mihi non licebat altrum quam osculos dare ad mammas, which caused her to quiver convulsively. " This intercourse lasted for a whole year, when the removal of her father to another city separated us." Miss X. admitted that in this homosexual intercourse she always felt in the role of man towards the woman, and that on one occasion, faute de mietcx, she granted cunnilingus to one of her male admirers. Case 133. Homosexuality. Mrs. C, aged thirty-two wife of an official, a large, not uncomely woman, feminine 408 PSYCHOPATHIA SEXUALIS. in appearance, conies of a neuropathic and emotional mother. A brother was psychopathic, and died of drink. Patient was always pecuhar, obstinate, silent, quick- tempered, and eccentric. The brothers and sisters are excitable people. Pulmonary phthisis has been frequent in the family. When only a girl of thirteen, with signs of great sexual excitement, she attracted attention by enthusiastic love for a female friend of her own age. Her education was strict, though the patient secretly read many novels, and wrote innumerable poems. She married at eighteen to free herself from unpleasant circumstances at home. She says she has always been indifferent toward men. In fact, she avoided balls. Female statues pleased her Her greatest happiness was to think of marriage with a beloved woman. She was not aware of her sexual peculiarity until marriage, and the thing had remained inexphcable to her. Patient did her marital duty, and bore three children, two of whom were subject to con- vulsions. She lived pleasantly with her husband, but she esteemed him only for his moral qualities. She gladly avoided coitus. " I should have preferred intercourse with a woman." Until 1878 she had been neurasthenic. On the occa- sion of a sojourn at a watering-place she made the ac- quaintance of a female urning, whose history I have reported as case 6, in the " Irrenfreund," No. 1, 1884. The patient came home a changed person. Her husband says : " She was no longer a woman, no longer had any love for me and the children, and would have no more of marital approaches. She was inflamed with passionate love for her female friend, and had taste for nothing else." After the husband forbade her lover the house, there was interchange of letters with such expres- sions in them as " My dove ! I hve only for you, my soul ". There were meetings and frightful excitement when an expected letter did not come. The relation was SEXUAL INVERSION IN WOMAN. 409 in nowise platonic. From certain indications it is pre- sumable that mutual masturbation was the means of sexual satisfaction. This relation lasted until 1882, and made the patient decidedly neurasthenic. She absolutely neglected the house, and her husband hired a woman of sixty years as a housekeeper, and also a governess for the children. The patient fell in love with both, who, at least, allowed caresses, and profited materially through the love of their mistress. In the latter part of 1883, on account of developing pulmonary tuberculosis, she had to go south. There she became acquainted with a Russian lady of forty years, and fell passionately in love with her ; but she did not meet with a return of love in her sense. One day in- sanity became manifest. She thought the Russian lady a nihilist ; that she was magnetised by her ; and she presented formal persecutory delusions. She fled, was caught in an Italian city, and placed in a hospital, where she soon became quiet. Again she worried the lady with her love, felt herself very unhappy, and planned suicide. "When she returned home, she was greatly depressed because she did not have the lady, and was harsh toward her family. A delusive, erotic state of excitement came on about the end of May, 1884. She danced, shouted, and called herself a man ; demanded her former lover, and said she was of royal blood. She escaped from the house in male attire, and was taken to the asylum in a state of eroto-maniacal excitement. After a few days the exaltation disappeared. The patient became quiet, and made a desperate attempt at suicide ; after it she was in great anguish of mind with tadium vita;. The perverse sexual feeling grew less and less noticeable as tuberculosis progressed. The patient died of phthisis in the beginning of 1885. The examination of the brain presented nothing un- usual as far as architecture and arrangement of convolu- tions were concerned. Weight of l)rain 1150 grammes. 410 PSYCHOPATHIA" SEXUALIS. Skull slightly asymmetrical. No anatomical signs of degeneration. External and internal genitals without anomaly. Case 134. Viraginity. Miss N., twenty-five years of age. Parents supposed to be healthy. Her brothers and sisters are all neuropathic. Three of her sisters are married. She is very talented, es[jecially in the fine arts. Even in her earliest childhood she preferred playing at soldiers and other boys' games ; she was bold and tom- boyish, and tried even to excel her little companions of the other sex. She never had a liking for dolls, needle- work or domestic duties. Puberty at fifteen. She soon fell in love with young ladies, but only in a platonic fashion, for she is a "respectable girl". For several years since then her libido is very strong. She can hardly restrain herself. Her dreams are of a lascivious character, only about females, with herself in the role of man. She is desperately in love with a woman of forty, whom she torments with her jealous conduct. Miss N. is indifferent to men. She could safely live with a man in the same room, whilst towards persons of her own sex she is most bashful. She is quite conscious of her pathological condition. Masculine features, deep voice, manly gait, without beard, small mammae ; crops her hair short, and makes the impression of a man in woman's clothes. Case 135. Viraginity. C. E., maid-servant, aged twenty-six, suffered from the time of her development with original paranoia and hysteria. As a result of her delusions, her life had been somewhat romantic, and in 1884, in Switzerland, where she had gone on account of delusions of persecution, she came under the observation of the authorities. On this occasion it was ascertained that E. was affected with sexual inversion. Concerning her parents and relatives, there is no SEXUAL INVEESION IN WOMAN. 411 information at hand. E,. asserted that, with the excep- tion of an inflammation of the lungs at the age of sixteen, she had never been severely ill. First menstruation at fifteen, without any difficulties ; thereafter it was very often irregular and abnormally excessive. The patient declared that she never had had inclinations toward the opposite sex, and had never allowed the approach of a man. She never could understand how her friends could describe the beauty and amiability of men. But it was charming and inspiring for her to imprint a kiss on the lips of a beloved female friend- She had a love for girls that was incomprehensible to her. She had passionately loved and kissed some of her female friends, and she would have given up her life for them. Her greatest delight would have been to have constantly lived with such a friend and absolutely possessed her. In this she felt toward the beloved girl like a man. Even as a little child she had an inclination only for the play of boys, and she loved to hear shooting and military music, was always much excited by them, and would gladly have gone as a soldier. The chase and war have been her ideals. In the theatre only feminine performers interested her. She knew very well that the whole of this inclination was unwomanly, but she could not help it. It had always been a great pleasure for her to go about in male clothing, and in the same way she had always pre- ferred masculine work, and had shown unusual skill in it ; while with reference to feminine occupations, especially handiwork, she had to say the contrary. The patient had also a weakness for smoking and spirits. On account of persecutory delusions, in order to rid herself of her per- secutions, the patient had often gone about in male attire and played the part of a man. She did this with such (natural) skill that, as a rule, she was able to deceive people concerning her sex. It is authoritatively established that in 1884 for a long time the patient went about in male attire, now 412 PSYCHOrATHIA SEXUALIS. in the garments of a civilian, now in the uniform of a heutenant ; and in August of the same year, dressed as a male servant, sh3 fled to Switzerland through delu- sions of persecution. There she found service in a mer- chant's family and fell in love with the daughter of the house, "the beautiful Anna," who, on her side, not recognising the sex of E., fell in love with the handsome young man. Concerning this episode the patient makes the follow- ing characteristic statement : " I was madly in love with Anna. I don't know how it came about, and I cannot put myself right concerning this impulse. In this fatal love lies the reason why I played the role of a man so long. I have never yet felt any love for a man, and I believe that my love is for the female and not the male sex. I can in nowise understand my condition." From Switzerland R. wrote letters home to her friend Amelia, which were produced at the examination. They are letters showing passionate love, which goes beyond the bounds of friendship. She apostrophises her friend : " My flower, sun of my heart, longing of my soul ". She was her greatest happiness on earth ; her heart was hers. And in her letters to her friend's parents she wrote : " You, too, should watch my 'flower,' for if she should die I also would be unable to endure life ". For the purpose of investigating her mental condition, E. remained for some time in an asylum. On one occa- sion, when Anna was allowed to pay E. a visit, there was no end of passionate embraces and kisses. The visitor acknowledged freely that they had before secretly embraced and kissed in the same way. E. is a tali, slim, stately person, of feminine form in all respects, but with masculine features. Cranium regular ; no anatomical signs of degeneration. Genitals normal and indicative of virginity. E. makes the impres- sion of a morally pure and modest person. All the circumstances indicate that she has only indulged in SEXUAL INVERSION IN WOMAN. 413 platonic love. Eye and appearance are indicative of a neuropathic person. Severe hysteria, occasional catalep- toid attacks, with visionary and dehrious states. The patient is very easily brought into a state of somnam- buhsm by hypnotic influence, and in this condition is susceptible to all possible suggestions. (Personal case. ''Friedreich's Blatter," 1881, Heft i.) Case 136. Viraginity. Miss 0., twenty-three years of age. Mother constitutionally and heavily hystero- pathic. Mother's father insane. Father's family un- tainted. Father died early of pneumonia. Patient was brought to me by her trustee because she ran away recently from home in male attire in order to rove through the world and become an " artiste ". Very gifted in music. For several years past she has attracted much atten- tion by her bold, mannish behaviour, and by wearing her hair and attire in male fashion. Since she was thirteen she was demonstrative in her love for girl friends, whom she often wearied with fervent embraces. She does not seek to conceal her passionate fondness for persons of her own sex. Claims that since her thirteenth year she is fully conscious of the fact that she can love only women. She feels as a man towards woman ; thinks she looks like a man, and would much rather wear men's clothes. A short time ago she seriously asked a relative who is in the police department to obtain permission for her to go about in male attire. Her erotic dreams deal only with intimate intercourse with female friends. She never took the slightest interest in men, and never thought of marriage. She feels quite happy in her abnormal sexual condi- tion, and does not recognise it as pathological. She cannot comprehend tliat her sexual instinct differs from that of other women. 414 PSYCHOPATHIA SEXUALIS. The circumference of the head is 51 cm. Frame quite feminine ; but the feet are exceptionally large and more of masculine type. Carriage, attitude and gait quite masculine. Female voice. Monthly periods regular since her thirteenth year. Case 137. Miss X., aged thirty-eight, consulted me late in the fall of 1881, on account of severe spinal irrita- tion and obstinate sleeplessness, in combating which she had become addicted to morphine and chloral. Her mother and sister were nervous sufferers, but the rest of the family were healthy. The trouble dated from a fall on her back in 1872, at which time the patient was terribly frightened, though, when a girl, she had been subject to muscular cramps and hysterical symptoms. Following this shock, a neurasthenic and hysterical neurosis developed, with predominating spinal irritation and sleeplessness. Episodically, hysterical paraplegia, lasting as long as eight months, and hysterical hallu- cinatory delirium, with convulsive attacks, occurred. In the course of this, symptoms of morphinism were added. A stay of some months in the hospital relieved the latter, and considerably improved the neurasthenic neurosis, in the treatment of which general faradisation exerted a remarkably favourable influence. Even at the first meeting, the patient produced a remarkable impression by reason of her attire, features, and conduct. She wore a gentleman's hat, her hair closely cut, eye-glasses, a gentleman's cravat, a coat-like outer garment of masculine cut that reached well down over her gown, and boots with high heels. She had coarse, somewhat masculine features ; a harsh, deep voice ; and made rather the impression of a man in female attire than that of a lady, if one but overlooked the bosom and the decidedly feminine form of the pelvis. During the long time that she was observed, there were never signs of erotism. When questioned concerning her attire, she SEXUAL INVERSION IN WOMAN. 415 would only respond that the style she chose suited her better. Gradually it was ascertained from her that, even when she was a small girl, she had had a preference for horses and masculine pursuits, and never any interest in feminine occupations. Later she developed a particular pleasure in reading, and prepared herself to be a teacher. Dancing had never pleased her ; it had always seemed silly to her. The hallet had never interested her. Her greatest pleasure had always been in the circus. Until her sickness, in 1872, she had neither had inclination for persons of the opposite nor for those of her own sex. From that time she had, what was remarkable to herself, a peculiar friendship for females, particularly for young ladies ; and she had a desire, and satisfied it, to wear hats and coats of masculine style. Since 1869, she had worn her hair short, and parted it on the side, as men do. She asserts that she was never sexually excited in the company of men, but that her friendship and self-sacrifice for sympathetic ladies was unbounded ; while from that time she also experienced repugnance for gen- tlemen and their society. Her relatives report that, before 1872, the patient had a proposal of marriage, which she refused ; and that when she returned from a sojourn at a watering-place, in 1874, she was sexually changed, and occasionally showed that she did not regard herself as a female. Since that time she would associate only with ladies, has had a kind of love-relation with one or another, and made remarks which indicated that she looked upon her- self as a man. This predilection for women was decidedly more than mere friendship, since it expressed itself in tears, jealousy, etc. When, in 1874, she was stopping at a watering-place, a young lady, who took her for a man in disguise, fell in love with her. When this lady married, later, the patient was for a long time depressed, and spoke of un- faithfulness. Moreover, since her illness, her relatives 416 PSYCHOPATHIA SEXUALIS. were struck by her desire for masculine attire, her mascuhne conduct, and disinclination for feminine pur- suits ; while previously, at least sexually, she had pre- sented nothing unusual. Further investigations showed that the patient had a love-relation, which was not purely platonic, with the lady described in case 133 ; and that she wrote her affectionate letters like those of a lover to his' beloved. In 1887 I again saw the patient in a sanatorium, where she had been placed on account of hystero-epileptic attacks, spinal irritation, and morphinism. The inverted sexual feeling existed unchanged, and only by the most careful watching was the patient kept from improper advances toward her fellow-patients. Her condition remained quite unchanged until 1889. Then the patient began to fail, and she died of " ex- haustion," in August, 1889. The autopsy showed, in the vegetative organs, amyloid degeneration of the kid- neys, fibroma of the uterus, and cyst of the left ovary. The frontal bone was much thickened, uneven on the inner surface, with numerous exostoses ; dura adherent to vault of cranium. Long diameter of skull, 175 milli- metres ; lateral diameter, 148 millimetres ; weight of the oedematous, but not atrophied, brain, 1175 grammes. The meninges delicate, easily removed. Cortex pale. Convolutions broad, not numerous, regularly arranged. Nothing abnormal in cerebellum and great ganglia. Case 138. Gynandry} History: On 4th November, 1889, the stepfather of a certain Count Sandor V. com- plained that the latter had swindled him out of 800f., under the pretence of requiring a bond as secretary of a stock company. It was ascertained that Sandor had entered into matrimonial contracts and escaped from the nuptials in the spring of 1889 ; and, more than this, that ^ Cf. the expert medical opinion of this case, by Dr. Birnbacher, in "Friedreich's Blatter f. ger. Med.," 1891, Heft 1. SEXUAL INVERSION IN WOMAN. 417 this ostensible Count Sandor was no man at all, but a woman in male attire — Sarolta (Charlotte), Countess V. S. was arrested, and, on account of deception and forgery of public documents, brought to examination. At the first hearing S. confessed that she was born on the 6th Sept., 1866 ; that she was a female, Catholic, single, and worked as an authoress under the name of Count Sandor V. From the autobiography of this man-woman I have gleaned the following remarkable facts that have been independently confirmed : — S. comes of an ancient, noble and highly respected family of Hungary, in which there have been eccentricity and family peculiarities. A sister of the maternal grand- mother was hysterical, a somnambulist, and lay seventeen years in bed, on account of fancied paralysis. A sec(md great-aunt spent seven years in bed, on account of a fancied fatal illness, and at the same time gave balls. A third had the whim that a certain table in her salon was bewitched. If anything were laid on this table, 'she would become greatly excited and cry, " Bewitched ! be- witched ! " and run with the object into a room which she called the " Black Chamber," and the key of which she never let out of her hands.. After the death of this lady, there were found in this chamber a number of shawls, ornaments, bank-notes, etc. A fourth great-aunt during two years did not leave her room, and neither washed herself nor combed her hair ; then she again made her appearance. All these ladies were, nevertheless, intellectual, finely educated and amiable. S.'s mother was nervous, and could not bear the light of the moon. She inherited many of the peculiarities of her father's family. One line of the family gave itself up almost entirely to spiritualism. Two blood relations on the father's side shot themselves. The majority of her male relatives are unusually talented ; the females are decidedly 27 418 PSYCHOPATHIA SEXUALIS. narrow-minded and domesticated. S.'s father had a high position, which, however, on account of his eccentricity and extravagance (he wasted over a milhon and a hall), he lost. Among many foolish things that her father encouraged in her was the fact that he brought her up as a boy, called her Sandor, allowed her to ride, drive and hunt, admiring her muscular energy. On the other hand, this foolish father allowed his second son to go about in female attire, and had him brought up as a girl. This farce ceased when the son was sent to a higher school at the age of fifteen. Sarolta-Sandor remained under her father's influence till her twelfth year, and then came under the care of her eccentric maternal grandmother in Dresden, by whom, when the masculine play became too obvious, she was placed in an institute and made to wear female attire. At thirteen she had a love-relation with an Eaglish girl, to whom she represented herself as a boy, and ran aWay with her. Sarolta returned to her mother, who, however, could do nothing, and was compelled to allow her daughter to again become Sandor, wear male clothes, and, at least once a year, to fall in love with persons of her own sex. At the same time S. received a careful education and made long journeys with her father, of course always as a young gentleman. She early became independent and visited cafh, even those of doubtful character, and, indeed, boasted one day that in a brothel she had had a girl sitting on each knee. S. was often intoxicated, had a passion for masculine sports and was a very skilful fencer. She felt herself drawn pariicularly toward actresses, or others of similar position, and, if possible, toward those who were not very young. She asserts that she never had any inclination for a young man, and that she has felt, from year to year, an increasing dislike for young men. SEXUAL INVERSION IN WOMAN. 419 "I preferred to go into the society of ladies with ugly, ill-favoured men, so that none of them could put me in the shade. If I noticed that any of the men awakened the sympathies of the ladies, I felt jealous. I preferred ladies who were bright and pretty ; I could not endure them if they were fat or much inclined toward men. It delighted me if the passion of a lady was disclosed under a poetic veil. All immodesty in a woman was disgusting to me. I had an indescribable aversion for female attire, — indeed, for everything feminine,— but only in as far as it concerned me ; for, on the other hand, I was all enthu- siasm for the beautiful sex." During the last ten years S. had lived almost con- stantly away from her relatives, in the gui^e of a man. She had had many liaisons with ladies, travelled much, spent much, and made debts. At the same time she carried on hterary work, and was a valued collaborator on two noted journals of the capital. Her passion for ladies was very changeable; con- stancy in love was entirely wanting. Only once did such a liaison last three years. It was years before that S., at Castle G., made the acquaintance of Emma E., who was ten years older than herself. She fell in love with her, made a marriage contract with her, and they lived together as man and wife for three years at the capital. A new love, which proved fatal to S., caused her to sever her matrimonial relations with E. The latter would not have it so. Only with the greatest sacrifice was S. able to purchase her freedom from E, who, it is reported, still looks upon herself as a divorced wife, and regards herself as the Countess V. ! That S. also had the power to excite passion in other women is shown by the fact that when she (before her marriage with E.) had grown tired of a Miss D., after having spent thousands of guldens on her, she was threatened with shooting by D. if she should become untrue. 420 PSYCHOPATHIA SEXUALIS. It was in the summer of 1887, while at a watering- place, that S. made the acquaintance of a distinguished official's family. Immediately she fell in love with the daughter, Marie, and her love was returned. Her mother and cousin tried in vain to break up this affair. During the winter the lovers corresponded zealously. In April, 1888, Count S. paid her a visit, and in May, 1889, attained her wish ; in that Marie— who, in the meantime, had given up a position as teacher — became her bride in the presence of a friend of her lover, the ceremony being performed in an arbour, by a pseudo- priest, in Hungary. S., with her friend, forged the mar- riage certificate. The pair Hved happily, and, without the interference of the stepfather, this false marriage, probably, would have lasted much longer. It is remark- able that, during the comparatively long existence of the relation, S. was able to deceive completely the family of her bride with regard to her true sex. S. was a passionate smoker, and in all respects her tastes and passions were masculine. Her letters and even legal documents reached her under the address of " Count S.". She often spoke of having to drill. From remarks of the father-in-law it seems that S. (and she afterward confessed it) knew how to imitate a scrotum with handkerchiefs or gloves stuffed in the trousers. The father-in-law also, on one occasion, noticed something like an erected member on his future son-in-law (probably a priapus). She also occasionally remarked that she was obliged to wear a suspensory bandage while riding. The fact is, S. wore a bandage around the body possibly as a means of retaining a priapus. Though S. often had herself shaved pro forma, the servants in the hotel where she lived were convinced that she was a woman, because the chambermaids found traces of menstrual blood on her linen (which S. explained, however, as hoemorrhoidal) ; and, on the occasion of a bath which S. was accustomed to take, they claimed to SEXUAL INVERSION IN WOMAN. 421 have convinced themselves of her real sex by looking through the key-hole. The family of Marie make it seem probable that she for a long time was deceived with regard to the true sex of her false bridegroom. The following passage in a letter from Marie to S., 26th August, 1889, speaks in favour of the incredible simplicity and innocence of this unfortunate girl : " I don't like children any more, but if I had a little Bezerl or Patscherl by my Sandi — ah, what happiness, Sandi mine ! " A large number of manuscripts allow conclusions to be drawn concerning S.'s mental individuality. The chirography possesses the character of firmness and certainty. The characters are genuinely masculine. The same peculiarities repeat themselves everywhere in their contents — wild, unbridled passion ; hatred and resistance to all that opposes the heart thirsting for love ; poetical love, which is not marred by one ignoble blot ; enthusiasm for the beautiful and noble ; appreciation of science and the arts. Her writings betray a wonderfully wide range of reading in classics of all languages, in citations from poets and prose writers of all lauds. The evidence of those qualified to judge literary work shows that S." poetical and literary ability is by no means small. The letters and writings concerning the relation with Marie are psychologically worthy of notice, S. speaks of the happiness there was for her when by M.'s side, and expresses boundless longing to see her beloved, if only for a moment. After such a happiness, she could have but one wish — to exchange her cell for the grave. The bitterest thing was the knowledge that now Marie, too, hated her. Hot tears, enough to drown herself in, she had shed over her lost happiness. Whole quires of paper are given up to the apotheosis of this love, and reminiscences of the time of the first love and acquaintance. 422 PSYCHOPATHIA SEXUALIS. S. complained of her heart, that would allow no reason to direct it ; she expressed emotions which were such as only could be felt — not simulated. Then, again, there were outbreaks of most silly passion, with the declara- tion that she could not live without Marie. " Thy dear, sweet voice ; the voice whose tone perchance would raise me from the dead ; that has been for me like the warm breath of Paradise ! Thy presence alone were enough to alleviate my mental and moral anguish. It was a magnetic stream ; it was a peculiar power your being exercised over mine, which I cannot quite define ; and, therefore, I cling to that ever-true definition : I love you because I love you. In the night of sorrow I had but one star— the star of Marie's love. That star has lost its light ; now there remains but its shimmer — the sweet, sad memory which even lights with its soft ray the deepening night of death — a ray of hope." This writing ends with the apostrophe : " Gentlemen, you learned in the law, psychologists and pathologists, do me justice ! Love led me to take the step I took ; all my deeds were conditioned by it. God put it in my heart. " If He created me so, and not otherwise, am I then guilty ; or is it the eternal, incomprehensible way of fate ? I relied on God, that one day my emancipation would come ; for my thought was only love itself, which is the foundation, the guiding principle, of His teaching and His kingdom. " God, Thou All-pitying, ' Almighty One ! Thou seest my distress ; Thou knowest how I suffer. Incline Thyself to me ; extend Thy helping hand to me, deserted by all the world. Only God is just. How beautifully does Victor Hugo describe this in his ' Legjndes du Siecle'! How sad do Mendelssohn's words sound to me : ' Nightly in dreams I see thee ' ! " Though S. knew that none of her writings reached her lover, she did not grow tired writing of her pain SEXUAL INVERSION IN WOMAN. 423 and delight in love, in page after page of deification of Marie. And to induce one more pure flood of tears, on one still, clear summer evening, when the lake was aglow with the setting sun like molten gold, and the bells of St. Anna and Maria- Worth, blending in harmonious melancholy, gave tidings of rest and peace, she wrote : "For that poor soul, for this poor heart that beat for thee till the last breath ". Personal examination : The first meeting which the experts had with S. was in a measure, a time of embarrass- ment to both sides ; for them, because perhaps S.'s some- what dazzling and forced masculine carriage impressed them ; for her, because she thought she was to be marked with the stigma of moral insanity. She had a pleasant and intelligent face, which, in spite of a certain delicacy of features and diminutiveness of all its parts, gave a decidedly masculine impression, had it not been for the absence of a moustache. It was even difficult for the experts to realise that they were concerned with a woman, despite the fact of female attire and constant association ; while, on the other hand, intercourse with the man Sandor was much more free, natural, and apparently correct- The culprit also felt this. She immediately be- came more open, more communicative, more free, as soon as she was treated like a man. In spite of her inclination for the female sex, which had been present from her earliest years, she asserts that in her thirteenth year she first felt a trace of sexual feeling, which expressed itself in kisses, embraces, and caresses, with sexual pleasure, and this on the occasion of her elopement with the red-haired English girl from the Dres- den institute. At that time feminine forms exclusively appeared to her in dream-pictures, and ever since, in sensual dreams, she has felt herself in the situation of a man, and occasionally, also, at such times, experienced ejaculation. She knows nothing of solitary or mutual onanism 424 PSTCHOPATHIA SEXUALIS. Such a thing seemed very disgusting to her, and not conducive to manliness. She had, also, never allowed herself to be touched ad genitalia by others, because it would have revealed her great secret. The menses began at seventeen, but were always scanty and without pain. It was plain to be seen that S. had a horror of speaking of menstruation; that it was a thing repugnant to -her masculine consciousness and feeling. She recognised the abnormahty of her sexual inclinations, but had no desire to have them changed, since in this perverse feeling she felt both well and happy. The idea of sexual intercourse with men disgusted her, and she also thought it would be impossible. Her modesty was so great that she would prefer to sleep among men rather than among women. Thus, when it was necessary for her to answer the calls of nature or to change her linen, it was necessary for her to ask her companion in the cell to turn her face to the window, that she might not see her. When occasionally S. came in contact with this com- panion, — a woman from the lower walks of hfe, — she experienced a sexual excitement that made her blush. Indeed, without being asked, S. related that she was overcome with actual fear when, in her cell, she was compelled to force herself into the unusual female attire. Her only comfort was that she was at least allowed to keep a shirt. Remarkable, and what also speaks for the significance of olfactory sensations in her vita sexualis, is her statement that, on the occasions of Marie's absence, she had sought those places on which Marie's head was accustomed to repose, and smelled them, in order to experience the delight of inhaling the odour of her hair. Among women, those who are beautiful, or voluptuous, or quite young, do not particularly interest her. The physical charms of w^omen she makes subordinate. As by magnetic attraction, she feels herself drawn to those between twenty-four and thirty. She found her sexual SEXUAL INVEESION IN WOMAN. 425 satisfaction exclusively in corpora femmce (never in her own person), in the form of manustupration of the beloved woman, or cunnilingus. Occasionally she availed herself of a stocking stuffed with oakum as a priapus. These admissions were made only unwillingly by S., and with apparent shame ; just as in her writings immodesty or cynicism are never found. She is religious, has a lively interest in all that is noble and beautiful, — men excepted, — and is very sensitive to the opinion others may entertain of her morality. She deeply regrets that in her passion she made Marie unhappy, and regards her sexual feelings as perverse, and such a love of one woman for another, among normal individuals, as morally reprehensible. She has great literary talent and an extraordinary memory. Her only weakness is her great frivolity and her incapability to manage money and property reasonably. But she is conscious of this weakness, and does not care to talk about it. She is 153 centimetres tall, of delicate build, thin, but remarkably muscular on the breast and thighs. Her gait in female attire is awkward. Her movements are powerful, not unpleasing, though they are somewhat masculine and lacking in grace. She greets one with a firm pressure of the hand. Her whole carriage is decided, firm and somewhat self-conscious. Her glance is intelligent ; mien somewhat diffident. Feet and hands remarkal)ly small, having remained in an infantile stage of development. Extensor surfaces of the extremities remarkably well covered with hair, while there is not the slightest trace of beard, in spite of all shaving experi- ments. The hips do not correspond in any way with those of a female. Waist is wanting. The pelvis is so slim and so little prominent, that a line drawn from the axilla to the corresponding knee is straight — not curved inward by a waist or outward by the pelvis. The skull is slightly oxycephalic, and in all its measurements falls 426 PSYCHOPATHIA SEXUALIS. below the average of the female skull by at least one centimetre. The circumference of the head is 52 centimetres ; the occipital half-circumference, 24 centimetres ; the line from ear to ear, over the vertex, 23 centimetres ; the anterior half-circumference, 28*5 centimetres ; the line from glabella to occiput, 30 centimetres ; the ear-chin line, 26*5 centi- metres ; long diameter, 17 centimetres ; greatest lateral diameter, 13 centimetres ; diameter at auditory meati, 12 centimetres; zygomatic diameter, 11'2 centimetres. The upper jaw projects strikingly, its alveolar process pro- jecting beyond the under jaw about 0"5 centimetre. The position of the teeth is not fully normal ; the right upper canine has not developed. Mouth remarkably small ; ears prominent ; lobes not differentiated, passing over into the skin of the cheek. Hard palate, narrow and high ; voice rough and deep ; mammae fairly developed, soft and without secretion, Mons veneris covered with thick, dark hair. Genitals completely feminine, without trace of hermaphroditic appearance, but at the stage of development of those of a ten-year-old girl. The labia majora touch each other almost completely ; labia minora have a cock's-comb-like form, and project under the labia majora. The clitoris is small and very sensitive. Frenu- lum delicate ; perineum very narrow ; introitus vaginaB narrow ; mucous membrane normal. Hymen wanting (probably congenitally) ; likewise the carunculee myrti- formes. Vagina so narrow that the insertion of a mem- brum virile would be impossible, and it is also very sensitive ; certainly coitus had not taken place. Uterus is felt, through the rectuin, to be about the size of a walnut, immovable and retroflected. The pelvis appears generally narrowed (dwarf-pelvis), and of decidedly masculine type. The distance between anterior superior spines is 22'5 centimetres (instead of 26*3 centimetres). Distance between the crests of the ilii, 26"5 centimetres (instead of 293 centimetres) ; be- SEXUAL INVERSION IN WOMAN. 427 tween the trochanters, 27-7 centimetres (31) ; the external conjugate diameter, 17-2 centimetres (19 to 20) ; therefore, presmnably, the internal conjugate would be 7'7 centi- metres (10-8). On account of narrowness of the pelvis, the direction of the thighs is not convergent, as in a woman, but straight. The opinion given showed that in S. there was a congenitally abnormal inversion of the sexual instinct, which, indeed, expressed itself, anthropologically, in ano- mahes of development of the body, depending upon great hereditary taint ; further, that the criminal acts of S. had their foundation in her abnormal and irresistible sexuality. S.'s characteristic expressions — " God put love in my heart. If He created me so, and not otherwise, am I, then, guilty ; or is it the eternal, incomprehensible way of fate ? " — are really justified. The court granted pardon. The " countess in male attire," as she was called in the newspapers, returned to her home, and again gave herself out as Count Sandor. Her only distress is her lost happiness with her beloved Marie. A married woman, in Brandon, Wisconsin, whose case is reported by Dr. Kiernan (" The Medical Standard," 1888, November and December), was more fortunate. She eloped, in 1883, with a young girl, married her, and lived with her as husband undisturbed. An interesting " historical " example of androgyny is a case reported by Spitzka (" Chicago Medical Keview," 20th August, 1881). It was that of Lord Cornbury, Governor of New York, who lived in the reign of Queen Anne. He was apparently affected with moral insanity ; was terribly' licentious, and, in spite of his high position, could not keep himself from going about in the streets in female attire, coquetting with all the allurements of a prostitute. 428 PSTCHOPATHIA SEXUALIS. In a picture of him that has been preserved, his narrow brow, asymmetrical face, feminine features, and sensual mouth at once attract attention. It is certain that he never actually regarded himself as a woman. Moreover, in individuals afflicted with sexual inversion, in themselves, the perverse sexual fueling and inclination may be complicated with other perverse manifestations. Thus here, with reference to the activity of the instinct, there may be acts quite analogous to acts indulged in by individuals in perverse satisfaction of the instinct, but who, at the same time, have a natural inclination toward persons of the opposite sex. Owing to the circumstance that abnormally increased sexuality is almost a regular accompaniment of anti- pathic sexual feeling, acts of lustful sadistic cruelty in the satisfaction of libido are easily possible. A remarkable example of this is the case of Zastrow (CasjJer-Liman, 7. Auflage, Bd. i., p. 160 ; ii., p. 487), who bit one of his victims (a boy), tore his prepuce, slit the anus, and strangled the child. Z. came of a psychopathic grandfather and melan- cholic mother. His brother indulged in abnormal sexual pleasures, and committed suicide. Z. was a congenital urning, and in hahitus and occupa- tion masculine. There was phimosis. Mentally, he was a weak, perverse, socially useless man. He had horror femince, and, in his dreams, he felt himself like a woman toward a man. He was painfully conscious of his want of normal sexual feeling and of his perverse instinct, and sought satisfaction in mutual onanism, with frequent desire for pederasty. Similar sadistic feelings of this kind, in those afflicted with antipathic sexual instinct, are found in some of the foregoing histories (c/. cases 107 and 108 of this edition, and case 96 of the sixth edition ; also Moll, SEXUAL INVERSION IN WOMAN. 429 " Contr. Sexualempfindung," second edition, p. 189; v. Krafft, " Jahrb. f. Psychiatrie," xii., pp. 357 and 389 ; Moll, " Untersuchungen iiber Libido sexualis," cases 26 and 27). As examples of perverse sexual satisfaction dependent on antipathic sexual instinct, may be mentioned the Greek, who, as Athendus reports, was in love with a statue of Cupid, and defiled it, in the temple of Delphi ; and besides the monstrous cases reported by Tardieu {" Attentats," p. 272), the terrible one reported by Lornbroso (" L'uomo delinquente," p. 200), of a certain Artusio, who wounded a boy in the abdomen, and abused him sexually by means of the incisions. Cases 92, 110 and 115 (eighth edition) show that fetichism may also occur with antipathic sexual instinct ; moreover a case of shoe-fetichism related by me in " Jahr- biicher f. Psychiatrie," xii., 1 ; Moll, op. cit., second edition, p. 179 ; Gamier, " Les Fetichistes," p. 98. The following case, taken from Gamier, is a classical example of boot-fetichism. At times masochism forms a complication of sexual inversion Of. Moll, second edition, p. 172 (case 12) and p. 190; Hem, " Internat. Centralbl. f. d. Physiol, and Pathol, der Harn- und Sexualorgane," iv., Heft 5 (homosexuality in a woman with passive flagel- lantism and koprophagia) ; v. Krafft, case 43 in sixth edition of this book, also case 115 of this edition and 114 of eighth edition ; ditto " Jahrbiicher fiir Psychiatrie," xii., p. 339 (homosexuality, abortive masochism), p. 351 (psych, hermaphrod. masochism). Case 139. Homosexuality. X., twenty-six years of age, of the upper classes, was arrested for having prac- tised masturbation in a public park. By heredity heavily tainted; skull abnormal ; was peculiar from earliest youth ; psychically abnormal ; at the age of ten he began to show a peculiar interest in patent leather shoes ; began to masturbate at thirteen, but in order to procure ejaculation he must fasten his eyes upon patent leather shoes. He 430 PSYCHOPATHIA SEXUALIS. never felt any inclination towards woman, and when, at the age of twenty-one, he once attempted coitus at a brothel derived no satisfaction from the act. With the twenty-fourth year his homosexual instinct began to assert itself more and more. But he felt himself drawn only to young men who wore elegant clothes and patent leather boots. Thinking of such men, he masturbated. His ideal was to live with such a man and practise mutual masturbation. Unable to realise his wishes, he would introduce a ball into his anus, and moving it in and out fancy himself to have coitus with his ideal young man wearing patent leather boots. Simultaneously he would masturbate. During this imitation of passive pederasty he would wear drawers made of red silk. For some time he was wont to stick notices on public buildings to this effect : " My nates are at the disposal of handsome gentle- men who wear patent leather boots ". Whilst writing such notices and looking at his own patent leather shoes, he would have an erection. Since his sixteenth year, when young men began to interest him, he had eyes only for their patent leather boots. He loved to loiter about the show-windows of boot shops and the drilling-grounds of the military school, where he had opportunity for admiring the officers in their patent leather boots. One day he bought a pair for himself and became quite in- toxicated by gazing at them. The very smell of them was sufficient to excite him very much sexually. He finally put them on, that in them he might make con- quests ; but he was not successful. Now he used them for another purpose. He would masturhando ejaculate into them. The most intense lustful pleasure he derived when he put, during this act, one of the shoes to his anus or inter femora, rubbing it about there. When one day X. found a defect on the uppers of one of these shoes, which he always saved most carefully, he was very de- jected. He looked upon hnnself as a person who has just discovered the first wrinkle in the face of the beloved. ANTIPATHIC SEXUAL INSTINCT. 431 One day when in the park he thought that a young man made advances to him according to his own desire ; he was highly elated, and could not resist to expose his person. He was arrested, but not sentenced. He was sent to an insane asylum {Gar7iier, " Les Fetichistes," p. 114). DIAGNOSIS, PROGNOSIS, AND THERAPY OF ANTIPATHIC SEXUAL INSTINCT. While up to this time antipathic sexual instinct has had but an anthropological, clinical, and forensic interest for science, now, as a result of the latest investigations, there is some thought of therapy in this incurable con- dition, which so heavily burdens its victims, socially, morally, and mentally. A preparatory step for the application of therapeutic measures is the exact differentiation of the acquired from the congenital cases ; and among the latter, again, the assignment of the concrete case to its proper position in the categories that have been scientifically established. The diagnostic differentiation of the acquired from the congenital condition is made without difficulty in the early stages of the anomaly. If sexual inversion has already taken place, then the history of the development of the case will throw light upon it. The important decision, prognostically, as to whether the inverted sexual instinct is congenital or acquired, can only be made in such cases by means of the most miimte details of the history. The establishment of the fact that antipathic sexual instinct existed before indulgence in masturbation is of great importance with reference to deciding whether the anomaly is congenital or not. In this, however, a diffi- culty arises, owing to the possibility of imperfect locali- sation of past events (illusions of memory). 432 PSYCHOPATHIA SEXUALIS. For the presumption of acquired antipathic sexual instinct, it is important to prove the existence of heterosexual instinct before the beginning of solitary or mutual onanism. In genera], the acquired cases are characterised in hat:— 1, The homosexual instinct appears as a secondary factor, and always may be referred to influences (mas- turbatic neurasthenia, mental) which disturbed normal sexual satisfaction. It is, however, probable that here, in spite of powerful sensual libido, the feeling and in- clination for the opposite sex are weak ab orirjine, especially in a spiritual and assthetic sense. 2, The homosexual instinct, as long as inversio scxualis has not yet taken place, is looked upon, by the indi vidua affected, as vicious and abnormal, and yielded to only faute de mieux. 3, The heterosexual instinct long remains predomi- nant, and the impossibility to satisfy it gives pain. It weakens in proportion as the homosexual feeling gains in strength. On the other hand, in congenital cases : — (a) The homosexual instinct is the one that occurs primarily, and becomes dominant in the vita scxualis. It appears as the natural manner of satisfaction, and also dominates the dream-life of the individual. (6) The heterosexual instinct fails completely, or, if it should make its appearance in the history of the individual (psycho-sexual hermaphrodism), it is still but an episodical phenomenon which has no root in the mental constitution, and is essentially but a means to satisfaction of sexual desire. The differentiation of the above groups of congenital inverted sexuality from one another, and from the cases in which the anomaly is acquired, will, after the foregoing, present no difficulties. The proijnosis of the cases of acquired antipathic sexual ANTIPATHIC SEXUAL INSTINCT. 433 instinct is, at all events, much more favourable than that of the congenital cases. In the former, the occurrence of effemination — the mental inversion of the individual, in the sense of perverse sexual feeling — is the limit beyond which there is no longer hope of benefit from therapy. In the congenital cases, the various categories established in this book form as many stages of psycho-sexual taint, and benefit is probable only within the category of the psychical hermaphrodites, though possible {vide the case of Schrenk-Notzing) in that of the urnings. The prophylaxis of these conditions becomes thus the more important — for the congenital cases, prohibition of the reproduction of such unfortunates ; for the acquired cases, protection from the injurious influences which experience teaches may lead to the fatal inversion of the sexual instinct. Numerous predisposed individuals meet this sad fate, because parents and teachers have no suspicion of the danger which masturbation brings in its train to children. In many schools and academies masturbation and vice are actually cultivated. At present much too little atten- tion is given to the mental and moral peculiarities of the pupils. If only the tasks are done, nothing more is asked. That many pupils are thus ruined in body and soul is never considered. In obedience to affected prudery, the vita sexiialis is made a mystery to the developing youth, and not the sHghtest attention given to the excitations of his sexual instinct. How few family physicians are ever called in, during the years of development of children, to give advice to their patients that are often so greatly pre- disposed ! It is thought that all must be left to Nature ; in the meantime, Nature rises in her power, and leads the help- less, unprotected innocent into dangerous by-paths. 28 434 PSYCHOPATHIA SEXUALIS. A more detailed treatment of this prophylactic side of the subject is impossible here.-^ To parents and teachers, the experiences detailed in this and numerous other scientific works on masturbation, present valuable suggestions. The lines of treatment, when antipathic sexual instinct exists, are the following : — 1. Prevention of onanism and removal of other in- fluences injurious to the vita sexnalis. 2. Cure of the neurosis {neurasthenia sexualis and uni- versalis) arising out of the unhygienic conditions of the viita sexualis. 3. Mental treatment, in the sense of combating homo- sexual, and encouraging heterosexual, feehngs and impulses. The most important part of the treatment lies ni fulfilling the third indication, particularly with reference to onanism. Only in very few cases, where acquired antipathic sexual instinct has not progressed far, can the fulfilment of 1 and 2 be sufficient, as a case fully reported by the author in the " Irrenfreund," 1885, No. 1, proves. Cf. case 128, ninth edition of this book. As a rule, physical treatment, even though it be re- inforced morally by good advice with reference to the avoidance of masturbation, the repression of homosexual feelings and impulses, and the encouragement of hetero- sexual desires, will not prove sufhcient, even in cases of acquired sexual inversion. Here a method of mental treatment — hypnotic sug- gestion — is all that can really benefit the patient. 1 With reference to prophylaxis, the following words, which were written to me by the subject of case 88 of the sixth edition, are note- worthy : " If it were only possible that — not as among the Spartans, where the weaklings were allowed to perish for the sake of perfect selec- tion, in accordance with the Darwinian idea — our antipathic sexual instincts might be recognised early in youth ; and if it were only possible that, at this time of life, the worst of all diseases could be cured by suggestion I Probably cure could be more easily effected in youth than later." ANTIPATHIC SEXUAL INSTINCT. 435 I know of but one case in which aato-suggestion proved successful, c/. case 129, ninth edition. As a rule, only suggestion coming fro^n a second person, and that by means of hypnosis, promises success. In such cases, the object of post-hypnotic suggestion is to remove the impulse to masturbation and homosexual feelings, and to encourage heterosexual emotions with a sense of virility, A prerequisite is, of course, the possibility to induce hypnosis of sufficient intensity. It is, unfortunately, in these very cases of neurasthenia that this proves impos- sible, since the subject is often excited, embarrassed, and in no condition to concentrate the thoughts. By reason of the great benefit that can be given to such unfortunates, and with Ladame's case in view {v. infra), in all such cases, everything should be done to force hypnosis — the only means of salvation. The result, in the three following cases, was satisfactory : — Case 140. Antipathic sexual instinct acquired through mast2irbation. Mr. X., merchant, aged twenty-nine. Father's parents healthy. Nothing nervous in father's family. Father was an irritable, peevish old man. One brother of the father was a man-about-town, and died unmarried. Mother died in third confinement, when the patient was six years old ; she had a deep, rough, masculine voice, and coarse appearance. Of the children, one brother is irritable, " melancholic," and indifferent to women. When a child, patient had scarlet fever with delirium. Up to his fourteenth year he was Hght-hearted and social, but, after that, quiet, sohtary, and " melancholic ". The first trace of sexual feehng appeared in his tenth or eleventh year, and at that time he learned masturbation from other boys, and practised mutual onanism with them. At the age of thirteen or fourteen, ejaculation for the 436 PSYCHOPATHIA SEXUALIS. first time. Patient has felt no evil results of onanism until the last three months. At school he learned easily, but was troubled with headaches. After the age of twenty, pollutions, in spite of daily practice of onanism. "With pollutions occurred " procreative " dreams, as man and wife might perform the act. In his seventeenth year he was seduced into mutual onanism by a man having a love for men. He found satisfaction in this, inasmuch as he was always very passionate sexually. It was a long time before the patient again sought new opportunities for intercourse with males. He did it simply to rid himself of semen. He felt no friendship or love for the person with whom he had intercourse. He felt satisfaction only when he played the passive role — when manustupration was prac- tised on him. When the act was once completed, he had no respect for the individual. If it happened that, later, he came to respect the man, then he ceased to indulge in the act with him. Later it became indifferent to him whether he masturbated or had masturbation practised on him. When he himself practised onanism, he always thought of pleasing men practising onanism on him during the act. He preferred a hard, rough hand. The patient thought that, had he not been led astray, he would have arrived at a natural mode of satisfaction of his sexual desires. He never felt love for his own sex, though he had pleased himself with the thought of loving men. At first he had had sensual inclinations to- ward the opposite sex. He had taken pleasure in dancing, and he had been pleased with women, but he had taken more, pleasure in the figure than the face. He had had erections at the sight of women that pleased him. He had never attempted coitus, for fear of infection ; whether he was potent or not with women, he did not know. He thought he could be so no longer, because his feeling for women had grown cold, especially during late years. While previously, in his sensual dreams, he had had ANTIPATHIC SEXUAL INSTINCT. 437 ideas of both men and women, of late years he had dreamed only of approaches to men ; he could not re- member that he had dreamed, in late years, of sexual relations with a woman. At the theatre, as well as in the circus and ballet, the feminine figure had always interested him. In museums, masculine and feminine statues had affected him equally. Patient is a great smoker, a beer-drinker, loves male society, and is a gymnast and skater. Anything dandified was repugnant to him, and he had never felt any desire to please men ; he would even liave preferred to please women. He now felt his position to be painful, because onanism had obtained the upper hand. Masturbation, that had previously been practised without evil effects, now began to disclose its bad results. Since July, 1889, he had suffered with neuralgia of the testicles. The pain occurred particularly at night ; and at night there was also trembling (increased reflex excitability). • Sleep was not refreshing, and he would wake up with pain in the testicles. He was inclined, now, to indulge more frequently in onanism. He was afraid of the con- sequences of the habit. He hoped that his sexual life might still be turned into normal channels. Now, he thought of the future ; he had a relation with a girl, who was attractive to him, and the thought to possess her as a wife was pleasing. For five days he had abstained from onanism, but he could scarcely believe that he would be able, with his own strength, to overcome the habit. Of late he had been very much depressed, having lost all desire for work, and become tired of life. Patient is tall, powerful, well nourished, and has a thick growth of beard. Skull and skeleton normal. Knee- jerks very prompt ; deep reflexes in upper extremities much increased. Pupils dilated, equal, and act promptly. 438 PSTCnOPATHIA S]:XUALIS. Carotids of equal calibre ; hyperaesthesia iirethrne ; cords and testicles not sensitive ; genitals normal. The patient was calmed, and given hope for the future, provided that he gave up onanism and attempted to transfer his sexual desires from persons of his own sex to females. Hip-baths (24° to 20° E.); extr. Secal. cornut. aquos., 0"5 ; antipyrm, I'O {pro die) ; pot. brom., 4'0 (evenings), were ordered. 13th December. To-day the patient came, in a dis- turbed condition of mind, complaining that, unaided, he was unable to resist the impulse to masturbate, and be asked for help. A trial of hypnosis induced a condition of deep lethargy in the patient. He was given the following suggestions : — 1. I can not, must not, and will not masturbate again. 2. I abhor the love for my own sex, and shall never again think men handsome. 3. I shall and will become well again, fall in love with a virtuous woman, be happy, and make her happy. 14th December. "While out walking to-day, patient saw a handsome man, and felt himself powerfully drawn toward him. From this time there were hypnotic sittings every second day, with the above suggestions. 18th December (fourth sitting), somnambulism oc- curred ; the impulse to onanism and interest in men disappear. At the eighth sitting " complete virility " was added to the above suggestions. The patient feels himself morally elevated and physically strengthened. The neuralgia of the testicles has disappeared. He now found that he was without sexual feeling. He now believed himself free from masturbation and inverted sexual inchnation. After the eleventh sitting he thought that further help was unnecessary. He wished to go home, and marry. ANTIPATHIC SEXUAL INSTINCT. 439 He felt well and potent. Early in January, 1890, treat- ment ceased. In March, 1890, the patient wrote : " I have since had several occasions on which it has been necessary for me to use all my moral strength in order to overcome my habit, and, thank God, I have been successful in freeing myself from this vice. Several times I have had opportunity for sexual intercourse, and I have found pleasure in it. I look calmly on my happy future." The foregoing details of the successful results of hypnotic suggestion, in cases of acquired sexual inversion, make it seem possible that those unfortunates who are afflicted with congenital perversion may be helped in some degree by the same means. The most favourable cases are those of psychosexual hermaphrodism in which at least rudimentary heterosexual feelings may be strengthened by suggestion and brought into active practice. Case 141. Mr. von X., aged twenty- five, landed proprietor. He comes of a neuropathic, irascible father, who is said to have been sexually normal. His mother was nervous, as were her two sisters. Maternal grand- mother was nervous, and maternal grandfather a roue, much given to venery. Patient is like his mother, and an only child. From birth he was weak, suffered much with migraine, and was nervous. He passed through several illnesses. At fifteen he began masturbation, with- out having been taught. Until his seventeenth year he says he never had feeling for men, or, in fact, any sexual inclination ; but at this time desire for men arose. He fell in love with a comrade. His friend returned his love. They embraced and kissed and indulged in mutual onanism. Occasionally patient practised coitus inter femora viri. He abhorred pederasty. Lascivious dreams were concerned only with 440 PSYCHOPATHIA SEXUALIS. men. In the circus and theatre males alone interested him. The inchnation was for those of about twenty years. Handsome, tall forms were enticing to him. Given these conditions, he was quite indifferent to other characteristics of the m-en. In his sexual affairs with men his part was always that of a man. After his eighteenth year the patient was always a source of anxiety to his highly respected parents, for he then began a love-affair with a male waiter, who fleeced him and made him an object of remark and ridicule. He was taken home. He consorted with servants and hostlers. He caused a scandal. He was sent away to travel about. In London he got into a " blackmailing scrape," but succeeded in escaping to his home. He profited in no way by this bitter experience, and again showed disgraceful inclinations toward men. Patient was sent to me to be cured of his fatal peculiarity (December, 1888). Patient is a tall, stately, robust, well- nourished young man, of masculine build ; large, well- formed genitals. Gait, voice, and attitude are masculine. He has no pronounced masculine passions. He smokes but httle, and only cigarettes ; drinks httle, and is fond of confectionery. He loves music, arts, Besthetics, flowers, and moves in ladies' society by preference. He wears a moustache, the face being otherwise cleanly shaved. His garments are in nowise remarkable. He is a soft, hlas4 fellow, and a do-nothing. He lies abed mornings, and can scarcely be made to rise before noon. He says he has never regarded his inclination toward his own sex as abnormal. He looks upon it as congenital ; but, tau[;ht by his evil experiences, he wishes to be cured of his perversion. He has httle faith in his own will. He has tried to reform, but always lapses into masturbation which he finds injurious, inasmuch as it causes (slight) neurasthenic symptoms. There is no moral defect. In- telligence is a little below the average. Careful education and aristocratic manners are app:u'cnt. The exquisite ANTIPATHIC SEXUAL INSTINCT. 441 neuropathic eye betrays a nervous constitution. The patient is not a complete and hopeless urninf:,^ He has heterosexual feelings, his sensual inclinations toivard the oppo- site sex, however, are manifested hut weakly and infrequently. When nineteen, he was first taken to a brothel by friends. He experienced no horror femince, had efficient erections, and some pleasure in coitus, bat not the instinctive dehght he experienced while embracing men. Since then, patient asserts that he has had coitus six times, twice sua sponte. He gives the assurance that he is always capable of it, but he does it only faute de micux, as he does masturbation, when the sexual impulse troubles him, as a substitute for intercourse with men. He has thought of the possibility of finding a sympathetic lady and marrying her. He would regard marital cohabitation and abstinence from intercourse with men as hard duties. Since there were rudiments of heterosexual feelings present, and the case could not be looked upon as hopeless, it seemed that treatment was indicated. The indications were clear enough, but there was no support for them in the will of the indolent patient, so unconscious of his own position. It lay near to seek support for the moral influence in hypnosis. The fulfilment of this hope seemed doubtful, because the famous ilawsew had tried several times, in vain, to hypnotise him. At the same time, by reason of the most important social interests of the patient, it was necessary to make another attempt. To my great surprise, Bemheim's pro- cedure induced immediately a condition of deep lethargy, with possibility of post-hypnotic suggestion. At the second sitting somnambulism was induced by merely looking at him. The patient easily yields to suggestions of all kinds ; indeed, contractures are induced by stroking him. He is awakened by counting three. Awakened, patient has amnesia for all the events of the hypnotic state. Hypnosis is induced every second or third day for the communication of hypnotic suggestions. 442 PSYCHOPATHIA SEXUALIS. At the same time, moral and hydro-therapeutic measures are employed. The hypnotic suggestions were as follow : — 1. I abhor onanism, because it makes me weak and miserable. 2. I no longer have inclination toward men ; for love for men is against religion, nature and law. 3. I feel an inclmatioii toward women ; for woman is lovely and desirable, and created for man. During the sittings the patient always repeated verbatim these suggestions. After the fourth sitting it was notice- able, that, when taken into society, he paid court to ladies. Shortly after that, when a famous prima-donna sang, he was all enthusiasm for her. Some days later the patient sought the address of a brothel. Yet he preferred the society of young gentlemen ; but the most careful watching failed to reveal anything suspicious. 17th February. Patient asks to be allowed to indulge in coitus, and is very well satisfied with his experience with one of the demi-monde. 16th March. Up to this time, hypnosis twice a week. The patient always passes into deep somnambulism by simply being looked at, and, at request, repeats the sug- gestions. He is susceptible to all kinds of post-hypnotic suggestion, and, in the waking state, knows not the least of the influences exerted on him in the hypnotic state. In the hypnotic condition he always gives the assurance that he is free from onanism and sexual feeling for men. Since he gives the same answers in hypnosis— e.(/., that on such and such a date he practised onan'sm for the last time, and that he is too much under the will of the physician to be able to lie — his assertions deserve belief; the more, since he looks well and is free from all neurasthenic symptoms, and, in the society of men, not the slightest suspicion rests on him. An open, free, and manly bearing is developed. ANTIPATHIC SEXUAL INSTINCT. 443 Moreover, since, of his own will, he now and then indulf:^es in coitus with pleasure, and occasional pollutions are induced by lascivious dreams which concern women, there can be no doubt of the favourable change of his vita sexualis ; and it is presumable that the hypnotic sug- gestions have developed into auto-suggestive inclinations, which direct his feelings, thoughts and will. Probably the patient will always remain a natura frigida ; but he more often speaks of marriage, and of his intention to win a wife as soon as he has become acquainted with a sympathetic lady. Treatment was stopped. (Author's own case, " Internat. Centralbl. fiir die Physiol, und Pathol, der Harn- und Sexualorgane " Band i.) In July, 1889, I received a letter from his father, telhng me of the son's good health and conduct. On 24th May, 1890, by chance, I met my former patient, while on a journey. His bright, healthful appear- ance allowed the most favourable opinion of his condition. He told me that he still had sympathetic feeling for some men, but never anything like love. He occasionally had pleasurable coitus with women, and now thought of marriage. I hypnotised him, in the former manner, to try him, and asked for the commands I had given him. In a deep condition of somnambulism, and in the same tone of voice as formerly, the patient repeated the suggestions he had received in December, 1888 — an excellent example of the possible duration and power of post-hypnotic sug- gestion. Other cases may be found in the eighth edition, cases 137, 138, 140, 141 ; and ninth edition, case 133 of this book. The cases quoted by the author, as well as those given by Ladavie in which suggestion removed the homosexual instinct, or, at least, neutralised it (as a protection from shame and law), seem to afford a proof that even the 444 PSYCHOPATHIA SEXUALIS. gravest cases of congenital sexual inversion may be bene- fited by the application of hypnotism. Wetterstrand (cf. Schrenck^op. cit., case 49), Bernheim (cf. Schrenck, case 51), Muller {cf. Schrenck, case 53), Schrenck (op. cit., cases 66, 67), report even complete success in displacing the homosexual by the heterosexual instinct coupled with virility. Schrenck (op. cit., cases 62, 63) succeeded also in cases of effeminatio. But only when hypnotism produces deep somnam- buhsm, decided and lasting results may be hoped for, which after all are nothing more than suggestive training, not a real cure. They are marvellous " arte/acta " of hypnotic science practised on abnormal human beings, but by no means " transformations " {cf. Schrenck) of a psychosexual existence. Very instructive in this respect is a case related by Schrenck, the representative of which after effected " cure " says of himself : " I am ever conscious of a certain insuperable coercion which does not rest upon moral principles, but must, as I beheve, be referable directly to treatment ". At any rate such " cures " afford no proof whatsoever against the assumption of original conditionahty of sexual inversion. It is necessary here to warn the reader against illusions about the true value of hypnotic therapy. IV.— SPECIAL PATHOLOGY. the manifestations of abnormal sexual life in the various forms and states of mental disturbance. Arrest of Mental Development. Sexual life in idiots is, generally speaking, but slightly developed. It is wanting entirely in idiots of high grade. In such instances the genitals are frequently small and deformed, and menstruation is late or does not occur at all. There is either impotence or sterility. Even in idiots of low grade, sexuality is not prominent. In rare cases it is manifested with a certain periodicity, and then with greater intensity. It may then find expression in sudden impulses, and be violently satisfied. Perversions of the sexual instinct do not seem to occur at the lowest levels of mental development. AVhen the desire for sexual satisfaction is opposed in these cases, great passion is excited, with danger of murderous assault on the pers-ons attacked. It is to be expected that idiots should not exercise choice, and even attempt to satisfy the sexual instinct on their nearest relatives. Thus Marc-Ideler reports the case of an idiot who attempted to rape his sister, and had almost strangled her when he was discovered. Friedreich reports an analogous case (" Friedreich's Blatter," 1858, p. 60). I have repeatedly had occasion to give opinions in cases of attempts to rape little girls. (445) 446 PSYCHOPATHIA SEXUALIS. Giraud (" Annal. med. psych," 1885, No. 1) also reports a case of this kind. Consciousness of the significance of the act is always wanting ; but an instinctive know- ledge that such obscene acts are not publicly permitted is often present, and causes the act to be undertaken in a deserted place. In imbeciles the sexual instinct is usually developed as in normal individuals. The moral inhibitory ideas are cloudy, and, therefore, the sexual impulse is more or less openly manifested. For this reason imbeciles are sources of disturbance in society. Abnormal intensity and per- version of the sexual instinct are infrequent. The most frequent manner of satisfaction of the sexual desire is onanism. The weak-minded seldom make sexual attacks on adults of the opposite sex. Sexual satisfaction with animals is frequently at- tempted. The great majority of cases of injury (sexual) to animals must be attributed to imbeciles. Children are quite often their victims. E7nminghaus (" Maschkas Handb.," iv., p. 234) draws attention to the frequency of unrestricted manifestation of sexual instinct, which comprises open masturbation, exhibition of the genitals, attacks on children and those of the same sex, and sodomy. Giraud ("Annal. med. psychol.," 1855, No. 1) has reported a whole series of immoral attacks on children ^ : — 1. H., aged seventeen, imbecile, enticed a little girl into a barn, by giving her nuts. There he exposed her genitals and showed his own, making movements of coitus on the child's abdomen. He had no idea of the moral significance of the act. 2. L., aged twenty-one ; imbecile ; degenerate. While ^ For numerous cases, "v. Henke's, Zeitschr.," xxiii., " Erganzungs- heft," p. 147 ; Combes," Annal. med. psychol.," 1866 ; Lijnan, " Zweifelh Geisteszustande," p. 389 ; Casper-Liman, " Lehrb., 7. Auflage," Fall 295; Bartels, " Friedreich's, Blatter f. gerichtl. Med.," 1890, Heft 1. AEEEST OF MENTAL DEVELOPMENT. 447 he was watching cattle, his sister of eleven years, with a playmate of eight years, came and told him how some miknown man had attempted to do them violence. L. led the children to a deserted house and attempted coitus with the younger child, but let her go because immission was unsuccessful, and because the child cried out. On the way home he promised to marry her if she would not say anything. At the trial he thought that by marriage he could right the wrong he had done. 3. G. aged twenty-one, microcephalic, imbecile, has masturbated since his sixth year, and practised active and passive pederasty. He has repeatedly tried to per- form pederasty with boys, and attacked little girls. He was absolutely without an understanding of his acts. His sexual desires were manifested periodically and in- tensely, as in animals.^ 4. B., aged twenty-one ; imbecile. While alone in a forest with his sister of nineteen, he demanded that she allow coitus. She, refused. He threatened to strangle her, and stabbed her with a knife. The frightened gnl wrenched his penis, and he then left her and quietly went on with his work. B. has a deformed, micro- cephalic skuU, and has no sense of the significance of his act. Emminghaus {op. cit., p. 234) reports the case of an exhibitionist : — Case 142. A man, aged forty, married, had for six- teen years been accustomed to exhibit himself in parks, at dusk, to httle girls and servants, and drew their atten- tion to himself by whisthng. After having been frequently punished for it, he avoided the places, but he carried on his practice elsewhere. Hydrocephalus. Mental weakness of slight degree. Mild sentence passed. 1 Other cases of pederasty, v. Casper, " Klin, Novcllen," Fall 5 ; Combes, " Annal. med. psychol.," July, 1866. 448 PSYCHOPATHIA SEXUALIS. Case 143. X.,of tainted family ; imbecile; defective and perverted in intellect, feeling and v^ill. For help and protection he was brought before an officer. It was complained that he had repeatedly exposed his genitals to servant-girls, and had shown himself at windows with the upper portion of his body naked. No other mani- festations of inverted sexual instinct. No onanism reported {Sander, " Archiv f. Psych.," i., p. 655). Case 144. Pederasty with a child. On 8th April, 1884, at ten o'clock a.m., while X. was sitting in the street, holding a boy of eighteen months on her lap, a certain Vallario approached and took the child from X., saying he was going to take it for a walk. He went the distance of half a kilometre, and returned, saying that the child had fallen from his arms, and thus injured its anus. The anus was torn, and blood was pouring from it. At the place where the deed was done, traces of semen were found. V. confessed his horrible crime, and, at his final trial, he acted so strangely that an examination of his mental condition was made. He had impressed the prison attendants as being an imbecile. V., aged forty- five, mason, defective morally and intellectaally, is dolicho- microcephalic ; has narrow, deformed fucial bones, and the halves of the face and the ears are asynnnetrical ; the brow is low and retreating ; genitals normal. V. shows general diminution of cutaneous sensibility, is imbecile, and has no ideas. He lives in the present, has no ambition, and does nothing of his own will. He has no desires and no emotional feeling. He has never had coitus. Nothing more could be ascertained about his vita sexualis. Proofs of intellectual and moral idiocy, due to microcephaly ; the crime is ascribed to a perverse, un- controllable sexual impulse. Sent to an asylum {Virgilio, " 11 Manicomio," v. y^ear, No. 3). A case mentioned by L. Meyer (" Arch. f. Psych.," Bd. STATES OF ACQUIRED MENTAL WEAKNESS. 449 i., p. 103) shows how female imbeciles may indulge in shameless prostitution and immorality/ States of Acquired IVlental Weakness. The numerous anomalies of the vita sexualis in senile dementia have been described in the section on " General Pathology ". In other conditions of acquired mental weakness — those due to apoplexy ; trauma capitis ; to the secondary stages of psychoses ; or to inflammatory pro- cesses in the cortex (lues, paretic dementia), — perversions of the sexual instinct seem to be infrequent ; and here the immoral sexual acts seem to depend on abnormally increased or uninhibited sexual feeling, which, in itself, is not abnormal. 1. Dementia Consecutive to Psychoses. Casper (" Klin. Novellen," Fall 31) reports a case that belongs here. It is that of a physician, aged thirty-three, who attempted rape on a child. He was weakened mentally, as a result of hypochondriacal melancholia. He excused his deed in a very silly way, and had no appreciation of the moral and criminal meaning of the act, which was apparently the result of a sexual impulse that could not be controlled on account of his mental weakness. Case 21, in Liman's, " Zweifelhafte Geisteszustande," is an analogous case (dementia after melancholia ; offence against morals by exhibition). 2. Dementia After Apoplexy. Case 145. B., aged fifty-two. He passed through a cerebral attack, and was no longer able to carry on his business as a merchant. 1 V. Sander, " Vierteljahrsschr. f. ger. Med.," xviii., p. 31 ; Casper, " Klin. Novellen," Fall 27. 29 450 PSTCHOPATHIA SEXUALIS. One day, in the absence of his wife, he locked two girls in the house, gave them liquors to drink, and then carried out sexual acts with the children. He commanded them to say nothing, and went to his business. The medical expert established mental weakness, resulting from repeated apoplexies. B., who, up to this time, had been well-behaved, says he committed the criminal act because of an uncontrollable and incomprehensible impulse ; and that, when he came to himself, he was ashamed, and sent the girls away. Since his apoplectic attack, B. had been weak-minded, incapable of business, and hemiplegic ; but, soon after arrest, he made an un- skilful attempt at suicide. He often cried, childishly. His moral and intellectual energy in opposing his sexual impulses was certainly much Weakened. No sentence {Giraud, " Ann. med. Psychol," March, 1881). '■ .. 3. Dementia After Injury of Head. Case 146. K, when fourteen years old, was injured on the head by a horse. The skull was fractured in several places, and several pieces of bone required re- moval. From that time K. was weak mentally, irascible, and ill-tempered. Gradually he developed an inordinate and truly beastly sensuality, which drove him to the most immoral acts. One day he raped a girl of twelve, and strangled her for fear of discovery. Arrested, he confessed. The medical experts declared him responsible, and he was executed. The autopsy revealed ossification of almost all the sutures, remarkable asymmetry of the halves of the skull, and evidences of healed fractures. The affected hemi- sphere had bands of cicatricial tissue running through it, and was one-third smaller than the other {Friedreich's " Blatter," 1885, Heft 6). STATES OF ACQUIRED MENTAL WEAKNESS. 451 4. Acquired Mental Weakness, Probably Resulting from Lues. Case 147. X,, officer, had repeatedly committed immoral acts with little girls ; among other things, he had induced them to perform manustupration on him, had exposed his genitals, and handled theirs. X., formerly healthy, and of blameless life, was in- fected with syphihs in 1867. In 1879 paralysis of the left abducens occurred. Thereafter mental weakijess was noticed, with a change of his disposition and character. Headache, occasional incoherence of speech, failure of power of thought and logic, occasional inequality of pupils, and paresis of the right facial muscles, were ob- served. X., aged thirty-seven, shows no trace of lues when examined. The paralysis of the left abducens is still present. The left eye is amblyopic. He is mentally weak. Concerning the trial that was before him, he said it was nothing but a harmless misunderstanding. Indi- cations of aphasia. Weakness of memory, particularly for recent events. Superficial emotional reaction ; rapid exhaustion of memory and ability to speak. Proved : that the ethical defect and the perverse sexual impulse are the symptoms of an abnormal condition of brain induced by lues. Suspension of criminal proceedings (personal case, " Jahrbiicher fiir Psychiatric "). 5. Paretic Dementia. Here the sexual life is usually abnormally affected ; in the incipient stages of the disease, as well as in episodical states of excitement, it is intensified, and sometimes per- verse. In the final stages libido and sexual power usually become 7nl. Just as in the prodromal stage of the senile forms, one sees here, in connection with more or less evident losses 452 PSYCHOPATHIA SEXUALIS. in the moral and intellectual spheres, expressions of an apparently intensified sexual instinct (obscene talk, las- civiousness in intercourse with the opposite sex, thouglits of marriage, frequenting of brothels, etc.), which is char- acteristic of the clouding of consciousness. Seduction, abduction and pubHc scandal are here the order of the day. At first there is still some appreciation of the circumstances, though the cynicism of the acts is striking enough. As the mental weakness increases, such patients- become criminal by reason of exhibition, mastur- bation in the streets and attempts at immoral acts with children. If conditions of mental excitement come on, attempts at rape are committed, or, at least, grossly immoral acts, — the patient attacks women on the street, appears in public in very imperfect dress ; or, half-clothed, tries to force his way into strange houses, to cohabit with the wife of an acquaintance, or to marry the daughter on the spot. Numerous cases belonging to this category are cited by Tardieu ("Attentats aux moeurs ") ; Mendel (" Progres- sive Paralyse der Irren," 1880, p. 123); Westphal ("Arch. f. Psych., vii., p. 622) ; and a case by Petrucci ("Annal. med. Psychol.," 1875) shows that bigamy may also occur here. The brutal disregard of consequences with which the patients in the advanced stages attempt to satisfy their sexual needs is characteristic. In a case reported by Legrand (" La folie," p. 519), the father of a family was found masturbating in the open street. After the act he consumed his semen. A patient seen by me, an officer, of a prominent family, in broad daylight, made attacks on little girls at a watering-place. A similar case is reported by Dr. Begis (" De la dynamie ou exaltation fonctionnelle au debut de la paral. gen.," 1878). Cases reported by TarnowsJcy {op. cit., p. 82) show that EPILEPSY. 453 also pederasty and bestiality may occur in the prodromal stages and course of this malady. Epilepsy. Epilepsy is allied to the acquired states of mental weakness because it often leads to them, and then all the possibilities of reckless satisfaction of the sexual impulse that have been mentioned may occur. Moreover, in many epileptics the sexual instinct is very intense. For the most part it is satisfied by masturbation, now and then by attacks on children, and by pederasty. Perver- sion of the instinct with perverse sexual acts seems to be infrequent. Much more important are the numerous cases in literature in which epileptics, who, during intervals, present no signs of active sexual impulse, but manifest it in connection with epileptic attacks, or during the time of equivalent or post-epileptic exceptional mental states. These cases have scarcely yet been studied clinically, and forensically not at all ; but they deserve careful study. In this way certain cases of violence and rape would be understood, and legal murders prevented. From the following facts it will certainly be clear that the cerebral changes which accompany the epileptic out- break may induce an abnormal excitation of the sexual instinct.^ Besides, in the exceptional mental states of epileptics, they are unable to resist their impulses, by reason of the disturbance of consciousness. For years I have known a young epileptic, of bad heredity, who, always after frequent epileptic seizures, ^ Arndt (" Lehrb. d. Psych," p. 410) especially emphasises the pas- sionate element in epileptics : " I have known epileptics who behaved in a most sensual way toward their mothers, and others who were suspected by their fathers of sexual intercourse with the mothers". But when Arndt declares that, wherever there is a peculiarity of the sexual life, thought of an epileptic element should come into consideration, he is in error. 454 PSYCHOPATHIA SEXUALIS. attacks his mother and tries to violate her. After a time he comes to himself, and has no recollection of his acts. In the intervals he is very strict in morals, and has hut slight sexual inclination. Some years ago I became acquainted with a young peasant, who, during epileptic attacks, masturbated shame- lessly, but during the intervals was above reproach. Simon (" Crimes et delits," p. 220) mentions an epilep- tic girl of twenty-three, well educated, and of the best morals, who, in attacks of vertigo, would shout out ob- scene words, then raise her dress, make lascivious move- ments, and try to tear open her undergarments. Eiernan ("Alienist and Neurologist," January, 1884) reports the case of an epileptic who always had, as an aura, the vision of a beautiful woman in lascivious attitudes, which induced ejaculation. After some years, with treatment with potassium bromide, the vision was changed to that of a devil attacking him with a pitchfork. The instant this reached him, he became unconscious. The same author speaks of a very respectable man who had, two or three times a year, epileptic attacks of furor and dysthymia, with impulses to pederasty, which lasted a week or two ; and of a lady who, with epilepsy that came on during the climacterium, had sexual desire for boys. Case 1 48. W., of good heredity, previously healthy ; before and after the attack, sound mentally, quiet, kind, temperate. On 13th April, 1877, he had no appetite. On the 14th, in the presence of his wife and children, he demanded coitus, first of his wife's friend, who was present, then of his wife. Taken away, he had an epileptoid attack ; after this he became wildly maniacal and destructive, threw hot water on those that tried to approach him, and threw a child in the stove. Then he soon became quiet, but for some days remained confused, and finally came to himself with no recollection of the events of his attack {Kowalewsky, " Jahrbiicher f. Psych.," 1879). EPILEPSY. 455 Another case, examined by Casper (" Klin. Novellen," p. 267), may be attributed to epilepsy (latent). A respect- able man attacked four women, one after another, in the open street (one before two witnessss), and violated one of them, " notwithstanding that his young, pretty and healthy wife " lived hard by. The epileptic significance of the sexual acts in the following cases is unequivocal : — Case 1 49. L., an official, aged forty; a kind husband and father. During four years he has offended public morals twenty-five times, for which he has had to endure long imprisonment. In the first seven complaints he was accused of expos- ing his genitals to girls from eleven to thirteen years old, while passing them on horseback, and calhng their attention by obscene words. While in confinement, he had exposed his genitals at a window which opened on a popular street. L.'s father was insane ; his brother was once met on the street wearing only a shirt. During his military service L. had had two attacks of severe fainting. Since 1859 he had suffered with peculiar attacks of vertigo, at such times becoming weak, tremulous, and deathly pale ; it grew dark before his eyes, he saw bright stars, and was forced to get support in order to keep upright. After violent attacks, great weakness, profuse sweating. Since 1861 he had been very irritable, which, respected though he was as an official, caused him much trouble in his work. His wife noticed the change in him. He had days when he would run about the house as if insane, holding his head between his hands, striking the wall, and complaining of headache. In 1864 he fell to the ground four times, lying there stiff, with eyes open. Confused states of consciousness were also proved to have occurred. L. declared that he had not the slightest remem- 456 PSTCHOPATHIA SEXUALIS. brance of the crime of which he was accused. Observa- tion showed further and more violent attacks of epileptic vertigo. L. was not sentenced. In 1875 paretic dementia developed with rapidly fatal results {Westphal, " Arch. f. Psych.," vii., p. 113). Case 150. A rich man of twenty-six had lived for a year with a girl with whom he was very much in love. He cohabited but rarely, but was never perverse. Twice during the year, after excessive indulgence in alcohol, he had had epileptic attacks. One evening after dinner, at which he had taken much wine, he hurried to the house of his mistress, and into her sleeping-apartment, although the servant told him she was not at home. From there he hastened into a room where a boy of fourteen was sleeping, and began to violate him. At the cry of the child, whose prepuce and hand he had injured, the servant hurried to them. He left the boy and raped the maid ; after that he went to bed and slept twelve hours. "When he awoke, he had an indistinct remem- brance of intoxication and coitus. Thereafter there were repeated epileptic attacks {Tarnowshy, op. cit., p. 52). Case 151. X., of high social position, led a dissolute life for some time, and had epileptic attacks. He be- came engaged. On his wedding day, shortly before the ceremony, he appeared on his brother's arm before the assembled guests. When he came before his bride, he exposed his genitals and began to masturbate. He was at once taken to an expert in mental disease. On the way he constantly masturbated, and for some days was actuated by this impulse, which gradually decreased in intensity. After this paroxysm the patient had only a confused remembrance of the events, and could give no explanation of his acts {Tarnotosky, op. cit, p. 53). Case 1 52. Z., aged twenty-seven ; very bad heredity ; EPILEPSY. 457 epileptic. He violated a girl of eleven, and then killed her. He lied about the deed. Absence of memory, i.e., mental confusion at the time of the crime, was not proved. (Pugliese, " Arch, di Psich.,"'viii., p. 622). Case 1 53. V., aged sixty ; physician ; violated chil- dren. Sentenced to imprisonment for two years. Dr. Marandon later on proved the existence of epileptoid attacks of apprehensiveness, dementia, erotic and hypo- chondriacal delusions and occasional attacks of fear {Lacas- sagne, "Lyon, med.," 1887, No. 51). Case 154. On 4th August, 1878, H., aged about fifteen, was picking gooseberries with several httle girls and boys as her companions. Suddenly she threw L., aged ten, to the ground and exposed her, and ordered A., aged eight, and 0., aged five, to bring about conjunctio membrorum with the girl, and they obeyed. H. had a good character. For five years she had been subject to irritability, headache, vertigo and epileptic attacks. Her mental and physical development had been arrested. She had not menstruated, but she manifested menstrual molimena. Her mother is suspected to be epileptic. For three months H., after seizures, had frequently done strange things, and afterward had no remembrance of them. H. seems to have been deflowered. Mental defect is not apparent She said she had no remembrance of the act of which she was accused. According to her mother's testimony, she had an epileptic attack on the morning of 4th August, and she had been, on that account, told by her mother not to leave the bouse (Pilrkhauer, "Friedreich's Blatter f. ger. Med.," 1879, H. 5). Case 155. Immoral acts of an epileptic in states of abnormal uyiconsciousness. — T., revenue collector ; aged fifty- two ; married. He is charged of being guilty of immo- 458 PSYCHOPATHIA SEXUALIS. rality with boys for the past seventeen years, by practising masturbation on them, and by inducing them to carry out the act on himself. The accused, a respected oiScer, is overcome by the terrible crime attributed to him, and declares that he knows nothing of the deeds of which he is accused. His mental integrity is questionable. His family physician, who has known him twenty years, emphasises his peculiar, retiring disposition and his mercurial moods. His wife asserts that T. once tried to throw her in the water, and that he sometimes had outbreaks in which he tore off his clothing, and tried to throw himself out of window. T. knew nothing of these attacks. Other witnesses testified to strange changes of mood and peculiarities of character. A physician reports the observation of occasional attacks of vertigo and convulsions in him. T.'s grandmother was insane ; his father was affected with chronic alcoholism, and of late years had had epilep- tiform attacks. The father's brother was insane, and had killed a relative while in a delirious state. Another uncle of T. had killed himself. Of T.'s three children, one was weak-minded, another cross-eyed, and the third was subject to convulsions. The accused asserted that he bad occasional attacks in which consciousness was so reduced that he did not know what he was about. These attacks were ushered in by an aura-like pain in the back of his neck. He was then impelled to go out in the air. He did not know where he went. His wife had perfectly satisfied him sexually. For eighteen years he had had chronic eczema (actual) of the scrotum, which had often caused him to have extraordinary sexual excitement. The opinions of the six experts were contradictory (sane, — attacks of latent epilepsy) ; the jury disagreed, and he was dismissed. Dr. Legrand du Saulle, who was called as an expert witness, found that, until his twenty-second year, T. had urinated in bed from ten to eighteen times a year. After that time the enuresis nocturna had ceased ; EPILEPSY. 459 but, from that time, states of mental confusion, lasting from an hour to a day, had occurred occasionally, and they left the patient without any remembrance of them. Soon T. was arrested again for public immorality, and sentenced to imprisonment for fifteen months. In prison he grew sick, and apparently much weaker mentally. For this reason he was pardoned, but the mental weakness increased. T. was noticed to have repeated epileptoid convulsions (tonic convulsion with tremor and loss of consciousness) {Auzouy, " Annal. med. psychol., 1874, Nov. ; Legrand du Saulle, " Etude med. legale," etc., p. 99). The following case of immoral acts with children, ob- served by the author and reported in " Friedreich's Blatter," will serve to conclude this group,^ so important in its legal bearings. It is the more important, in that a state of unconsciousness was established at the time of the act, and because, for allied reasons, the facts related in Latin show how a complicated and refined act becomes possible in such a state of unconsciousness. Case 156. P., aged forty-nine; married; hospital beneficiary. He was accused of having committed the following terrible acts with two girls, — D., aged ten, and G., aged nine, — whom he had taken to his work-shop on 25th May, 1883. D. testifies : " I was in the meadow with G. and my sister J., aged three. P. called us into his shop and fastened the door. Tum nos exosculabatur, linguam in OS meum demittere tentabat faciemque mihi lambebat ; sustulit me in gremium, bracas aperuit, vestes meas sublevavit, digitis me in genitalibus titillabat et membro vulvam meam fricabat ita ut humida fierem. When I cried, he gave me twelve kreuzers, and threatened to ^ Cf. also Liman, " Zweifelhafte Geisteszustande," Fall 6; Lasigtie, "Exhibitionists, Union med.," 1877; Ball and Chambard, "Art. Som- nambulisme" (" Diet, des scienc. med.," 1881). 460 PSYCHOPATHIA SEXUALIS. shoot me if I exposed him. At last he tried to persuade me to come again the next day." G. testified : "P. nates et genitaha D . . se exosculatus, iisdem me conatibus aggressus est. Deinde filiolum quoque tres annos natum in manus acceptum osculatus est nudatumque parti suse virih appressit. Postea quae nobis essent nomina interrogavit ac censuit, genitalia D . . se meis multo esse majora. Quin etiam nos impuHt, ut membrum suum intueremur, manibus comprehendere- mus et videremus, quantopere id esset erectum." At his examination, 29th May, P. said he had but an indistinct recollection of having fondled, caressed and made presents to a little girl a short time before. If he had done anything more, it must have been in an irre- sponsible condition. Besides, he had suffered for years with weakness in his head as result of an injury. On 22nd June he knew nothing of the events of 25th May, and nothing of his examination on 29th May. This amnesia was shown also on cross-examination. P. comes of a family affected with cerebral disease ; a brother was epileptic. P. was formerly a drinker. Years before he had actually received an injury to his head. Since then, from time to time, he has had attacks of mental disturbance, introduced by moroseness, irritability, tendency to alcoholic excesses, apprehension, and delu- sions of persecution sufficient to induce threats and deeds of violence. At the same time he would have auditory hypersesthesia, vertigo, headache and cerebral conges- tion, — all this, with great mental confusion and amnesia for the whole period of the attack, which would sometimes last for weeks. During the intervals he was subject to headache, which started from the seat of injury on the head (a small scar in the skin over the right temple), which was painful on pressure. With exacerbation of the headache he became very irritable, morose to an extent that in- clined him to suicide, and mentally like one drunk. In PEEIODICAL INSANITY. 461 1879, while in such a state, he made an impulsive attempt at suicide, of which he afterward had no remembrance. Soon after this, being sent to hospital, he gave the impression of being epileptic, and for a long time was treated with pot. bromide. At the end of 1879 he was taken to the infirmary, no actual epileptic attack having been observed. During his lucid intervals he was a virtuous, indus- trious, good-natured man, and had never shown any sexual excitement ; and, until this time, never sexual inclinations, even during his mental confusion. More- over, until lately he had lived with his wife. At the time of the criminal act he had shown signs of an approaching attack, and had asked the physician to prescribe pot. bromide. P. asserted that, since the injury to his head, he had been intolerant of heat and alcohol, which immediately brought on headache and confusion. The medical exami- nation proved the truth of his assertions about mental weakness, irritability and poor sleep. If pressure were made at the seat of the trauma, P. became congested, irritable, confused and trembled all over ; he appeared excited ; consciousness was disturbed, and remained so for hours. At times, when he is free from the sensations that start from the scar, he seems kind, free, willing and open, though he is mentally weak and cloudy. P. was not sentenced (vide "Friedreich's Blatter" for full report). Periodical Insanity. Just as in cases of non-periodical mania, an abnormal intensity or a noticeable prominence of the sexual sphere ■js very often manifested in the periodical attacks {v. infra, "Mania"). The following case, reported by Scrvaes ("Arch. f. Psych."), shows that it then may also be perverted : — 462 PSYCHOPATHIA SEXUALIS. Case 157. Catharine W., aged sixteen; she has not yet menstruated ; previously healthy. Father very irascible. Seven weeks before admission (3rd December, 1872), melancholic depression and irritability. 27th November, maniacal outbreak, lasting two days ; thereafter, melan- cholic. 6th December, normal condition. 24th December (twenty-eight days after the first maniacal attack), silent, shy, depressed. 27th December, exaltation (jolly, laughing, etc.), with violent love for an attendant (female). 31st December, suddenly melan- cholic catalepsy, which disappeared after two hours. 20th January, 1873, new attack like the previous one. A simi- lar one on 18th February, with traces of menses. The patient had no recollection whatever for what occurred in the paroxyms, and blushed scarlet with astonishment and shame when told about them. Thereafter there were abortive attacks, which entirely disappeared, to give place to the normal mental condition in June. In a case reported by Gock ("Arch. f. Psych." v.), which was probably circular insanity, in a man of very bad heredity, during the stage of exaltation there was •manifestation of sexual feeling for men. In this case, however, the patient thought himself a girl, and it is questionable whether the sexual inclination was induced by the delusion or by an antipathic sexual instinct. In connection with these cases of abnormal manifesta- tion of the sexual instinct are those which, as a symptoui of mania, manifest an abnormal and frequently a perverse sexual instinct in an impulsive way, analogous to dipso- mania, which forms the nucleus of the psychical disturb- ance, while in the intervals the sexual instinct is neither' intense nor perverse. Quite a genuine case of such periodical psychopathia sexualis, connected with the process of menstruation, is PERIODICAL INSANITY. 463 the following reported by Anjd (" Arch. f. Psych." xv., Hett 2) :— Case 1 58. A quiet lady, near the climacteric. Very bad heredity. In her youth attacks of petit mat. Al- ways eccentric, quick-tempered ; very moral ; childless marriage. Several years ago, after a violent emotional disturb- ance, a hystero-epileptic attack, with post-epileptic in- sanity of several weeks' duration. Thereafter there was sleeplessness for several months. Following this, there was always menstrual insomnia, and the impulse to embrace and kiss boys of ten, and fondle their genitals. During this excitement there was no desire for coitus ; certainly not for intercourse with adults. The patient often speaks openly of this impulse, and asks to be watched, as she is not to be trusted. In the intervals she anxiously avoids all talk of it, is very modest, and in nowise passionate sexually. With reference to the still imperfectly known cases of periodical j)sijchopatliia sexualis of this kind, Tarnowsky {op. cit., p. 38) has made valuable contributions, though his cases were not all of a periodic nature. Tarnowsky reports cases where married, cultured men, the fathers of families, were, from time to time, compelled to perform the most terrible sexual acts, while during the intervals they were sexually normal, abhorred their paroxysmal sexual acts, and shuddered before the expec- tation of their repetition. If a new paroxysm came on, the normal sexual instinct disappeared ; a state of mental excitement arose with insomnia, and thoughts and impulses to commit the per- verse sexual acts, with anxious confusion and an increas- ing impulse to the abhorred indulgence. In this state the act was a relief, because it ended the condition. The analogy with dipsomania is complete. 4:64 PSYCHOPATIIIA SEXUALIS. For other cases (of periodical pederasty), vide 'I'limov- shy, op. cit., p. 41. The case there reported, on page 40 belongs in the category of epilepsy. The following case, reported by Anjdl (" Arch. f. Psych,," XV., Heft 2), is one of the most typical of the convulsive-like occurrence of sexual excitement : — Case 159. A gentleman of high social position, aged forty -five ; generally respected and beloved ; heredity good ; very moral ; married fifteen years. Previously sexually normal , the father of several healthy children, and living in happy matrimony Eight years ago he had a sudden fright. For some weeks thereafter he had a feeling of apprehension and cardiac attacks. Then came attacks, at intervals of several months or a year, of what the patient called his " moral catarrh ". He became sleepless. After three days, loss of appetite, increasing irritability, strange appearance ; fixed stare, staring into space ; pale- ness, changing with redness ; tremor of the fingers ; red, shining eyes, with peculiar glassy expression ; and violent, quick manner of speech. There was a desire for girls of from five to ten years, even for his own daughters. He would beg his wife to guard the children. For days at a time, while in this state he would shut himself in his room. Previously he was compelled to pass school-girls on the street, and he found a peculiar pleasure in exposing his genitals before them, by actmg as if about to urinate. For fear of exposure, he shuts himself in his room, morose, incapable of movement, and torn by feelings of fear. Consciousness seems to be undisturbed. The at- tacks last from eight to fourteen days. The cause of their return is not clear. Improvement is sudden ; there is great desire for sleep, and, after this is satisfied, he is well again. In the interval there is nothing abnormal, Anjel assumes an epileptic foundation, and considers the attacks to be the psychical equivalents of epileptic con- vulsions. SATYEIASIS AND NYMPHOMANIA. 465 IWania. . With the general excitation that here exists in the psychical organ, the sexual sphere is likewise often impli- cated. In maniacal individuals of the female sex, this is the rule. In certain cases, it may be questionable whether the instinct, which, in itself, is not intensified, is simply recklessly manifested, or whether it is present in actual abnormal intensity. For the most part, the latter is the true assumption — certainly so where sexual delusions and their rehgious equivalents are constantly expressed. In accordance with the degrees of intensity of the disease, the intensified instinct is expressed in different forms. In simple maniacal exaltation in men, courting, frivolity, and lasciviousness in speech, and frequenting of brothels, are observed ; in women, inclination for the society of men, personal adornment, perfumes, talk of marriage and scandals, suspicion of the virtue of other women ; or there is manifested the rehgious equivalent — pilgrimages, missionary work, desire to go into a cloister or to become the servant of a priest ; and in this case there is much talk about innocence and virginity. At the height of mania there may be seen invitations to coitus, exhibition, obscenity, great excitation at sight of women, tendency to smear the person with saliva, urine, and even faeces; rehgio-sexual delusions, —to be under the protection of the Holy Ghost, to have given birth to Christ, etc. ; open onanism and pelvic movements of coitus. In maniacal men care must be taken to prevent shameless masturbation and sexual attacks on women. Satyriasis and Nymphomania. States of mental excitement in which an abnormal intense sexual impulse is prominent are called satyriasis (in males) and nymphomania or uteromania (in women). 30 466 PSYCHOPATHIA SEXUALIS. Moreau considers these cases peculiar to themselves, but he is certainly in error. The sexual complexus of symptoms is always but the partial manifestation of a general psychosis (mania, hallucinatory insanity ?), The essential element of the state of sexual excitement is a condition of psychical hypersesthesia with involve- ment of the sexual sphere. The imagination calls up only sexual images, which may lead to hallucinations, illusions and true hallucinatory delirium. The most indifferent ideas excite sensual association, and the lustful colouring of the ideas and apperceptions is very much intensified. The abnormal state of consciousness implicates the whole- course of feehng and desire, and is accompanied by general physical excitement like that which accompanies coitus {v. "Physiology"). Often the genitals are in a constant state of turgor (priapism in males). The man affected with this sexual passion seeks to satisfy his desire at any price, and, therefore, becomes very dangerous to women. Faute de mieux, he practises onanism or sodomy. The nymphomaniacal woman seeks men by exhibition, or to attract them by her sensual conduct; at the sight of men she is intensely excited sexually, and satisfies herself by masturbation or by pelvic movements of coitus. Satyriasis is rare. Nymphomania is more frequently observed, and not seldom in the climacteric. It may occur in senility. Abstinence,^ with constant excitation of the sexual sphere as a result of psychical or peripheral irritation {pmrikis, pudcndi oxyuris, etc.), may cause these conditions, but probably only in those predisposed. The assertion that it may also result from poisoning by cantharides seems to depend upon confounding it with priapism. The primary lustful feeling that accompanies priapism due to cantharides soon becomes painful. Saty- 1 Cf. the interesting cases of Marc-Ideler, ii., p. 137 ; Ideler, " Grund- riss der Seelenheilkunde," ii., pp. 488-92. HYSTERIA. 467 riasis and nymphomania are acute abnormal psycho- sexual states. There are also cases that, not without reason, might be called chronic satyriasis or nymphomania. To these belong the men who, for the most part as a result of abusus veneris, or more particularly of masturbation, suffer with neurasthenia sexualis, and at the same time have intense libido sexualis. The imagination, as in acute cases, is in a state of excitement, and the mind full of obscene images ; so that the most elevated ideas are besmirched with the cynical images and thoughts. The thought and desire of such men are solely directed to the sexual sphere ; and since their flesh is weak, led on by their fancy, they come to indulge in the grossest per- versions' of the sexual act. Analogous cases in women may be called chronic nymphomania. They naturally lead to prostitution. Le- grand du Saulle ("La folie," p. 510) reports interesting cases which apparently are genuine. Melancholia. The thoughts and feelings of melancholiacs are not favourable for the excitation of sexual desires. At the same time, these patients sometimes masturbate. In my experience such cases have always been hereditarily pre- disposed and previously given to onanism. The act did not seem to be so much due to a lustful desire as to be induced by habit, ennui, anxiety and the impulse to change temporarily the painful mental condition. Hysteria. In this neurosis the sexual life is very frequently abnormal ; indeed, always in predisposed individuals. All the possible anomalies of the sexual function may occur here, with sudden changes and peculiar activity ; 468 PSYCHOPATHIA SEXUALIS. and, on an hereditary degenerate basis and in moral imbecility, they may appear in the most perverse forms. The abnormal change and inversion of the sexual feeling are never without effect upon the patient's disposition. The following case, reported by Giraud, is one of this nature worthy of repetition : — Case 160. Marianne L., of Bordeaux. At night, while the household was asleep under the influence of narcotics which she had administered, she had given the children of the house to her lover for sexual enjoy- ment, and made them witness immoral acts. It was found that L. was hysterical (hemianaesthesia and con- vulsive attacks), but before her illness she had been a moral, trustworthy person. Since her illness she had become a shameless prostitute, and lost all moral sense. In the hysterical the sexual sphere is often abnorm- ally excited. This excitement may be intermittent (menstrual?). Shameless prostitution, even in married women, may result. In a milder form the sexual impulse expresses itself in onanism, going about in a room naked, smearing the person with urine and other filthy things, or wearing male attire, etc. Schille (" Klin. Psychiatrie," 1886, p. 237), finds very frequently an abnormally intense sexual impulse " which disposes girls, and even women living m happy marriage, to become Messalinas ". The author cites known cases in which, on the wed- ding-journey, attempts at flight with men who had been accidentally met were made ; and respected wives who entered into liaisons, and sacrificed everything to their insatiable impulse. In hysterical insanity the abnormally intense sexual impulse may express itself in delusions of jealousy, un- PARANOIA. 469 founded accusations against men for immoral acts,' hallucinations of coitus,^ etc. Occasionally frigidity may occur, with absence of lust- ful feeling — due, for the most part, to genital anaBsthesia. Paranoia. Abnormal manifestations in the sexual sphere, in the various forms of paranoia, are not infrequent. Many of these cases are developed on sexual abuse (masturbatic paranoia) or sexual excitement ; and, according to experi- ence, in individuals psychically degenerate, with other functional signs of degeneracy, the sexual sphere is, for the most part, deeply implicated. In paranoia religiosa and erotica the abnormally intense and, under certain circumstances, perverse sexual instinct is most clearly manifested. In the first variety, however, the condition of sexual excitation is expressed not so much in a direct method of satisfaction of the sexual desires as (there are exceptions) in platonic love — in enthusiastic admiration of a person of the opposite sex who is pleasing aesthetically. Under certain circumstances, the enthusiasm is for an imaginary person, a portrait, or a statue. A love for the opposite sex that is weak and purely mental also, often has its basis in weakness of the geni- tals due to long-continued masturbation ; and, under the guise of virtuous admiration for a beloved person, great lasciviousness and sexual perversion are often concealed. Episodically, especially in women, violent sexual excite- ment may occur as a nymphomania. For the most part, paranoia religiosa rests upon sexual- ity which manifests itself in a sexual impulse that is ab- ^ Vide case of Merlac, in the author's "Lehrb. d. ger. Psychopathol.," 2 Aufl., p. 322 ; Morel, " Traitu des malad. mentales," p. 687 ; Legrand, " La folie," p. 337 ; Process La Ronciere, in " Annal. d'hyg.," 1 Seric, iv. ; 3 Serie, xxii. 2 The incubus in the witch-trials of the middle ages depended on them. 470 PSYCHOPATHIA SEXUALIS. normally early and intense. The libido finds satisfaction in masturbation or religious enthusiasm, the object of which may be a certain minister, saint, etc. The psycho-pathological relations between the sexual and religious domains have been described in detail on p. 10 et seq. Apart from masturbation, sexual crimes are relatively frequent in religious paranoia. Marc's work (p. 160) contains a remarkable example of religious insanity. Giraiid ("Annal. med. psychoL") has reported a case of immorality with a little girl by a religious paranoiac, aged forty-three, who was temporarily erotic. Here, also, belongs a case of incest {Liman, '* Vierteljahrsschr. f. ger. Med."). Case 161. M. impregnated his daughter. His wife, mother of eighteen children, and herself pregnant by her husband, lodged the complaint. M. had had religious paranoia for two years. "It was revealed to me that I should beget the Eternal Son with my daughter. Then a man of flesh and blood would arise by my faith, who would be 1800 years old. He would be a bridge between the Old and New Testament." This command, which be deemed divine, was the cause of his insane act. Sexual acts that have a pathological motive sometimes occur in persecutory paranoia. Case 162. A woman of thirty had, under promise of money and food, enticed a boy of five, who played near her, handled bis genitals, and then attempted coitus. She was a teacher, who had been betrayed and then cast off. Previously moral, for some time she had given herself to prostitution. The explanation of her immoral change was given, when it was found that she had various delu- sions of persecution, and thought she was under the secret PARANOIA. 471 influence of her seducer, who impelled her to sexual acts. She also believed that the boy had been put in her way by her seducer. Coarse sensuality as a motive for her crime came less into consideration, as it would have been easy for her to satisfy sexual desire in a natural way [Kilssner, " Berl. klin. Wochenschrift "). Cullerre ("Perversions sexuelles chez les persecutes," in "Annal. medico-psychol.," March, 1886) has reported similar cases, — the case of a patient who, suffering with 'paranoia sexualis pcrsecutoria, tried to violate his sister, giving as a reason that the impulse was given him by Bonapartists. In another case a captain, suffering with delusions of persecution by electro-magnetism, was driven to ped- erasty, — a thing he abhorred. In a similar case the persecutor impelled to onanism and pederasty. V. PATHOLOGICAL SEXUALITY IN ITS LEGAL ASPECTS.' The laws of all civilised nations punish those who commit perverse sexual acts. Inasmuch as the preserva- tion of chastity and morals is one of the most important reasons for the existence of the commonwealth, the state cannot be too careful, as a protector of morality, in the struggle against sensuality. This contest is unequal ; because only a certain number of the sexual crimes can be legally combated, and the infractions of the laws by so powerful a natural instinct can be but little influenced by punishment. It also lies in the nature of the sexual crimes that but a part of them ever reach the knowledge of the authorities. Public sentiment, in that it looks upon them as disgraceful, lends much aid. Criminal statistics prove the sad fact that sexual crimes are progressively increasing in our modern civili- sation.^ This is particularly the case with immoral acts with children under the age of fourteen. The morahst sees in these sad facts nothing but the decay of general morality, and in some instances comes to the conclusion that the present mildness of the laws punishing sexual crimes, in comparison with their severity in past centuries, is in part responsible for this. ^ S. Weisbrod, " Die Sittlichkeitsverbrechen vor dem Gesetz," Berlin, 1891; Dv. Pasqnale Pcnta, " 1 -peYveYtimenti sessuali neiruomo," Napoli, 1893; Se?/(^ and, later, once, as a civilian, for stealing cigars. L. had repeatedly been in asylums on account of insanity (at- tacks of insanity ?). Besides, he was often remarkable on account of his changeable, quarrelsome character, occa- sional excitement and inconstancy. L.'s brother died of paralysis. He himself presents no degenerative signs; no epileptic antecedents. At the time of observation he is neither insane nor mentally weakened. He behaves himself very well, and expresses great regret for his sexual crimes, which he explains in this wise : though not a drinker, he occasionally has an im- pulse to drink. Soon after beginning, congestion of the head, vertigo, restlessness, anxiety and oppression come on. He then passes into a dreamy state. An irresistible impulse now forces him to expose himself ; and he then experiences a feeling of relief and breathes more easily. "When he has once exposed himself, he knows nothing more of what he does. As precursors of such attacks, he had often, a short time before, had flames before the eyes and vertigo. For the time of his clouded state of con- sciousness he had but an obscure, dreamy memory. It was only after a time that sexual ideas and impulses had become associated with these apprehensive, cloudy states of consciousness. Years ago, in such states, with- out motive and with great danger, he had deserted ; once he had jumped from a third-storey window ; on another occasion he had left a, good position to wander about aimlessly in a neighbouring country, where he was at once arrested for exhibition. 484 PSYCHOPATHIA SEXUALIS. When, outside of his abnormal periods;, L. once became intoxicated, there was no exhibition. In the hicid state his sexual feeling and intercourse are perfectly normal (Dr. Hotzen, "Friedreich's Blatter," 1890, Heft 6). For other instances, vide cases 149, 151. A clinical group that very nearly approaches the epi- leptic exhibitionists is made up of certain neurasthenic individuals, in whom, likewise, there may occur attacks (epileptoid ?) of imperfect consciousness ^ in connection with a feeling of apprehensive oppression ; and with this sexual impulses may be associated, resulting in acts of exhibition having an impulsive character. Case 169. Dr. S., academic teacher, had aroused public indignation by being seen repeatedly running about in the Zoological Garden at Berlin, before ladies and chil- dren, with his genitals hanging out. S. admitted this, but denied all thought or consciousness of causing public offence, and excused himself by saying that his running about with exposed genitals afforded him relief from nervous excitement. Mother's father was insane, and died by suicide ; his mother was constitutionally neuro- pathic, a somnambulist, and had been temporarily insane. The culprit was neuropathic, had been a somnambulist, and had had continuous aversion to sexual intercourse with females. In his youth he practised onanism. He was a neurasthenic man, shy, torpid and easily became embarrassed and confused. He was sexually always much excited. Frequently he dreamed that he was running about with exposed genitals, or that, dressed only in a shirt, he hung from a horizontal bar with his head down- ward, so that the shirt fell down, exposing his erected penis. His dreams would induce pollution, and he would then have rest for a few days or an entire week. 1 Gf. V. Krafft, " Ueber trarisitorisches Irresein bei Neurasthenischen," " Irrenfreund," 1883, No. 8; and " Wiener Kliu. Wocheuschr.," 1891, No. 50. OFFENCE AGAINST MORALITY. 485 In his waking state also the impulse would often come upon him, just as in his dreams, to run about with exposed genitals. As he was about to expose himself, he would become very hot, and then he would run aimlessly about. The member would become moist with secretion, but pollution was never induced. Finally, when it had become flaccid, he would put it up, and then come to himself, glad if no one had seen him. In such conditions of excitement he seemed to be in a dream ; as if intoxicated. He bad never had the intention to offend women. S. was not epileptic. His declarations had the impress of truth. He had actually never followed or spoken to women while in this condition. Frivolity and coarseness were excluded. No doubt S.'s act was due to pathological sensation and idea, and S. was in a condition of pathological disturbance of mental action at the time of the commission of his acts (Liman, " Vierteljahrsschrift fiir gerichtel. Med.," N. F. XXX. viii., Heft 2). Case 1 70. X., aged thirty-eight ; married ; father of one child. Always sullen and silent. Suffers frequently with headache. Very neurasthenic, though not insane. He is troubled much at night by pollutions. He has repeatedly followed shop-girls, for whom he had lain in wait, exposing and handhng his genitals. In one case he even followed a girlinto a shop (Trochon, "Arch, de I'an- thropologie criminelle," iii., p. 256). In the following case the exhibition seems subsidiary to the impulsive desire to satisfy sudden, intense libido by means of masturbation : — Case 171. E., coachman, aged forty-nine; Vienna; married since 1866; childless. Father neuropathic and given to sexual excesses ; died of cerebral disease. He presents no degenerative signs. At the age of twenty-nine he suffered a severe concus- 486 PSYCHOPATHIA SEXUALIS. sion by falling from a height. Up to that time the vita sexualis had been normal. Since then, however, every three or four months he has been seized with very painful sexual excitement, accompanied by an intense desire to masturbate. A feeling of weariness and discomfort, with a desire for alcoholic indulgence, precedes this. In the intervals he is sexually cold, and has but very infrequent desire for his wife, who, moreover, for five years has been sick and incapable of cohabitation. He gives the assurance that, as a young man, he never masturbated, and that, in the intervals between his attacks, he has never thought of satisfying himself sexually in this way. The impulse to masturbate during the attack is always excited by certain feminine charms — short cloak, pretty foot and ankle, elegant appearance. Age makes no dif- ference ; even little girls excite him. The impulse is sudden and unconquerable. B. describes the situation and act as characteristically impulsive. He had often tried to resist it ; but then he would grow hot, terribly frightened, his head would burn, and he would seem to be in a fog ; but he never lost consciousness. At the same time he would have violent, darting pain in the testicles and sper- matic cords. He regretted it, but had to confess that the impulse was stronger than his will. In such a situation it forced him to masturbate, no matter where he might be. After ejaculation he would become calm, and regain his self-control. He regarded it as a terrible affliction. Defence shows that E. has been punished six times for similar offences — exhibition and masturbation in the open street. Although an examination into his mental condi- tion by experts was demanded by his counsel, the court refused it on the ground that the proceedings had raised no doubt as to his responsibility. On 4th November, 1889, E., while in his worst condi- tion, happened to be in the street as a crowd of school- girls went by. This awakened his unconquerable impulse. OFFENCE AGAINST MORALITY. 487 There was not time to run to a closet, he was too excited. There was immediate exhibition, masturbation in front of a house — great scandal and immediate arrest. R. is not weak-minded, and has no ethical defect. He bemoans his fate, deeply regrets his act, and fears new attacks. He regards his condition as abnormal — as a fate against which he is powerless. He thinks himself still virile. Penis abnormally large. Cremasteric reflex present ; patellar reflex increased. Weakness of the sphincter of the bladder, that has existed for some years. Various neurasthenic difficulties. The opinion showed that R. was subject to the influ- ence of abnormal conditions, and had acted impulsively. Patient was sent to an asylum, from which he was discharged after a few months. In the foregoing case the important point, clinically, hes not in the neurosis that is present, but rather in the impulsive character of the act (exhibition dependent on masturbation). With the enumeration of the categories of imbeciles, of mentally weakened individuals, and of the exhibitionists that are in a neurotic (epileptic or neurasthenic) state of benumbed consciousness, apparently the clinical and for- ensic side of this phenomenon is still uiiexhausted ; in addition to these, there is another class, the represent- atives of which, owing to deep hereditary taint {hereditary degenerative neurosis ?), are impelled to periodical and very impulsive exhibition. With reference to these conditions of psychopathia sexualis periodica (cf. " Periodical Insanity,") in which the accidentally awakened impulse to exhibition is but a partial manifestation of a clinical whole, like in dipsommia periodica the craving for drink, Magnan,^ from whom I borrow the following instructive cases, justly lays the greatest stress " Recherchcs snr les Centres Ncvvcux," 2e sc'irie, Paris, 1893. PSYCHOPATHIA SEXUALIS. upon the impulsive, periodical feature of these abnormal impulses ; and no less upon the fact that they are often accompanied by terrible anxiety, which, after the realisa- tion of the impulse, gives place to a feeling of relief. These facts, and, no less, the chnical picture of de- generacy that, for the most part, is referable to injurious conditions that are hereditary, or that exercise an in- jurious effect on the development of brain in early years (rachitis, etc.,) are, medico-legally, of decisive importance. Case 172. G., aged twenty-nine, waiter in a cafe. In 1888, while standing under a church-door, he exhibited himself to several girls working opposite. He confessed the act, and also that, many times, in the same place and at the same time of day, he had been guilty of the same crime, having been punished for it the year before with imprisonment for one month. G. has very nervous parents. His father is mentally unstable and very irascible. His mother is at times in- sane, and suffers with severe neurotic affection. G. has always had nervous twitching of the face, and constant alternation of causeless depression, with tadmm vita, and periods of elation. At the ages of ten and fifteen, for sHght cause, he wished to commit suicide. When ex- cited, he has similar twitching of the extremities. He presents constant general analgesia. In prison he was at first beside himself with shame about the disgrace he had brought on his family, and said he was the worst of men, deserving the severest punishment. Until his nineteenth year G. had satisfied himself with solitary and mutual masturbation, and, on one occasion, he had practised onanism with a girl. From that time, working in a cafe, the female customers had excited him so intensely that ejaculation was often induced. He suf- fered with almost constant priapism, and, as his wife stated, in spite of coitus, it often disturbed his rest at night. For seven years he had repeatedly exhibited him- OFFENCE AGAINST MORALITY. 489 self at his window, and also exposed himself naked to female neighbours living opposite. In 1883 he married for love. Marital intercourse did not satisfy his needs. At times his sexual excitement was so intense that he had headache, and seemed confused, like one drunk, strange and incapable of work. In one of these attacks he had recently exhibited him- self before ladies in two streets of Paris (12th May, 1887). Since then he was fighting a desperate battle against these morbid impulses which had now become almost per- manent, and when at their height made him morose and confused, and caused him to weep all night. In spite of all efforts he backslided again and again. Opinion : Proof of hereditary degeneration with delusions and irresis- tible impulses (" perversion dehrante du sens genital ")_ Pardon {Magnan, " Arch, de I'anthropologie criminelle," v.. No. 28). Case 173. B., aged twenty-seven; of neuropathic mother and alcoholic father. He has one brother who is a drinker ; and a hysterical sister. Four blood rela- tions on paternal side are drunkards, one female cousin is hysterical. After his eleventh year, onanism, solitary or mutual. After his thirteenth year, impulses to exhibition. He at- tempted it at a street urinal ; he felt pleasure in it, but also immediately twinges of conscience. If he attempted to oppose his impulse thereafter, he became apprehensive, and had a feehng of oppression in his chest. When a soldier, he was often impelled to expose himself, under various pretexts, to his comrades. After his seventeenth year he had sexual congress with women. It gave him great pleasure to show himself naked before them. He continued his exhibition on the street. Since he could but infrequently count on female spectators at urinals, he changed his place to churches. In order to exhibit himself at such places, he always had 490 PSYCHOPATHIA SEXUALIS. to strengthen his courage by drinking. Under the in- fluence of spirits, the impulse, at other times controllable with difficulty, became irresistible. He was not sentenced. He lost his position, and then drank more. Not long after, he was again arrested for exhibition and mastur- bation in a church (Magnan, ibid}). Case 1 74. X., aged thirty-five ; barber's assistant. Repeatedly punished for offence against decency, he is again arrested ; for, during three weeks he had been hanging around girls' schools, trying to attract the at- tention of the pupils, and, when he had succeeded in this, had exhibited himself. Occasionally he had promised them money, with the words, " Habeo mentulam pulcher- rimam, venite ad me ut earn lambatis ". At his examination X. confessed everything, but did not know how it had come about. He was the most reasonable of men in other respects, but had the impulse to commit this crime, and could not overcome it. In 1879, when in the army, he was once out on leave, and had run around exhibiting himself to children : im- prisonment for a year. The same crime in 1881. He chased the crying children, and " stared " at them : im- prisonment of one year and three months. Two days after his discharge, he said to two little girls : " Si men- tulam meam videre vultis mecum in banc tabernam veni- atis ". He denied these words, and claimed drunkenness ; imprisonment for three months. In 1883 renewed exhibition ; during the act he said nothing. At his examination he stated that, since a severe illness, eight years previously, he had suffered with such excitations : imprisonment for one month. In 1884 exhibition before girls in a churchyard ; again in 1885. He declared : " I understand my crime, but it is like a disease. When it comes over me, I cannot keep 1 Analogous case: Boissicr et Lachaux, "Archives de Neurologie," 1893, October. OFFENCE AGAINST MORALITY. 491 from such acts. It sometimes happens that, for quite a long time, I am free from these inchnations." Imprison- ment for six months. Discharged on 12th August, 1885, he had a relapse on 15th August. The same excuse was given. This time he underwent medical examination. The examination re- vealed no mental disturbance. Sentenced to three years. After discharge, a series of new exhibitions. On this occasion, examination revealed the followingf : — His father suffered with chronic alcoholism, and is said to have been guilty of the same crime. Mother and a sister nervously ill, and the whole family of excitable temperament. From his seventh to his eighteenth year X. suffered with epileptic convulsions. First cohabitation at sixteen ; later, gonorrhoea and, it is stated, syphilis. After that, normal sexual intercourse until his twenty-first year. At that time he often had to pass a playground, and at times would urinate there ; and it happened that the children watched him out of curiosity. He noticed, occasionally, that being watched in this manner caused him sexual excitement, induced erection and even ejaculation. He now found more pleasure in this kind of sexual gratification, and became indijfferent about coitus ; satisfying himself only in this manner. He felt that all his thought was ruled by this, and he dreamed only of exhibitions, with pollutions. His attempts to con- trol his impulse became more and more ineffectual. It came over him with such force that he noticed nothinfr around him, and saw and heard nothing, and was like one " devoid of reason " — like " a bull trying to butt his head through a wall ". X. has an abnormally broad head ; small penis ; the left testicle deformed. Patellar reflex absent. Symptoms of neurasthenia, especially cerebral. Frequent pollutions. For the most part, his dreams are about normal coitus, only infrequently about exhibition before little girls. 492 PSTCHOPATHIA SEXUALIS. With reference to his sexual acts, he states that the impulse to seek and approach little girls is primary ; only when he has succeeded earum intentionem in sua geni- talia nudata transferre, erectionem et ejaculationem fieri. He does not lose consciousness in the act. After it he is troubled about his deed, and, if undiscovered, says to himself, " Once more I have escaped the authorities ". In prison he did not have the impulse; there, he was troubled only with dreams and pollutions. In freedom he had daily sought opportunity to satisfy himself with ex- hibition. He would give ten years of his life to be free from the thing ; " this life of constant anxiety, this alter- nation between freedom and imprisonment,is unendurable". The opinion assumed a congenital (?) perversity of the sexual instinct, with unmistakable hereditary taint, neuro- pathic constitution, asymmetry of cranium, and defective development of the genitals. It is also worthy of remark that the exhibition began when the epilepsy ceased; so that one might think of a vicarious phenomenon. The sexual perversity developed, with predisposition, through accidental association of ideas of sexual content (children looking at him urinating) with an act that, in itself, was purposeless. The patient was not sentenced, but sent to an asylum (Dr. Freyer, " Zeitschr. f. Medicinalbeamte," 3 Jahrg., No. 8). Case 175. At nine o'clock at night, in the spring of 1891, a lady, in great trepidation, came to the policeman in the city park of X., with the statement that a man, absolutely naked in front, had approached her from the bushes, and she had run away frightened. The officer went at once to the place indicated, and found a man, who exposed ventrem et genitalia nuda. He attempted to escape, but was overtaken and arrested. He stated that he had been sexually excited by alcohol, and had been on OFFENCE AGAINST MORALITY. 493 the point of going to a prostitute. On his way through the park, however, he recalled the fact that exhibition gave him much greater pleasure than was afforded him by coitus, in which he seldom, and only faute de mieux, in- dulged. After drawing up his shirt, he posted himself in the bushes, and when two women came up the path he approached them with exposed genitals. In such exhibi- tion he had a pleasurable feehng of warmth, and the blood mounted to his head. The accused works in a factory, and his employer states that he is faithful, saving, sober and intelligent. In 1886 B. had been punished because he had twice exhibited himself publicly,— once in broad daylight and once at night, under a street lamp. B., age 37, single, makes a pecuHar impression owing to his dandified dress and affected manner. His eyes have a neuropathic, languishing expression ; around his mouth plays a smile of self-satisfaction. He is said to come of healthy parents. A sister of his father and one of his mother's were insane. Others of their relatives were thought religiously eccentric. B. has never had any severe illness. From childhood he was eccentric and imaginative. He loved romances about knights and others, was entirely absorbed by them, and even went so far as to identify himself in fancy with the heroes. He always thought himself a httle better than others, and thought much of elegant dress and ornament; and when he strutted about on Sundays he imagined himself a high official. B. has never shown epileptic symptoms. In youth, moderate indulgence in masturbation ; later, moderate indulgence in coitus. Previously, never any perverse sexual feelings or impulses. Eetired manner of Hfe ; in leisure hours, reading (popular novels, heroic tales, Dumas and others). B. was not a drinker. Exceptionally Le made himself a kind of punch, by which he was always excited sexually. 494 PSYCHOPATHIA SEXUALIS. For some years, with marked decrease of libido, after such alcohohc indulgence, he had developed the " accursedly silly thought" and the desire genitalia adspec- hti fcminarum puhlice exhibere. If he got into this state he felt warm, his heart beat violently, blood rushed to his head, and he could then no longer resist his impulse. He heard and saw nothing more, and was absolutely absorbed in his lust. Afterward he had often pounded his crazy head with his fists, and firmly resolved never to do such a thing again ; but the crazy ideas had always returned. In his exhibition his penis became only half-erected, and ejaculation never occurred ; even in coitus it was always tardy. In exhibition he was satisfied with genitalia sua adspicere, and he had the lustful thought that this sight must be very pleasant to women, since he himself liked so much to see genitalia feminarum. He was capable of coitus only when the puella showed herself very partial to him ; without this he preferred rather to pay and go without doing anything. In his dreams he exhibited himself to young, voluptuous women. The medico-legal opinion recognised the hereditary psychopathic character of the culprit, and the perverse, impulsive desire to perform the incriminating acts ; and pointed out, further, the remarkable fact that in B., who was otherwise sober and saving, the impulses to indulge in alcohol depended on abnormal conditions that recurred periodically, and forced him to indulge. That, during his attacks, B. was in an exceptional psychical state, in a kind of mental confusion, and absolutely absorbed in his perverse sexual fancy, is clearly shown by the species facti. Thus is explained the fact that he became aware of the approach of the police only when it was too late to try to escape. In this hereditary and degenerate impulsive exhibitionism, it is interesting to note how the perverse sexual impulse is awakened from its latency by the in- fluence of alcohol. OFFENCE AGAINST MORALITY. 495 The foregoing cases seem to justify the assumption oi a psycho-pathological meaning of "exhibition" in the sense of sexual demonstration. Dr. Hoche, however, counsels caution, quoting the following case observed by himself and Prof. Furstner, which was by the experts and the court not considered to be of psychopathic import. Case 176. Dr. X. has for several years scared the women of Strassburg by exposing before them his genitalia mcda. He would walk about in a long cloak and when meeting ladies throw it back either under a street lamp or igniting a red-fire match, and thus exhibit himself. At other times he would early in the morning ring the bells of houses and exhibit himself before the servants who came to open the door or looked out of the window. The result of psychiatric examination was : hereditary taint was estabhshed but faint. From childhood strong sexual instinct (onanism, later on normal sexual excesses up to the present). Excuse : " irresistible impulse," but never loss of the consciousness of infamous and criminal behaviour. Epilepsy and mental disturbance in the narrower sense of the word to be excluded. X. is of an effeminate, weak nature, but not an imbecile. The clinical observation offered, according to the pro- secution, no ground for the claim of irresponsibility (§ 51 " Deutsch. Stgb."). Sentence : one year's imprisonment. During confinement no abnormal " impulses ". Marriage after release (Dr. Hoche, "Neurolog. Centralblatt," 1896, 2). The report of this case is too aphoristic to allow of the admission of Dr. Hoche's contention. The impartial observer will gain the impression that the subject was affected, even though "moderately yet directly, with hereditary taint," and in consequence was a person of abnormal psychical individuality, to whom the benefit of " extenuating circumstances " should have been extended. 496 PSYCHOPATHIA SEXUALIS. One year's imprisonment was much too severe a punish- ment, and by no means an adequate protection for the public against X. A forensically important variety of exhibition, which, chnically speaking, rests for certain upon a similar neu- rotic and degenerate foundation, and which expresses itself in a peculiar act, conditioned by violent libido (hypercBsthesia sexualis), associated with diminished virility, is made up of the so-called frottcurs. The three following cases, borrowed from Magnan {op. cit.), are typical : — Case 177. C, age forty-four; hereditarily predis- posed ; drinker, and suffering with lead poisoning. Until the last year he had masturbated much, and often drawn pornographic pictures and shown them to his acquaint- ances. He had repeatedly dressed himself as a woman in secret. For two years, since becoming impotent, he had felt desire, while in crowds at dusk, mentulam denudare eamque ad nates mulieris crassissime terere. Once, when discovered in the act, he had been sentenced to imprisonment for four months. His wife kept a milk-shop. Iterum iterumque sibi temperare non potuit quin genitalia in ollam lacte com- pletam mergeret. In the act he felt lustful pleasure, " as if touched with velvet ". He was cynical enougli to use this milk for himself and the customers. During im- prisonment alcoholic persecutory insanity developed in him. Case 178. M., age thirty-one; married six years; father of four children ; badly predisposed ; subject to melancholia at times. Three years before, he was dis- covered by his wife with a silk dress on, masturbating. One day he was discovered, in a shop, in the act oi /rot- OFFENCE AGAINST MORALITY. 497 tage on a lady. He was very repentant, and asked to be severely punished for his irresistible impulse. Case 1 79. G., age thirty-three ; badly predisposed hereditarily. At an omnibus station he was discovered in the act of frottage with his penis on a lady. Deep repentance ; but he stated that at the sight of a noticeable jjosteriora of a lady, he was irresistibly impelled to practise frottage, and that he became confused and knew not what he did. Sent to an asylum. Case 180. Afrotteur. Z., born in 1850; of blame- less life previously ; of good family ; private official. He is well to do financially ; untainted. After a short married life he became a widower, in 1873. For some time he had attracted attention in churches, because he crowded up behind women, both old and young indifferently, and toyed with their " bustles ". He was watched, and one day he was arrested in the act. Z. was terribly frightened, and in despair about his situation ; and, in making a full confession, he begged for pardon, for nothing but suicide remained for him. For two years he had been subject to the unhappy impulse to go in crowds of people — in churches, at box- offices of theatres, etc. — and press up behind females and manipulate the prominent portion of their dresses, thus producing orgasm and ejaculation. Z. states that he was never given to masturbation, and had never been in any way perverse sexually. Since the early death of his wife, he had gratified his great sexual desire in temporary love-affairs, having always had an aversion for prostitutes and brothels. The impulse to frottage had suddenly seized him, two years ago, while he happened to be in church. Though he was conscious that it was wrong, he could not help yielding to it immediately. Since then he had been excitable to the posteriora of females, and had been actually impelled to 32 498 PSYCHOPATHIA SEXUALIS. seek opportunity for frottage. The only thing on women that excited him was the " bustle " ; every other part of the body and attire was a matter of indifference to him ; neither did he mind whether the woman was old or young, beautiful or ugly. Since this began, he had had no more inclination for natural gratification. Of late frottage scenes had appeared in his dreams. During his acts he was fully conscious of his situation and the act, and tried to perform it in such a way as to attract as little attention as possible. After his act he was always ashamed of what he had done. The medical examination revealed no sign of mental disease or mental weakness, but symptoms of neuras- thenia sexualis — ex ahstinentia libidinosi (?) — which was also proved by the circumstance that even the mere touch of the fetich with the unexposed genitals sufficed to in- duce ejaculation. Apparently Z., weakened sexually and distrusting his virility, and yet libidinous, had come to practise frottage by having the sight of posteriora femma fall together accidentally with sexual excitement; and this associative combination of a perception with a feeling per- mitted the former to attain the significance of a fetich. Whether these frotteurs (if considered as men who in consequence of disturbed virility have become either temporarily or permanently hypersexually degenerated) should come under the category of exhibitionists, or should be classified with the fetichists, as Gamier does (" Les fetichistes," p. 73), can hardly be decided on account of the limited number of cases thus far observed. The point whether denudatio genitalium takes place or not, cannot affect this decision, for it may depend in the frotteur on the intensity of the orgasm which may lead even to lustful ecstasy, or also from external circumstances favourable to this loathsome impulse. The very fact that up till now in pathological fetichism the fetich has never had reference to partes gcnitnhs or the surrounding parts OFFENCE AGAINST MORALITY. 499 seems to upset Gamier's theory as to fetichism of nates femina (cf. p. 209). The simplest explanation seems to be that " frottage " is a masturbatorial act of a hypersexual individual who is uncertain about his viriHty in corpore femince. This would also explain the motive of the assault being made not ad anteriora but ad posteriora {cf. case 177). That fetichism may be involved seems to follow from case 178 which clearly proves silk-fetichism. Very hkely the lady in question wore a silk gown, and the indecent attack was directed upon the dress, not the nates. In case 180 the act is evidently quahfied by the " bustle " and not by the particular part of the body. As an act which offends public morals, and which is, therefore, punishable, the violation of statues — a whole series of cases of which Moreau {op. cit.) has collected from ancient and modern times — may be enumerated here. They are, unfortunately, given too much hke anecdotes to allow satisfactory judgment of them. They always give the impression of being pathological — hke the story of a young man (related by Lucianus and St. Clemens, of Alexandria) who made use of a Venus of Praxiteles for the gratification of his lust ; and the case of Clisyphus, who violated the statue of a goddess in the Temple of Samos, after having placed a piece of meat on a certain part. In modern times, the " Journal L'evenement " of 4th March, 1877, relates the story of a gardener who fell in love with a statue of the Venus of Milo, and was discovered attempting coitus with it. At any rate, these cases stand in etiological relation with abnormally intense libido and defective virility or courage, or lack of oppor- tunity for normal sexual gratification. The same thing must be assumed in the case of the so-called "voyeurs''^ — i.e., men who are so cynical that 1 Dr. Moll calls this perversion (?) mixoscopia (from fn^is, cohabit- ation ; and (TKiirTnv, to look). His assumption that it is related to maso- chism, in that there is a stimulus for the voyeur in sufTcring at seeing a, 600 PSYCHOPATHIA SEXUALIS. they seek to get sight of coitus, in order to assist their virility ; or who seek to have orgasm and ejaculation at the sight of an excited woman. Concerning this moral aberration, which, for various reasons, cannot be further described here, it will suffice to refer to Coffigiwns book, "La Corruption a Paris". The revelations, in the domain of sexual perversity, and also perversion, which this book makes, are horrible. 2. Rape and Lust-Murder. (Austrian Statutes, §§ 125, 127; Austrian Abridgment, § 192; German Statutes, § 177.) By the term rape, the jurist understands coitus, out- side of the marriage relation, with an adult, enforced by means of threats or violence ; or with an adult in a condi- tion of defencelessness or unconsciousness ; or with a girl under the age of fourteen years. Immissio penis, or, at least, conjunctio memhrorum (Schiltze) is necessary to estab- lish the fact. To-day, rape on children is remarkably frequent. Hofmann (" Ger. Med.," i., p. 155) and Tardieu ("Attentats") report horrible cases. The latter establishes the fact that, from 1851 to 1875 inclusive, 22,017 cases of rape came before the courts in France, and of these 17,657 were committed on children. The crime of rape presumes a temporary, powerful excitation of sexual desire, induced by excess in alcohol or by some other condition. It is highly improbable that a man morally intact would commit this most brutal crime. Lombroso {Goltdammcr s " Arch.") considers the majority of men who commit rape to be degenerate, par- ticularly when the crime is done on children or old women. He asserts that, in many such men, he has found actual signs of degeneracy. It is a fact that rape is very often the act of degenerate woman in the possession of another, does not seem to me to be justified. For further details, vide Moll " Die contriire Sexualempfindung," p. 137. EAPE AND LUST-MURDER. 501 male imbeciles/ who, under some circumstances, do not even respect the bond of blood. Cases as a result of mania, satyriasis and epilepsy- have occurred, and are to be kept in mind. The crime of rape may be followed by the murder of the victim.^ There may be unintentional murder, murder to destroy the only witness of the crime, or murder out of lust (v. supra). Only for cases of the latter kind should the term lust-murder ^ be used. The motives of lust-murder have been previously con- sidered. The cases given in illustration are characteristic of the manner of the deed. The presumption of a murder out of lust is always given when injuries of the genitals are found, the character and extent of which are such as could not be explained by merely a brutal attempt at coitus ; and, still more, when the body has been opened, or parts (intestines, genitals) torn out and are wanting.* Lust-murders dependent upon psychopathic conditions are never committed with accompHces. Case 181. Weak-mindedness ; epilepsy; attempt at rape ; murder. On the evening of 27th May, 1888, a boy eight years old, Blasius, was playing with other children in the neighbourhood of the village of S. An unknown man came along and enticed the boy into the woods. The next day the boy's body was found in a ravine, with the abdomen slit open, an incised wound in the cardiac region and two stab-wounds in the neck. Since, on 21st May, a man answering to the descrip- tion given of the murderer of the boy had attempted to treat a six-year-old girl in a similar manner, and had only accidentally been prevented, it was presumed to be a case of lust-murder. 1 "AnnaL medico-paychol.," 1849, p. 515; 1863, p. 57; 18G4, p. 215 1866, p. 253. 2 Cf. the cases of Tardieu, "Attentats," pp. 182-92. ^ Cf. Holtzendorff, " Psychologie des Mords ". * Tardieu, "Attentats," case 51, p. 188. 502 PSTCHOPATHIA SEXUALIS. It was proved that the body was found in a heap, with only the shirt and jacket on ; also that there was a long incision in the scrotum. Suspicion fell upon a farm-hand, E. ; but, on con- frontation with the children, it was not possible to identify him with the stranger who had enticed the boy into the woods. Besides, with the help of his sister, he proved an alibi. The untiring efforts of the officers brought new evi- dence to light, and finally E. confessed. He had enticed the girl into the woods, throvTn her down, exposed her genitals, and was about to abuse her ; but, as she had an eruption on her head and was crying loudly, his desire cooled, and he fled. After he had enticed the boy into the woods, under the pretext of showing him a bird's nest, he was taken with a desire to abuse him. Since the boy refused to take off his trousers, he did it for him ; and when the boy began to cry out he stabbed him twice in the neck. Then he made an incision, just above the pubes, in imitation of female genitals, in order to use it to satisfy his lust. But, since the body grew cold immediately, he lost his desire, and, cleaning his knife and hands near the body, he fled. When he saw the boy dead, he was filled with fear, and his member became flaccid. During his examination E. toyed apathetically with a rosary. He had acted in a state of mental weakness. He could not understand how he came to do such a thing. He must have been beside himself ; for he often became so weak in his head that he would almost fall down. Previous employers report that he had periods when he was confused and stubborn, doing no work all day, and avoiding others. His father states that E. learned with difficulty, was unskilful at work, and often so obstinate that one did not dare to punish him. At such times he would not eat, and occasionally ran away and remained from home for RAPE AND LUST-MUEDER. 503 days. At such times he also seemed quite lost in thought, screwed his face up, and said senseless things. When a youth, he still sometimes wetted the bed, and often came home from school with wet or soiled clothing. He was very restless in sleep, so that no one could sleep beside him. He had never had playmates. He had never been cruel, bad, or immoral. His mother gave similar testimony ; and further, that, in his fifth year, E. had convulsions for the first time, and once lost the power of speech for seven days. Some- time about his seventh year he once had convulsions for forty days, and was also dropsical. Later, too, he was often seized in sleep, and he often then talked in his sleep ; and mornings, after such nights, the bed was found wet through. At times it was impossible to do anything with him. Since his mother did not know whether it was due to viciousness or disease, she did not venture to punish him. Since the convulsions in his seventh year, he had failed so in mind that he could not learn even the common prayers ; and he also became very irascible. Neighbours, persons prominent in the community, and teachers state that E. was peculiar, weak-minded, and irascible ; that at times he was very strange, and ap- parently in an exceptional mental state. The examinations of the medical experts gave the following results : — E. is tall, slim, and poorly nourished. His head measures 53 centimetres in circumference. The cranium is rhombic, and in the occipital region flattened. His expression is devoid of intelHgence ; his glance is fixed, expressionless ; his attitude is careless, and his body is bent forward. Movements are slow and heavy. Genitals normally developed. E.'s whole appearance points to torpidity and mental weakness. There are no signs of degenerative marks, no ab- normaHty of the vegetative organs, and no disturbances of 504 PSTCHOPATHIA SEXUALIS. motility or sensibility. He comes of a perfectly healthy family. He knows nothing of convulsions or of wetting his bed at night, but he states that, of late years, he has had attacks of vertigo and loss of mind. At first, he denies the murder point blank. Later, in great contrition, before the examining judge, he confessed all, and gave a clear motive for his crime. He had never had such a thought before. He has been given to onanism for years; he even practised it twice daily. He states that, for want of courage, he had never ventured to ask coitus of a woman, though in dreams such scenes exclusively passed before him. Neither in dreams nor in the waking state had he ever had perverse instincts ; particularly no sadistic or antipathic sexual feelings. The sight of the slaughter of animals had never interested him. When he enticed the girl into the woods, his desire, of course, was to satisfy his lust with her ; but how it happened that he tried such a thing with a boy, he could not explain. He thought he must have been out of his mind at that time. The night after the murder he could not sleep on account of fear ; he had twice confessed already, to ease his con- science. He was only afraid of being hanged. This should not be done, as he had done the deed in a weak-minded condition. He could not tell why he had cut open the boy's abdomen. It had not occurred to him to grope among the intestines, smell them, etc. He stated that, after the attempt on the girl in the day time, and in the night, after the murder of the boy, he had convulsions. At the time of his crime he was indeed conscious, but he had given no thought to what he was doing. He suffered much with headache ; could not endure heat, thirst, or alcohol ; there were times when he was perfectly confused. The test of his intelligence showed a high grade of weak-mindedness. The opinion (Dr. Kautznar, of Graz) showed the im- RAPE AND LUST-MURDER. 505 becility and neurosis of the accused, and made it probable that his crime, for which he had only a general recollec- tion, had been committed in an exceptional (pre-epileptic) mental state, qualified by the neurosis. Under all circum- stances, E. was considered dangerous, and probably would require commitment to an asylum for life. Case 182.^ Eape on a little girl by an idiot. Death of the victim. On the evening of the 3rd of September, 1889, Anna, aged ten years, daughter of a labourer, went to the village church, distant about two miles, but did not return. The following day her body was found about fifty paces from the main road, in a copse, The face was turned to the ground ; the mouth was gagged with moss ; signs of a criminal assault about the anus. Suspicion fell upon a young labourer, K., nineteen years of age, because he had on the 1st of September attempted to entice the child in the wood when she was returning from church. K. was arrested. At first he denied the deed ; but afterwards made a complete confession. He had strangled the child, and when she stopped kicking and resisting, actum sodomiticum in ana infantis perpetravit. During the prehminary examination no one had raised the question as to the mental condition of this monster ; in consequence, when shortly before the trial counsel defending him asked for an examination of the mental condition of his client, his request was refused on the ground "that the previous proceedings contained nothing which could warrant the plea of insanity ". By accident, counsel for the defence succeeded in establishing the fact that the great grandfather and the paternal aunt of the accused had been insane ; that the father was an inveterate alcohoHst since earliest youth 1 Cf. the complete medico-legal opinion on this case reported in "Friedreich's Blatter," 1891, Heft 6. 506 PSYCHOPATHIA SEXUALIS. and a cripple on one side of the body. These facts were verified during the trial. But it made no impression. The defence finally pre- vailed upon the medical adviser of the court to suggest that K. be sent for observation to an insane asylum for a period of six weeks. The opinion of the physician at the institute estab- lished K.'s idiocy, thus rendering him irresponsible for his deed. He appeared insipid, stolid, apathetic ; had forgotten nearly all he had ever learned at school ; neither by voice or mien he betrayed the slightest emotions of compassion, contrition, shame, hope, or fear of the future. His face was immovable as a mask. Head quite abnormal ; bullet-shaped. Proof that the brain was diseased already during the foetal period or during the earhest years of development. Upon this report K. was permanently interned at the asylum. Through the indefatigable efforts of a brave lawyer the court was saved from committing a judiciary murder, and the honour of society was sustained. Case 1 83. Lust-murder ; moral imbecility. A man of middle age ; born in Algeria ; said to be of Arabic descent. Had served for several years in the colonial troops ; had then shipped as a sailor between Algeria and Brazil, and later on, in the hope of finding hghter emi)loyment, had gone to North America. He was known among his acquaintances as being lazy, cowardly and brutal. Several times he had been sentenced for vagrancy; it was said that he was a thief of the lowest kind ; that he knocked about with women of the lowest class, and made common cause with them. His perverse sexual relations and acts were also well known. On several occasions he had bitten and beaten women with whom he sexually conversed. According to the description given of him, TOETUEE OF ANIMALS DEPENDENT ON SADISM. 507 the authorities thought they had secured a certain un- known party who had scared at night the women in the streets by embracing and kissing them, and had the nick- name of "Jack the Kisser ". He was a tall man (over six feet), slightly bent for- ward. Low forehead, very prominent cheek bones, massive jawbones ; small, narrow, inflamed eyes, piercing look ; big feet, hands hke birds' claws ; shambling gait. His arms and hands were tattooed all over. Eemarkable was the picture of a woman in colours, around which the name " Fatima " was inscribed, because tattooing the female form upon the body is considered to be disgraceful among the Arabs of the Algerian army ; and prostitutes generally have a cross tattooed in their skin. His general appearance gave the impression of a low grade of intelli- gence. N. was convicted of the murder of an elderly female with whom he had spent the night. The corpse bore various wounds, some remarkable for their length ; the abdomen was ripped open, pieces of the intestines were cut out, so was one of the ovaries ; other parts were strewn around about the corpse. Several of the wounds were hke crosses ; one was in the shape of a crescent. The murderer had strangled his victim. He denied the deed, and every inclination to commit such an act (Dr. MacDonald, Clark University, Mass.). 3. Bodily Injury, Injury to Property, Torture of Animals Dependent on Sadism. (Austrian, §§ 152, 411 ; German, § 223 [bodily injury]. Austrian, §§ 85, 468 ; German, § 303 [injury to property]. Austrian Police Eegula- tions ; German Statutes, § 360 [torture of animals].) Aside from lust-murder, described in the forecroingf section, as milder expressions of sadistic desires, impulses to stab, flagellate or defile females, to flagellate boys, to maltreat animals, etc., also occur. 508 PSYCHOPATHIA SEXUALIS. The deep degenerative significance of such cases is clearly demonstrated by the series of examples given under " General Pathology ". Such mentally degenerate indi- viduals, should they be unable to control their perverse impulses, could only be objects of care in asylums. Case 184. X , aged twenty-four. Parents healthy ; two brothers died of tuberculosis ; one sister suffers from periodical convulsions. X. at the age of eight experienced a sensation of lust with erection when he pressed his abdomen against the school-desk. He often indulged in this pleasure. Later on mutual masturbation with a school-fellow. First ejaculation at the age of thirteen. Felt impotent in the first attempt at coitus at eighteen. Continued auto-masturbation, heavy neurasthenia consequent upon the reading of a popular book graphically describing the sinister effects of onanism. Improvement by hydropathic treatment. Upon a renewed attempt at coitus again impotent. Recourse to mastur- bation. This fails as time goes on, X. now resorts to swinging around in the air living fowls by their bills. The sight of torture in the animal produces erection. As soon as the fowl's wing touches in transit X.'s glans penis ejaculation takes place, accompanied by intense feelings of lust (Dr. Wachholz, " Friedreicli s Blatter f. ger. Med.," 1892, Heft 6, p. 336). Case 185. Sadism on boys and girls committed by a moral idiot. K., fourteen years and five months old ; killed a small boy in a cruel manner. The trial developed the following details : Two cases of murder ; a long series of cases (seven) in which K. had cruelly tortured little boys. All these children ranged in age from seven to ten years. K. would lure them into a hidden place, strip them naked, bind them hand and foot, tie them against some object, gag the moilth with a handkerchief and then beat them TOKTURE OF ANIMALS DEPENDENT ON SADISM. 509 with a stick, a strap or a piece of rope, slowly, pausing for minutes — grinning all the time without uttering a word. One of the boys he forced under threat of death to repeat the Lord's Prayer twice, to promise under oath secrecy and to repeat curse words and oaths after him. In another instance he pricked the boy's cheeks with a needle, played with his genitals, and stabbed him in the XDubic region ; he then ordered him to he on his stomach when he would jump on his back dancing all over the body ; finally he stabbed him in the nates and dug his teeth into them. Another boy he bit in the nose and stabbed him with a knife. The eighth victim, a httle girl, he enticed into his mother's shop, fell upon her from behind, and clapping one hand over her mouth cut her throat with the other. The body was found in a dark corner covered over with ashes and manure. The head was severed from the body, the flesh cut away from the bones, the whole body covered with cuts and wounds. The largest cut was on the inner side of the left thigh penetrating through the genitals into the abdomen. Another cut extended from the fossa iliaca obliquely across the abdomen. The clothes and linen were torn and cut into shreds. The corpse of the ninth victim was found with the throat cut across, blood was flowing from the eyes, the heart was pierced by innumerable stabs. A number of thrusts were found in the abdomen. The scrotum was ripped open, the testicles were hanging out, and the glans penis was cut off. K. had first lured the boy to him as he had done the little girl, cut his throat and then stabbed him all over. K, whose hereditary conditions are not known, had been suffering from a severe illness during the whole of his first year's existence, and thus had become very much emaciated. He began to recover, and it is claimed that since then he was not afflicted with bad health, exceptin<:^ frequent complaints about pain in the head and eyes and 510 PSYCHOPATHIA SEXUALIS. vertigo, until he was eleven, when he went through a " severe illness " which made him delirious. Headaches would suddenly seize him, so that he would run away from play, and return only after a considerable interval. When asked on such occasions about his conduct, he would slowly answer, " My head, my head ". He was intractable, disobedient and beyond control. Showed sudden, and extreme moods, desires and opinions. When three years old he was one day seen to torture a chicken with a knife. He lied with every appearance of truth. At school he was a disturbing element, making faces, constantly talking to himself ; was obstinate and dis- respectful. Punishment to him is injustice ; he is renitent. In the house of correction he is secluded, preoccupied with himself, suspicious, disliked by his comrades — in fact, without any chum. His intellectual powers are good ; he possesses sagacity, reason and a good memory. He shows great defect in the ethical direction. He betrays not the slightest signs of sorrow or penitence for his deeds, or the least consciousness of his responsibility. Only for his mother he seems to have a sort of tender feeling. He can assign no object for his actions. He calmly discusses his chances : " they cannot condemn him to death because he is only fourteen years of age ; hereto- fore they have not been wont to hang boys of his age, and surely they would not make a beginning with him ". What motive he had in his deeds cannot be ascertained from him. Once he said that reading a description of the tortures visited upon their victims by the Ked Indians had tempted him to imitate them. He had even once thought of running away from home to join the Indians. Whenever he espied a victim his imagination would be filled with pictures of cruel actions. On the morning of such days he would always wake up with vertigo and pressure in the head, which condition would last all day. As physical anomalies only an exceptionally large penis TORTURE OF ANIMALS DEPENDENT ON SADISM. 511 and very big testicles are mentioned. Mons veneris com- pletely and thickly covered with hair ; in fact the genitals were fully developed like those of an adult. No symptoms of epilepsy (Dr. MacDonald, Clark University, Mass.). Case 186. Sadism; bodily injury. B., seventeen years of age, tinsmith, bought on the 4th January, 1893, a long knife ; went to a prostitute, had repeatedly sexual intercourse with her, gave her money, and made her sit undressed on the edge of the bed. He now stabbed her shghtly three times in the chest and abdomen whilst his mcmbrum was erected. When the girl began to yell and people came to her assistance B. fled, but immediately gave himself up to the pohce. At first he said he had stabbed the girl in a quarrel, but afterwards stated he had had no motive for his deed. Several blood relations of his father had been insane. B. is not tainted, not a drunkard, has not gone through any severe illness, never masturbated, but had practised coitus for two years. Genitals normal. Seems, under observation, mentally normal ; is ashamed of his action, to which the experts properly ascribed a sexual motive. In spite of definite proof of mental sanity, he was released {Coutagne, "Annal. med. psych.," 1893, July, Aug.). Case 187. Acts of violence emanating from sadism. M., sixty years of age, owner of several millions, happily married, father of two daughters, one eighteen, the other sixteen years of age, is convicted of seduction of minors and acts of violence on females. He was accustomed to go to the house of a procuress, where he was known as Vhomme qui pique, and there, lying upon a sofa in a pink silk dressing-gown lavishly trimmed with lace, would await his victims — puellas tres nudas. They had to approach him in single file, in silence and smiling. They gave him needles, cambric handkerchiefs and a whip. Kneehng before one of the girls, he would now stick 512 PSYCHOPATHIA SEXUALIS. about a hundred needles in her body, and fasten with twenty needles a handkerchief upon her bosom ; this he would suddenly tear away, whip the girl, tear the hair from her 7nons veneris and squeeze her mammcB, etc., whilst the other two girls would wipe the perspiration from his forehead and strike lascivious plastic attitudes. Now excited to the highest pitch, he would have coitus with his victim. Later on, for the sake of economy, he was satisfied to perform his brutality with one girl alone. This girl fell in consequence into a severe illness, and in her distress asked him for help. He reported this " extor- tion " to the police, who on their part made inquiries, and brought a charge against him. At first he denied the facts, but convicted, expressed his surprise that such a fuss should be made about a mere trifle. M. was described as a man of repulsive appearance, with receding forehead. He was sentenced to six months' imprisonment, a fine of 200 francs, and 1000 francs damages to his victim (" Journal Gil Bias," Aug. 14 and 16, 1891). A less revolting case, that of a young man, is related by Fcrrioni, "Archivio delle psicopatie sessuaH," i., p. 106, 1896. This young sadist would first wrestle with the girl in order to bring about virility and would, inter actum, bite and pinch her in order to produce satisfaction. But one daj^ he bit the girl so hard that she brought an action against him. Case 188. Murder through sadism. Married man, at the time of this crime thirty years of age. He had lured a girl to the bell tower of the church of which he was the sexton and there killed her. Circumstantial evidence forcing him to admit the deed, he confessed to another similar murder. Both corpses showed numerous contu- sions about the fleshy parts of the head, fractures of the skull, extravasations under the dura mater and in the brain. No other bodily injuries were found ; the genital organs were intact. MASOCHISM AND SEXUAL BONDAGE. 513 Spermal stains were found on the underwear of the criminal, who was arrested soon after the deed was committed. L. was described as of pleasing appearance, of dark complexion, beardless. No details about his hereditary relations, antecedents, vita sexioalis ante acta, etc. His motive according to his own admission was " lust of the cruellest and most abominable kind " (Dr. MacDonald, Clark University, Mass.). 4. Masochism and Sexual Bondage. Masochism ^ may under certain circumstances attain forensic importance, for modern criminal law no longer recognises the principle volenti non fit injuria, and the present Austrian statute in § 4 says expressly : " Crimes may also be committed on persons who demand their commission on themselves ". Psychologically speaking, the facts of sexual bondage are of greater criminal importance (c/. p. 193). If sensuality is predominant, or in other words, if a man is held in fetich-thraldom and his moral power of resistance is but weak, he may by an avaricious or vindictive woman into whose bondage his passion has led him be goaded on to the very worst crimes. The follow- ing case is a striking instance : — 1 As Ilcrbst (" Handb. d. osterr. Strafrcchts, Wien," 1878, p. 72) remarks, there are, nevertheless, crimes conditioned by the absence of assent on the part of the injured individual, which cease to be such as soon as the injured individual has given consent — e.g., theft, rape. But Herbst also enumerates here the limitation of personal freedom (?). Of late a decided change of views on this point has taken place. The German criminal law regards the consent of a man to his own death of such importance that a very different and much milder punishment is inflicted under such circumstances (§ 216) ; and it is the same in Austrian law (Austrian Abridgment, § 222). The so-called double suicide of lovers was the act considered. In bodily injury and deprivation of freedom, the consent of the victim must also receive consideration at the hands of the judge. Certainly a knowledge of masochism is of importance in making a judgment of the probability of asserted consent. 33 514 PSYCHOPATHIA SEXUALIS. Case 189. Murder of a family through sexual bondage. N., soap manufacturer in Catania ; thirty-four years of age ; previously of good character ; stabbed his wife in her sleep to death on the 21st of December, 1886, and strangled his two daughters, one seven years and the other six weeks old. At first he denied the deed, tried to throw suspicion upon others, but finally confessed to all the details and begged to be hanged. N. came of a sound family, was healthy himself, a good business man and highly respected ; married well, but for several years was under the fascinating influence of a mistress who had captivated and completely controlled him. He had kept this matter a secret from the world and his wife. By playing on his jealousy and declaring that by marriage alone he could for the future possess her, this monster of a woman had brought the weak and infatuated N. to become the murderer of his wife and children. After the deed he had induced his young nephew to fetter him as if he himself were the victim of the villains and under the threat of death commanded him to silence. When the neighbours came in he played the role of the unhappy, maltreated father. After a full confession he showed the deepest contri- tion. During the two years of the subsequent trial, N. never showed signs of mental derangement. His mad love for the mistress he could only explain as an infatuation. He never had cause to find fault with his wife. There were no traces of abnormal or perverse sexual instinct in this exceptional criminal. His sorrow and contrition over the deed gave sufficient proof that no moral defect was present. His mental condition was declared to be sound. Exclusion of irresistible impulse {Madalari, " II morgagni," 1890, Feb.). Case 190. Sexual bondage in a lady. Mrs. X., thirty-six years of age; mother of four MASOCHISM AND SEXUAL BONDAGE. 515 children. Comes from a neuropathic and heavily-tainted mother. Father psychopathic. She began to masturbate at the age of five, had an attack of melancholia at the age of ten, during which period she was troubled with the delusion that she could not go to heaven on account of her sins. This made her nervous, excitable, emotional, neurasthenic. At the age of seventeen she fell in love with a man who was denied her by her parents. She now showed symptoms of hysteria. When twenty-one she married a man by many years her senior who had but little sexual appetite. Her conjugal relations with him never satisfied her ; coitus produced severe ercthlsmus genitalis which she could not satisfy with masturbation. She suffered tortures from this libido insatiata, yielded more and more to onanism, became heavily hystero- neurasthenic, capricious and quarrelsome, so that marital relations grew ever colder. After nine years of mental and physical anguish, Mrs. X. succumbed to the blandishments of another man in whose arms she found that gratification for which she had so long languished. But now she was tormented with the consciousness of having broken her marriage vow, often feared she would become insane, and only the love for her children prevented her from committing suicide. She scarcely dared to appear before her husband whom she highly esteemed on account of his noble character, and felt dreadful qualms of conscience because she had to conceal the awful secret from him. Although she found full gratification and immense sensual pleasure in the arms of the other man, she had repeatedly made attempts to give up this liaison. Her efforts were in vain. She got deeper and deeper into the bondage of this man, who recognising and abusing his power had merely to dissemble as if he would leave her in order to possess her without restraint. He abused this bondage of the miserable woman only to gratify his sexual 516 PSYCHOPATHIA SEXUALIS. appetite, gradually even in a perverse manner. She was unable to refuse him any demand. When Mrs. X. in her despair came to me for pro- fessional advice she declared that she could no longer continue such a life of misery and anguish. An insuper- able lihido, disgusting to herself, drevi^ her to this man, whom she could not love but as little do without, whilst on the other hand she was constantly tormented with the danger of discovery, and with self-reproach on account of her offence against the law of God and man. The greatest mental pain was caused by the thought of losing her paramour, who often threatened to leave her if she did not yield to his wishes, and who controlled her so thoroughly that she would do anything and everything at his bidding. The soundness of mind in the horrible case 189 and in many other analogous cases cannot be called in question. As matters stand now-a-days when the public cannot comprehend the more refined analysis ' of the motives in a tragedy and when the law profession eschews psychology in favour of logical formahsm, it can hardly be expected that judge and jury will regard the weight of sex^iol bo7idage — especially as in this condition the incentive to the crime is not a morbid one and the intensity of the incentive itself cannot be dealt with. Nevertheless in such cases it behoves to consider whether the accused was possibly still susceptible to counter-motives or whether these were excluded from an effective presence. If the latter be the case it would be equivalent to a disturbance of the psychical equilibrium. No doubt in these cases a sort of acquired moral weak- ness is produced which impairs the soundness of mind. Sexual bondage should certainly constitute a cause for leniency in crimes committed through its agency. ROBBERY AND THEFT DEPENDENT ON FETICHISM. 517 5. Bodily Injury, Robbery and Theft Dependent on Fetichism. (Austrian, § 190; German, § 249 [robbery]. Austrian, §§ 171, 460; German, § 242 [theft].) It is seen from the section on fetichism, under " Gen- eral Pathology," that pathological fetichism may become the cause of crimes. There are now recognised, as such, hair-despoiling (cases 81, 82, 83) ; robbery or theft of female linen, handkercliiefs, aprons (cases 86, 87, 91, 93) ; shoes (cases 66, 93, 94), and silks (case 99). It cannot be doubted that such individuals are the subjects of deep mental taint. But, for the assumption of an absence of mental freedom and consequent irresponsibility, it must be proved that there w&s an irresistible impulse, which, either owing to the strength of the impulse itself or to the existence of mental weakness, rendered control of the criminal perverse impelling force impossible. Such crimes and the peculiar manner in which they are carried out — whereby they differ very much from common robbery and theft — always demand a medico- legal examination. But that the act per sc docs not by any means necessarily arise from psycho -pathological conditions is shown by the infrequent cases of hair- despoiling^ simply for the purpose of gain. Case 191. Handkerchief -fetichisin ; repeated thefts of handkerchiefs belonging to women. D., forty-two years of age, man-servant, single, was sent on 11th March, 1892, by the pohce to the district asylum of Deggendorf (Niederbayern) for observation of his mental faculties. He is 1.62 m. high, muscular and well fed. Head is submicrocephalic ; expression of face blank. The eye is 1 According to Austrian law, this crime should fall under § 411, as slight bodily injury; according to the German criminal law, it is bodily injury (c/. Liszt, p. 325). 518 PSYCHOPATHIA SEXUALIS. distinctly neuropathic. Genital organs normal. With the exception of a moderate degree of neurasthenia and increased patellar reflexes, there is nothing abnormal in D.'s nervous system. In 1878 D. received his first sentence of one and a half years' imprisonment at Straubing for stealing hand- kerchiefs. In 1880 he stole a handkerchief from a tradeswoman in the yard of an inn, and was sentenced to fourteen days. In 1882 he made an attempt in the public road to pull the handkerchief from the hand of a peasant girl. Charged with attempted robbery, he was found not guilty on the strength of medical opinion, which stated weak- ness of mind and a morbid disturbance of the mental faculties tempore delicti. In 1884 he was tried before a jury for having com- mitted, under similar circumstances, robbery of a woman's handkerchief, found guilty, and sentenced to four years' imprisonment. In 1888 he took in the public market-place a hand- kerchief from the pocket of a woman. Sentence, four months. In 1889, for a similar offence, nine months. In 1891, ditto, ten months. Otherwise his record shows only a few fines or detentions at the police station for carrying a concealed weapon (a knife) and for vagrancy. All the thefts of handkerchiefs were committed from young females, chiefly in broad daylight, in the presence of other people, and so clumsily and impudently that each time he was arrested on the spot. In the proceedings not the slightest traces of theft of other articles, never so small, can be found. On the 9th December, 1891, D. was once more released from jail. On the 14th he was caught steahng the hand- kerchief from a peasant girl in a crowd at the annual fair. He was at once arrested, and upon searching him the police found two more white handkerchiefs belonging to women. ROBBERY AND THEFT DEPENDENT ON FETICHISM. 519 On former occasions also whole collections of women's handkerchiefs had been found on his person (1880, thirty- two pieces ; 1882, fourteen, nine of which he wore next his skin ; on another occasion twenty-five. In 1891 seven white handkerchiefs were found upon him). When questioned as to the motive for stealing hand- kerchiefs, he always said that he was drunk at the time, and had taken the handkerchiefs for a joke. The handkerchiefs found upon him he claimed to have bought or swapped for something else, or he said women with whom he had relations had given them to him. Under observation D. shows weakness of mind, appears run down through vagrancy, drink and masturbation, but good-natured, obedient, and by no means afraid of work. He knows nothing of his parents, grew up without supervision ; when a child he made a living by begging ; at thirteen he was a stable-boy, and was used at fourteen by others for pederasty. He declares that at a very early period he felt the sexual instinct very strongly; began early to have coitus and to practise masturbation. When he was fifteen, a coachman had told him that great pleasure could be derived by applying the handkerchiefs of young women ad genitalia. He tried it, found it to be the case, and now sought to obtain in all manner possible such handkerchiefs. This craving became so strong that wherever he saw a pleasing young woman with a hand- kerchief in her hand or visible in her pocket violent sexual excitement would seize him, and he was impelled to make his way to this woman and take the handkerchief away from her. When sober he generally contrived to resist this impulse for fear of punishment. But when he had drink in him he could not resist. When serving in the army he had often induced young and pleasing girls to give him their handkerchiefs that had already been in use, and to exchange them for others after he had used them for a while. 520 PSYCHOPATHIA SEXUALIS. When lie slept with a girl he generally exchanged his own handkerchief for the girl's. Often he had bought handkerchiefs that he might exchange them with those used by women. New and unused handkerchiefs had no effect on him. The girl must have carried it about and used it before it excited him sexually. In order to bring unused handkerchiefs into contact with women, he would at times throw them in the road in front of a woman coming towards him, that she might step on it (this is taken from the proceedings). Once he fell upon a girl, pressed a handkerchief against her neck, and ran away. As soon as he came into possession of a handkerchief that had been touched by a woman, bet would have erection and orgasm. He would then put Iho bandker- chicf ad corpus nudum, or preferablj' ad genitalia, and thus produce a pleasurable ejaculation. He never asked such women to have coitus with him, partly because he feared a refusal, chiefly, however, be- cause he preferred the handkerchief to the girl. D. made all these confessions with great reserve, and piecemeal. Repeatedly he broke into tears and refused to say more because "he was so ashamed of himself". "I am not a thief, and have never stolen a penny's worth even when I was in dire distress. I never could have brought myself to sell one of these handkerchiefs. I am not a bad man. Only when I do these stupid things I am beside myself." Tlic favourable opinion given b}^ the authorities of the asylum attributed his misdeeds to an abnormal mental condition producing a morbid, irresistible impulse to com- mit these acts, coupled with weakness of intellect in a moderate degree. Free pardon from theft. Case 192. Violation of ladies' toilets emanating from stuff-fetichism. VIOLATION OF INDIVIDUALS UNDER AGE OF FOURTEEN. 521 X., heavily tainted (great uncle insane, father a drunkard, sister an idiot), was arrested in an office whilst pushing up against ladies, he was catting with a pair of scissors pieces of fur, velvet or cloth from their apparel. In his pockets and in his room a big lot of sucli cuttings was found. X. had shown since his tenth year a weakness for woolly and fluffy materials. Even the very sight, but especially the touch, of them would bring on orgasm and ejaculation. Fur particularly had this effect on him, and after that satin. The latter accounted for the fact that in his collection a number of cuttings of satin ribbons were found. He induced lustful emotions by placing the stolen pieces of stuff next to his skin. If ejaculation was not spontaneous he assisted with masturbation. Woman in her capacity as woman, or sexual intercourse with her, had no charm for him {Gamier, " Les Fetichistes per- vertes," p. 49, Paris, 1896). 6. Violation of Individuals Under the Age of Fourteen. (Austrian Statutes, §§ 128, 132 ; Austrian Abridgment, §§ 139, igi''^ ; German Statutes, §§ 174, 176^.) By violation of sexually immature individuals, tbe jurist undei stands all the possible immoral acts with persons under fourteen years of age that are not com- prehended in the term rape. The term violation, in the legal sense of the word, comprehends the most horrible perversions and acts, which are possible only to a man who is a slave to lust and morally weak, and, as is usually the case, lacking in sexual power. A common feature of these crimes, committed on persons that really still belong more or less to childhood, is that they are unmanly, knavish, and often silly. It is a fact that such acts, excepting pathological cases, like those of imbeciles, paretics, and senile dements, are almost 522 PSYCnOPATHIA SEXUALIS. exclusively committed by young men who lack courage or have no faith in their virility ; or by roues who have, to some extent, lost their power. It is psychologically incomprehensible that an adult of full virility and mentally sound should indulge in sexual abuses with children. The imagination of debauchees, in actively or pas- sively picturing immoral acts, is exceedingly lively ; and that the following enumeration of the sexual acts of this kind known to law exhausts all the possibilities is questionable. Most frequently the abuse consists of sexual handling (under some circumstances, flagellation,^) active manus- tupration, or seducing children to immorality by making them perform onanism on the seducer, or lustfully touch him. Less frequent acts are cunnilmgus, irrumare on boys or girls, pcBdicatio puellarum, coitus inter femora, and exhibi- tion. In a case reported by Maschka ("Handb.," iii., p. 174), a young man had naked girls, from eight to twelve years old, dance about in his room, and urinate before him, until he ejaculated. Not infrequently boys are abused by sensual women, who undertake to bring about conjunctio membrorum with them, in order to satisfy themselves by means of friction or onanism.^ Tardieu saw one of the most disgusting examples. A servant, in company with her lover, masturbated children intrusted to them, performed cunnilingus with a girl of seven and introduced carrots and potatoes into her vagina, and put similar things into the rectum of a baby of two years ! Case 193. Z., aged sixty-two ; deeply tainted, mas- turbator. He states he has never had coitus, but has 1 Cases, vide " Friedreich'' s Blatter f. ger. Anthropologie," iii., p. 77. 2 Cases, Maschka, " Handb.," iii., p. 175 ; Casper, " Vieiteljahrsschr.," 1852, Bd. i. ; TardicM, " Attentats aux moeurs ". VIOLATION OF INDIVIDUALS UNDER AGE OF FOURTEEN. 523 frequently practised fellatio. He is in an asylum, on account of paranoia. It had been his greatest pleasure to entice girls, from ten to fourteen years of age and practise cwmilingus and other vile acts with them. In these acts he had orgasm and ejaculation. Masturbation did not give him the same satisfaction, and induced ejaculation only with difficulty. Fautc de mieux he also practised /eZZaiio with men. Occasionally an exhibitionist. Phimosis. Asymmetrical cranium (Pelanda, " Arch, di Psichiatria," x., fascic. 3, 4). Case 194. X., priest, aged forty. He was accused of enticing girls, aged from ten to thirteen, undressing and fondling them lustfully, and finally masturbating. He is tainted, and has been an onanist from childhood ; morally imbecile ; always very excitable sexually. Head somewhat small. Penis unusually large ; indications of hypospadiasis {Pelanda, loc cit.). Case 195. K., aged twenty-three; labourer. He was accused and convicted of repeatedly enticing boys, and now and then girls, to an out-of-the-way place, and practising abuses with them (mutual masturbation, fellatio puerorum, fondling of the genitals of the girls). K. is an imbecile, and physically deformed, being scarcely 1"5 metres tall ; cranium rachitic and hydro- cephalic ; teeth bad — furrowed, defective, and irregular. Large hps, idiotic expression, stuttering speech, and an awkward attitude complete the picture of psychophysical degeneration. K. behaves like a child discovered in some mischievous act. Scarcely any growth of beard. Genitals well and normally developed. He has a superficial con- sciousness of having done something improper, but he is unconscious of the moral, social, and legal significance of his crimes. K. comes of a drunken father, and a mother who became insane from the abuse of her husband and died 624 PSYCHOPATHIA SEXUALIS. in an asylum. In his babyhood the boy was ahxiost blinded by corneal ulcers, and, after his sixth year, he grew up with an almoner, and later with difficulty earned his living as an organ-grinder. His brother is good for nothing, and the culprit himself was considered a surly, quarrelsome, vicious, moody, irrital)le man. The opinion emphasised the intellectual, moral and physical defect of the culprit. Unfortunately it must be admitted that the most revolting of these crimes are done by sane individuals who, by reason of overindulgence in normal sexual acts, lasciviousness and brutahty, and not seldom whilst intoxi- cated, forget that they are human beings. A great number of these cases, however, certainly depend upon pathological states. A review of the psycho-pathological cases of immorahty with children shows that the largest number may be reduced to conditions of acquired mental weakness. First of all we must mention dementia senilis ^ {Kirn, " Allg. Zeitschr. f. Psychiatrie," 39, p. 217), then chronic alcohol- ism," paralysis,^ mental debihty due to epilepsy,* injuries to the head and apoplexy,^ lues cerebri.^ Then follow the original mental defects," and states of degeneration.^ The cause for these offences may also be found in states of morbid unconsciousness. Not infrequently these outrages on morality are due 1 Cases, No. 163, IGd, 165 quoted in this book. "^ Lcppmann, "Die Sachverstandigentlaiitigkeit," p. 96; Lovihroso, " Archivio di psichiatria," viii., p. 519. * Cf. supra, page 451. * Cases 152, 153, supra ; Liman, " Zweifelhafto Geisteszustiinde," case 6. 5 Cases 145, 146, supra. ^ Case 147, supra. "> Casper's, " Klin. Novellen," p. 161, 193, 272 ; Leppmann, op. ciL, p. 115 ; Henke's, " Zeitschr.," xxiii., " Erganzungsh.," p. 147 ; cf. supra, pp. 445, etc. ; 501, etc. « Vide supra, cases 174, 193, 194 ; " Vierteljahrsschr. f. gcr. Med.," N.F. xlix., 2. VIOLATION OF INDIVIDUALS UNDEE AGE OF FOURTEEN. 525 to overindulgence in alcoholic stimulants or epilepto- psychical conditions of an exceptional character, at times also to error sexus aut persona. They may be explained on the ground of the sexual excitement concomitant with these conditions, especially in epileptic subjects.^ Eape and pederasty are of frequent occurrences under these circumstances. In the states of psychical weakness the point whether viriHty is at command decides as to the quality of the sexual act. In addition to the aforesaid categories of moral rene- gades, and those afflicted with psychico-moral weakness — be this congenital or superinduced by cerebral disease or episodical mental aberration — there are cases m which the sexually needy subject is drawn to children not in consequence of degenerated morality or psychical or physical impotence, but rather by a morbid disposition, a psycho-sexual perversion, which may at present be named pcedophilia erotica.^ In my own experience I have come across four cases only. They all refer to men. The first case is of more value than the others for it appears iuthe form of platonic love ; but it manifests its sexual character in the fact that this (paranoic) lover of children is only stimulated by little girls. He is quite callous towards the grown-up woman and, as it appears, a hair-fetichist. (In the other cases it came to libidinous acts.) Observation No. 2. represents a man tainted by here- dity. Since the time of puberty (which came very late at the age of twenty-four) sensual emotions towards little girls of five to ten years of age. The very sight of such a girl brought on ejaculation ; a touch from her absolute sexual paroxism with only a succinct recollection as to its duration. The marital act gave a slight gratification, 1 Vide sup-a, cases 149, 150, 154, 155, 156. - Cf. author's original article in Friedreich's " Blatter f. ger. Med." 1896. \ 526 PSYCHOPATHIA SEXUALIS. thus enabling him to control his desire for little girls for a time. But a heavy neurasthenia supervened (chiefly due to coitus interntptus) when he became a criminal either because his moral powers of resistance slackened, or his sexual appetite increased in volume. The third case is a man tainted by heredity and constitutionally neurasthenic ; cranium abnormal, never had a normal inclination to the adult woman ; but in coitus was like an animal at rutting time. To immorally touch little girls gave this man the highest possible plea- sure. He became paedophilic only at the age of twenty- five. My fourth case is a man, tainted, who has ever found sexual charm only in immature girls. Mature women had but little attraction for him. When impotence (e tabe ?) and dementia paralytica set in he could no longer resist the morbid impulse. The cases quoted here under the head of " pcedophilia erotica " in the sense of sexual perversion have the follow- ing traits in common :— (1) The individual afflicted is tainted. (2) The affection for immature persons of the opposite sex is of a primary nature (quite in opposition to the debauchee) ; the imaginary representations are in an ab- normal manner and very strongly indeed marked by lustful feelings. (3) The libidinous acts — if you exclude the one case in which virihty was present — consist only in immodest touches or manustupration of the victim. Nevertheless they adduce the gratification of the subject, even though ejaculation be not attained. The following cases taken from Magnan (" Lectures on Psychiatry ") show clearly that this pcedophilia erotica occurs also in women. Magnan s first case is a lady twenty-nine years of age, tainted by heredity ; has delusions and phobias. VIOLATION OF INDIVIDUALS UNDEE AGE OF FOURTEEN, 527 Since eight years strong desire for sexual union with one of her (five) nephews. First her desire is directed towards the oldest when he was five years of age. She transferred this desire to each of them in turn as they grew up. The sight of the child in question was sufficient to produce orgasm and even pollution. She was able to resist her inclination, which she cannot explain. She had no inclination for mature men. The second case is a women thirty-two years of age, mother of two children ; heavily tainted by heredity ; separated from her husband on account of brutal treat- ment. For several months she had neglected her children, had visited a friend's house every day, and always at the time when the son of the house was returnincr from school. She hugged and kissed the child, and at times said that she was in love with him and wanted to marry him. One day she told his mother that the boy was ill and unhappy. She wanted to cohabit with him in order to cure him. She was forbidden the house, but laid siege to it. One day she tried to force her way in, when she was sent to an asylum, where she continued to rave about the boy. That padophilia erotica may occur periodically is de- monstrated by Anjel's observation (vide sjipra, cases 158 and 159). In the sphere of antipathic sexual instinct this perver- sion is by no means rare. In the same measure in which the former is an equivalent of the heterosexual instinct, so in this instance the predilection for the immature is equally abnormal and exceptional. Practically speaking, acts of immorality committed on boys by men sexually inverted are of the greatest rarity. I have already laid stress upon this fact in my pamphlet " Der contrar Sexuale vor dem Strafrichter," 528 PSYCHOPATHIA SEXUALIS. second edition, p. 9. I have pointed out there that the real seducer of youth is the weak-minded man, though born sexually normal ; the roue who is impotent or at least sexually perverted and morally depraved ; the senile man who is morally enfeebled but sexually excited. Under such accidental conditions, the sexually in- verted individual may also eventually become a danger to boys (c/. case 106 of the present and 109 of the ninth edition of this book) ; but this has nothing to do with padophilia, for the very reason that in these cases the boys were puhertati proximi, whilst in cases of genuine pcEclophilia the subject is drawn only to the sexually quite immature. The second case of Macjnan seems to be the most instructive in this regard, for in it the desire turned in each instance from the older boy to the younger one as he grew to the age of three to five years. The following case, reported by Pacotte and Raynaud ("Archives d'Anthropologie criminelle," x., p. 435), may be looked upon as a proof that pcedophilia erotica may also occur in cases of antipathic sexuality. Case 196. X., thirty-six years of age, journalist; heavily tainted by heredity ; ethically and intellectually defective; since early youth afflicted with epileptoid spells; intolerant of alcohol ; face asymmetrical ; never cared for woman ; masturbated since he was eighteen ; attempts at coitus found him cold and impotent. But boys of ten to fifteen years of age excited him very much. Although he was conscious of the criminality of the act, he could not resist the impulse to poBdicate with them. Oftentimes he was sated with their "enchant- ing looks and their sweet smiles ". Neither the adult nor little girls possessed any charms for him. Only at the age of twenty-two, when a boy of twelve years old forced sexual intercourse upon him, he became psedophific. At that time he refused his seducer, but soon he could resist no longer the desire awakened in VIOLATION OF INDIVIDUALS UNDER AGE OF FOURTEEN. 529 him by that incident, although he was repeatedly sen- tenced and imprisoned for this offence. His life was blighted by this unfortunate weakness, and he made several attempts at suicide. Expert opinion established congenital sexual inver- sion, and, within the limits of homosexuality, a special anomaly, viz., exclusive love for boys of a certain age and of delicate constitution. It was claimed that degenerative mental disturbance affected the soundness of his mind and rendered him a danger to the community. X. was inconsolable over the result of his trial, for he was sent to an insane asylum. He had anticipated a free pardon. It is impossible to deduce from the real facts of a 'pcedoj)hilia erotica the claim of impunity for offences resulting from it ; for in all cases thus far observed the absolute control over the psedophilic impulse succeeded in every instance until a pathological condition either weakened or completely suspended the moral power of resistance. Very instructive in this regard are the cases observed by myself, in which, despite of taint and sexual perver- sion, the morbid impulse remained under control until a third factor was added to these. In the second and third case this happened through an attack of neicrasthenia gravis, in the fourth through dementia paralytica. At any rate, the proof that a current of morbid sexual impulse in the sense of pcedophilia erotica is present and constitutes an ex parte symptom of taint should always be considered on the ground of ameliorating circumstances. 34 530 PSYCHOPATHIA SEXUALIS. 7. Unnatural Abuse (Sodomy). ^ (Austrian Statutes, § 129 ; Abridgment, § 190 ; German Statutes, § 175.) (a) Violation of Animals (Bestiality).^ Violation of animals, monstrous and revolting as it seems to mankind, is by no means always due to psycho- pathological conditions. Low morality and great sexual desire, with lack of opportunity for natural indulgence, are the principal motives of this unnatural means of sexual satisfaction, which is resorted to by women as well as by men. To Polak we owe the knowledge that in Persia bestial- ity is frequently practised because of the delusion that it cures gonorrhoea ; just as in Europe an idea is still prevalent that intercourse with children heals venereal disease. Experience teaches that bestiality with cows and horses is none too infrequent. Occasionally the acts may be undertaken with goats, bitches, and, as a case of Tardictis and one by Schauenstein show (" Lehrb.," p. 125), with hens. The action of Frederick the Great, in the case of a 1 1 follow the usual terminology in describing bestiality and pederasty under the general term of sodomy. In Genesis (chap, xix.), whence this word comes, it signifies exclusively the vice of pederasty. Later, sodomy was often used synonymously with bestiality. The moral theologians, like St. Alphons of Ligouri, Gury, and others, have always distinguished correctly, i.e., in the sense of Genesis, between sodomia, i.e., concubitus cum persona ejusdem sexus, and bestialitas, i.e., concubitus cum bestia (cf. Olfers, " Pastoralmedicin," p. 78). The jurists brought confusion into the terminology by establishing a " Sodomia ratione sexus " and a " S. ratione generis ". Science, however, should here assert itself as ancilla tJieologics, and return to the correct usage of words. 2 For interesting histories, vide Krauss, " Psychol, d. Verbrechens," p. 180 ; Maschka, " Hdb. iii., p. 188 ; Hofmann, " T;ehrb. d. ger. Med.," p. 180; Rosenhaum, " Die Lustseuche," 5th edition, 1892. UNNATURAL ABUSE — SODOMY. 531 cavalryman who had committed bestiality with a mare, is well-known : " The fellow is a pig, and shall be reduced to the infantry ". The intercourse of females with beasts is limited to dogs. A monstrous example of the moral depravity in large cities is related by Maschka (" Handb.," iii.,) it is the case of a Parisian female who showed herself in the sexual act with a trained bull- dog, to a secret circle of roues, at ten francs a head. Case 197. In a provincial town a man was caught in intercourse with a hen. He was thirty years old, and of high social position. The chickens had been dying one after another, and the man causing it had been " wanted " for a long time. To the question of the judge, as to the reason for such an act, the accused said that his genitals were so small that coitus with women was impossible. Medical examination showed that actually the genitals were extremely small. The man was mentally quite soimd. There were no statements concerning any abnormali- ties at the time of puberty, etc. {Gyurkovechky, " Mannl. Impotenz," 1889, p. 82). Case 198. On the afternoon of 23rd September, 1889, W., aged sixteen, shoemaker's apprentice, caught a goose in a neighbour's garden, and committed bestiality on the fowl until the neighbour approached. On being accused by the neighbour, W. said, "Well! Is there anything wrong with the goose ? " and then went away. At his examination he confessed the act, but excused himself on the ground of temporary loss of mind. Since a severe illness in his twelfth year, he several times a month had attacks, with heat in his head, in which he was intensely excited sexually, could not help himself, and did not know what he was doing. He had done the act during such an attack, He answered for himself in the same way at the trial, and stated that he knew 532 PSYCHOPATHIA SEXUALIS. nothing of the sj)ecies facti except from the statements of the neighbour. His father states that W., who comes of a healthy family, had always been sickly since an attack of scarlatina in his fifth year, and that, at the age of twelve, he had a febrile cerebral disease. W. had a good reputation, learned well in school, and later helped his father in his work. He was not given to masturbation. The medical examination revealed no intellectual or moral defect. The physical examination revealed nor- mal genitals ; penis relatively greatly developed ; marked exaggeration of the patellar reflexes. In other respects, negative result. The history of the condition at the time of the deed was not to be depended upon. There was no proof of previous attacks of mental disturbance, and there were none during the six weeks of observation. There was no perversion of the vita sexualis. The medical opinion allowed the possibility that some organic cause (cerebral congestion), dependent upon cerebral disease, may have exercised an influence at the time of the commission of the criminal act (from the opinion of Dr. Fritsch, of Vienna). But there is another group of cases falling well within the category of bestiality, in which decidedly a patho- logical basis exists, indicated by heavy taint, constitutional neuroses, impotence for the normal act, impulsive manner of performing the unnatural act. Perhaps it would serve a purpose to put such cases under the heading of a special appellation; for instance, to use the term "bestiahty" for those cases which are not of a pathological character, and the term " Zooerasty " for those of a pathological nature. Case 199. Impulsive sodomy. A., aged sixteen ; gardener's boy; born out of wedlock; father unknown ; mother deeply tainted, hystero-epileptic. A. has a de- formed, asymmetrical cranium, and deformity and asym- UNNATURAL ABUSE — SODOMY. 533 metry of the bones of the face ; the whole skeleton is also deformed, asymmetrical and small. From childhood he was a mastm'bator ; always morose, apathetic, and fond of solitude; very irritable, and pathological in his emotional reaction. He is an imbecile, probably much reduced physically by masturbation, and neurasthenic. Besides, he presents hysteropathic symptoms (limitation of the visual field, dyschromatopsia ; diminution of the senses of smell, taste and hearing on the right side ; anaesthesia of the right testicle, clavus, etc.). A. is convicted of having committed masturbation and sodomy on dogs and rabbits. When twelve years old he saw how boys masturbated a dog. He imitated it, and thereafter he could not keep from abusing dogs, cats and rabbits in this vile manner. Much more frequently, how- ever, he committed sodomy on female rabbits, — the only animals that had a charm for him. At dusk he was accustomed to repair to his master's rabbit-pen in order to gratify his vile desire. Babbits with torn rectums were repeatedly found. The act of bestiality was always done in the same manner. There were actual attacks which came on every eight weeks, always in the evening, and always in the same way. A. would become very uncom- fortable, and have a feeling as if some one were pounding his head. He felt as if losing his reason. He struggled against the imperative idea of committing sodomy with the rabbits, and thus had an increasing feehng of fear and intensification of headache until it became unbearable. At the height of the attack there were sounds of bells, cold perspiration, trembhng of the knees, and, finally, loss of resi&tive power, and impulsive performance of the perverse act. As soon as this was done he lost all anxiety ; the nervous cycle was completed, and he was again master of himself, deeply ashamed of the deed, and fearful of the return of an attack. A. states that, in such a condition, if called upon to choose between a woman and n female rabbit, he could make choice only of the latter. In the 534 PSYCHOPATHIA SEXUALIS. intervals, also, of all domestic animals he is partial only to rabbits. In his exceptional states simple caressing or kissing, etc., of the rabbit suffices, as a rule, to afford him sexual satisfaction ; but sometimes he has, when doing this, such furor sexualis that he is forced to wildly perform sodomy on the animal. The acts of bestiahty mentioned are the only acts which afford him sexual satisfaction, and they constitute the only manner in which he is capable of sexual indul- gence. A. declares that, in the act, he never had a lustful feeling, but satisfaction only, inasmuch as he was thus freed from the painful condition into which he was brought by the imperative impulse. The medical evidence easily proved that this human monster was a psychically degenerate, irresponsible in- valid, and not a criminal {Boeteau, " La France medicale," 38th year, No. 38). Case 200. X., peasant, aged forty ; Greek-Catholic. Father aijd mother were hard drinkers. Since his fifth year patient has had epileptic convulsions — i.e., he falls down unconscious, lies still two or three minutes, and then gets up and runs aimlessly about with staring eyes. Sexuahty was first manifested at seventeen. The patient had inclinations neither for women nor for men, but for animals (birds, horses, etc.). He had intercourse with hens and ducks, and later with horses and cows. Never any onanism. The patient paints pictures of saints ; is of very Hmited intelligence. For years, religious paranoia, with states of ecstasy. He has an "inexplicable" love for the Virgin, for whom he would sacrifice his life. Taken to hospital, he proves to be free from infirmity and signs of anatomical degeneration. He always had an aversion for women. In a single attempt at coitus with a woman he was impotent, but with animals he was always potent. He is bashful before UNNATURAL ABUSE — SODOMY. 535 women ; coitus with women he regards ahnost as a sin {KowalciDsky , " Jahrb. f. Psychiatrie," vii., Heft 3). Case 201. T., thirty-five years of age. Father an inebriate ; mother psychopathic. Never had a severe illness ; never showed special peculiarities. At the age of nine immorality with a hen ; later on with other domestic animals. When he began to have sexual relations with women his bestial desires disappeared. Married when twenty, and found sexual satisfaction. When twenty-seven he began to drink. Then his former perverse inclinations were awakened. One day he took a she-goat to a neighbouring village to have her covered. He felt a strong desire to commit sodomy with her, but he at first overcame the impulse. Palpitation of the heart, pain in the chest, and a violent orgasm made him succumb. T. declares that these bestial acts gave him greater lustful gratification than coitus cum femina. His acts of bestiality remained unnoticed. He was finally sent to an insane asylum on account of delirium tremens, when, during his examination upon admission, he made the above revelations {Boissier et Lachaux, "Annal. medico-psychol.," July- August, 1893, p. 381). In the explanation of zooerasty great difficulties are encountered. The attempt to reduce it to fetichism, as is possible in zoophilia erotica {cf. p. 267), has utterly failed. It is questionable whether zoophilia can ever lead to sexual acts with beasts (eventually bestiahty). If it be in reality a fetichistic manifestation, this possibility cannot be based upon the present knowledge of fetichism. Even in the case of zoophilia erotica fetischistica (p. 267), acts of bestiality were never committed; in fact, the sex of the animals there in question was never considered. The only thing that at present can be done is to consider zooerasty as an original perversion of the vita sexualis, and place it on the same level with antipathic sexuality. 536 PSTCHOPATHIA SEXUALIS. The following case, although it is only rudimentary and abortive, seems to support this theory and to establish complete unconsciousness of the motive of the impulse. Case 202. Y., tv^enty years of age, intelligent, well educated ; claims to be free from taint by heredity ; physically sound except evidences of neurasthenia and hypercBstlicsia urethroi; says he never masturbated. Always fond of animals, especially dogs and horses. Since the age of puberty increased love for animals, but sexual ideas in connection with sport seem to have been absent. One day when he mounted a mare for the first time he experienced a sensation of lust ; two weeks later, on a similar occasion, the same sensation with erection. During his first ride he had ejaculation. A month after the same thing happened. Patient feels disgusted at the occurrence, and is angry with himself. He gave up the saddle. But from now on pollutions almost daily. When he sees men on horseback, or dogs, he has erections. Almost every night he has pollutions accom- panied by dreams in which he rides on horseback or is training dogs. Patient comes for medical advice. Treatment with sounds removed the hypcrcesthesia urethra and diminished pollutions. The patient followed reluctantly the advice of the physician to have coitus, partly on account of dislike for women, partly on account of diffidence in his virihty. He made abortive attempts at coitus, but could not even bring about an erection, which, however, took place the moment he saw a man on horseback. This depressed him ; he considered his condition abnormal beyond remedy. Continued medical treatment. A further attempt at coitus was successful with the assistance of fancied images of riders and dogs, which stimulated erection. Patient grew more virile ; his love for animals waned ; erections at the sight of riders and dogs disappeared, UNNATURAL ABUSE — SODOMY. 537 nocturnal pollutions with dreams of animals became less frequent ; he dreamed now of girls. Erection, which at first did not support ejaculatio 2)rcccox, and pathological coitus grew normal under treatment with sounds Patient now finds sexual gratification, and is freed from his ab- normal sexual impulse (Dr. Hanc, " Wien. med. Blatter," 1887, No. 5). The preceding case justifies the assumption of an original perversion, for instead of the idea of the normal object (woman), it is the idea of animals (dogs and horses) frequently seen which awalvens sexual feelings and desires. There may have been a latent sadistic element in the case, for, at least in the vita sexualis of the dreams, the riding of horses and the training of dogs played a prom- inent part. The following case, that of a stiqvator hestiarum, is of pathological interest. Case 203. Mr. X., forty-seven years of age, of high social position, came to me for advice on account of a troublesome anomaly of his vita sexualis. He is about to be married and in his present condition considers it morally impossible to enter upon matrimony. X. is evidently heavily tainted — his father, two of his sisters and one brother are highly neurotic. The mother is presumed to have been a healthy woman. The sexual instinct awoke early in X. ; he began to masturbate spontaneously at the age of eleven. He is decidedly hypersexual, practised masturbation with passion, and at the age of fourteen he forgot him- self so far as to sodomise bitches, mares and other fe- male animals. He ascribed these acts to excessive sexual desire and to want of opportunity to satisfy his cravin^^s in the normal way — he spent his childhood and boyhood in a lonely part of the country and later on he visited a boarding school. 538 PSYCHOPATHIA SEXUALIS. X. admits that he was quite conscious of the abomin- ation of his acts, and says that he fought with all his will power against these bestial impulses. But the greed, the lust, the pleasure which they gave always over- powered him. When grown up to manhood he never had homosexual desires, nor did he feel an inclination for woman. Up to this part of his confession the opinion seems justified that his bestiality was not a perversion, but only a perversity which found root in his habits. But it strikes one as peculiar that his erotic dreams were always about bestial intercourse, and that when at the age of twenty-five he sought to improve bis condition by coitus cum muliere, he derived not the slightest gratifi- cation from it, although he was quite potent and the puella pleasing and sympathetic. He had the same experience at other attempts which he repeatedly made during the subsequent twenty-two years. He describes coitus as a mere mechanical act devoid of lustful excitement. He might as well have coitus with a piece of wood. It simply disgusted him, whilst cum bestia he experienced the height of pleasure. The mere sight of animals excited him wildly. The society of ladies caused him ennui. When he went with a girl she had to resort to all kinds of manipulations to prepare him for the act. For two months previous to his first visit to me X. had exerted all his will power to resist the impulses to masturbation and bestiality. He is physically a pecuhar being, evidently a degdnere sttpdriaur. There are no symptoms of anatomical degener- ation, no traces of neurasthenia. I made strong suggestions to be on his guard against masturbation and bestiality, to seek more the society of ladies, prescribed antaphrodisiacs, advised frugality, slight hydrotherapy, plenty of open-air exercise, steady occupa- tion, and had the satisfaction to learn that the patient at UNNATURAL ABUSE — SODOMY. 539 the end of ten months experienced a sHght gratification in repeated sexual intercourse cum femina and that he was ahxiost free from his former perverse desires. An analogous case is reported by Moll, " Libido sexualis," p. 421. Another remarkable case of zooerasty is published by Howard (" Ahenist and Neurologist," 1896, vol. xvii., 1.). It refers to a young man of sixteen years of age who found sexual gratification only with pigs. The rarity of cases of real zooerasty seems to be remarkable. But this may be explained by the ease with which they are kept secret. The forensically important distinction between bestial- ity and zooerasty can never be difficult in coiicreto. Whoever seeks and finds sexual gratification exclusively with animals, although the opportunities for the normal act are at hand, must at once be suspected of a patho- logical condition of the sexual instinct. At any rate more so than the sexually inverted person, for in sexual acts with animals the psychical infection is wanting, i.e., the possil)ility of the perversion of one part leading to the perversity of the other. It may be assumed, however, that the number of cases of zooerasty as compared with those of sexual inversion is unequally smaller. This follows a 'priori from the character of both these perversions. The zooerast as compared with the sexual invert is much farther removed from the normal object. This would qualify the perver- sion of the former as a much graver condition — because more degenerative — than that of the latter. ^fci"- (b) With Persons of the Same Sex (Pederasty ; Sodomy in its Strict Sense). German law takes cognizance of unnatural sexual relations only between men ; Austrian, between those of 540 PSTCnOPATHIA SEXUALIS. the same sex ; and therefore, unnatural relations between women are punishable. Among the immoralities between men, pederasty (immissio penis in anum) claims the principal interest. In- deed, the jurist thought only of this perversity of sexual activity ; and, according to the opinions of distinguished interpreters of the law {Oppenhoff, " Stgsb.," Berlin, 1872 p. 324, and Budolf and Stenglein, " D. Strafgesb. f. d. Deutsche Keich," 1881, p. 423), immissio penis in corpus vivum must take place to establish the criminal act covered by §175. According to this interpretation, legal punishment would not follow other improper acts between male per- sons, so long as they were not complicated with offence to public decency, with force, or undertaken with boys under the age of fourteen. Of late this interpretation has again been aban- doned, and the crime of unnatural abuse between men is assumed to have been committed when merely acts similar to cohabitation are performed.^ The study of antipathic sexual instinct has placed male love for males in a very different light from that in which it, and particularly pederasty, stood at the time the statutes were framed. The fact that there is no doubt about the pathological basis of many cases of inverted sexual instinct shows that pederasty may also be the act of an irresponsible person, and makes it necessary, in court, to examine not merely the deed, but also the mental condition of the perpetrator. The principles laid down previously must also here be 1 How difficult, unpleasant, and dangerous it may be for the judge to form a proper judgment of these " coitus-like " acts for the establish- ment of the objective fact of the crime is well shown by an article on the punishableness of male intercourse, in the " Zeitschr. f. d. gesammte Strafrechtswissenschaft.," Bd. vii., Heft 1, as well as by a similar one in Friedreich's " Blatter f. ger. Medicin, 1891, Heft 6. Vide, further, Moll, " Contrare Sexualempfindung, p. 22.3 ct seq., and Bernliardi, " Der Uranis- mus," Berlin, 1895; van Erkelens, " Strafgesetz u. widernatiirl. Unzucht," Berlin, 1895 UNNATURAL ABUSE — SODOMY. 541 adhered to. Not the deed, but only an anthropological and clinical judgment of the perpetrator can permit a decision as to whether we have to do with a perversity deserving punishment, or with an abnormal perversion of the mental and sexual life, which, under certain circum- stances, excludes punishment. The next legal question to settle is whether the anti- pathic sexual feeling is congenital or acquired ; and, in the latter case, whether it is a pathological perversion or a moral perversity. Congenital sexual inversion occurs only in predisposed (tainted) individuals, as a partial manifestation of a defect evidenced by anatomical or functional abnormalities, or by both. The case becomes clearer and the diagnosis more certain if the individual, in character and disposition, seems to correspond entirely with his sexual peculiarity ; if the inclination toward persor^ of the opposite sex is entirely wanting, or horror of sexual intercourse with them is felt ; and if the individual, in the impulses to satisfy the antipathic sexual instinct, shows other anomalies of the sexual sphere, such as more pronounced degenera- tion in the form of periodicity of the impulse and impul- sive conduct, and is a neuropathic and psychopathic person. Another question concerns the mental condition of the urning. If this be such as to remove the possibility of moral responsibility, then the pederast is not a criminal, but an irresponsible insane person. This condition is apparently less frequent in congenital urnings. As a rule, these cases present elementary psy- chical disturbances which do not remove responsibility. But this does not settle the question of responsibility in the urning. The sexual instinct is one of the most powerful organic needs. There is no law that looks upon its satisfaction outside of marriage as punishable in itself; if the urning feels perversely, it is not his fault, but the fault of an abnormal condition natural to him. His 542 PSYCHOPATHIA SEXUALIS. sexual instinct may be aesthetically very repugnant, but, from his morbid standpoint, it is natural. And again, in the majority of these unfortunates the perverse sexual instinct is abnormally intense, and their consciousness recognises it as nothing unnatural. Thus moral and aesthetic ideas fail to assist them in resisting the instinct. Innumerable normally constituted men are in a posi- tion to renounce the gratification of their libido w^ithout suffering from it in health. Many neuropathic indi- viduals, — and urnings are almost always neuropathic, — on the contrary, become nervously ill when they do not satisfy the sexual desire, either as Nature prompts or in a way that to them is perverse. The majority of urnings are in a painful situation. On the one hand, there is an impulse toward persons of their own sex that is abnormally intense, the gratification of which has a good effect, and is natural to them ; on the other hand, there is public sentiment, which stigmatises their acts, and the law which threatens them with dis- graceful punishment. Before them lies mental despair, — even insanity and suicide, — at the very least, nervous disease ; behind them, shame, loss of position, etc. It cannot be doubted that, under these circumstances, states of stress and compulsion may be created by an unfortu- nate natural disposition and constitution. Society and the law should understand and appreciate these facts. The former should pity, and not despise, these unfortu- nates ; the latter must cease to punish them, — at least while they remain within the limits which are set for the activity of their sexual instinct. As a confirmation of the opinions and demands con- cerning these step-children of Nature, it is permissible to reproduce here the memorial of an urning to the author. The writer of the following lines is a man of high position in London : — "You have no idea what a constant struggle we all — UNNATUEAL ABUSE — SODOMY. . 543 particularly those of us who have the most mind and finest feelings — must endure, and how we suffer under the prevailing false ideas about us and our so-called ' immorality '. " Your opinion that the phenomenon under considera- tion is primarily due to a congenital ' pathological ' dis- position will, perhaps, make it possible to overcome existing prejudices, and awaken pity for poor, ' abnormal ' men, instead of the present repugnance and contempt. " Much as I beheve that the opinion expressed by you is exceedingly beneficial to us, I am still compelled, in the interest of science, to repudiate the word ' pathological ' ; and you will permit me to express a few thoughts with respect to it. " Under all circumstances the phenomenon is anom- alous ; but the word ' pathological ' conveys another meaning, which I cannot think suits this phenomenon ; at least, as I have had occasion to observe it in very many cases. I will allow, a priori, that, among urnings, a far higher proportion of cases of insanity, of nervous exhaus- tion, etc., may be observed than in other normal men. Does this increased nervousness necessarily depend upon the character of urningism, or is it not, in the majority of cases, to be ascribed to the effect of the laws and the pre- judices of society, which prohibit the indulgence of their sexual desires, depending on a congenital peculiarity, while others are not thus restrained? " The youthful urning, when he feels the first sexual promptings and naively expresses them to his comrades, soon finds that he is not understood ; he shrinks into himself. If he tells his parents or teacher what moves him, that which is as natural to him as swimming is to a fish is described as wrong and sinful, and he is told it must be fought a.nd overcome at any price. Then an inner conflict begins, a powerful repression of sexual in- clinations ; and the more the natural satisfaction of desire is repressed, the more lively the fancy becomes, and paints 544 PSYCHOPATHIA SEXUALIS. the very pictures that the wish is to banish. The more energetic the character that carries on this inner conflict, the more the whole nervous system must suffer. Such a powerful repression of an instinct so deeply implanted in us, in my opinion, develops the abnormal symptoms which are observed in many urnings ; but this does not necessarily follow from the urning's disposition. " Some continue the conflict for a longer or shorter time, and thus injure themselves ; others at last come to the knowledge that the powerful instinct born in them cannot possibly be sinful, and, therefore, they cease to try to do the impossible — -the repression of the instinct. Then, however, begin constant suffering and excitement. When a normal man seeks satisfaction of sexual inclina- tion, he knows how to find it easily ; it is not so with the urning. He sees men that attract him, but he dares not say — nay, not even betray by a look — what his feel- ings are. He thinks that he alone of all the world has such abnormal feelings. Naturally he seeks the society of young men ; but he does not venture to confide in them. Thus he comes to provide himself with a satis- faction that he cannot otherwise obtain. Onanism is practised inordinately, and followed by all the evil results of that vice. When, after a time, the nervous system has been ii)jured, the abnormality is again not the result of urningism, but it is produced by the onanism to which the urning resorts, as a result of the public sentiment that denies him opportunity to satisfy the sexual instinct that is natural to him. " Or let us suppose the urning has had the rare for- tune to soon find a person like himself ; or that he has been introduced by an experienced friend to the events of the world of urnings. Then he is spared much of the inner conflict ; but, at the same time, fearful cares and anxieties follow his footsteps. Now he knows that he is not the only one in the world that has such abnornjal feelings ; he opens his eyes and wonders that he meets so UNNATURAL ABUSE — SODOMY. 545 many of his kind in all social circles and in all callings ; he also learns that, in the world of urnings, as in the other, there is prostitution, and that men as well as women can be bought. Thus there is no longer any want of opportunity for sexual satisfaction. But here how differ- ently the experience is gained from that obtained in the normal manner of sexual indulgence ! " Let us consider the happiest case. After longing all one's life, the friend of like feeling is found. But he can- not be approached openly, as a lover approaches the girl he loves. In constant fear, both must conceal their rela- tions ; nay, even intimacy that might easily excite sus- picion — especially should they not be of like age, or should they belong to different classes — must be kept from the world. Thus, even in this relation, is forged a chain of anxiety and fear that the secret will be betrayed or discovered, which leaves them no joy in the indulgence. The slightest thing that would not affect others makes them tremble with fear that suspicion might be excited and the secret discovered, and destroy social position and business. Could this constant anxiety and care be endured without leaving a trace, without exerting an influence on the entire nervous system? " Another less fortunate man does not find a friend of like feeling, but falls into the hands of a handsome man, who sought him until the secret was discovered. Now the most refined blackmail is extorted. The unfortunate, persecuted man, brought to the alternative of paying or of losing his social position, and bringing disgrace on himself and his family, pays ; and the more he gives, the more voracious the vampire becomes ; until at last there remains nothing but absolute financial ruin or dishonour. "Who can wonder that nerves are not equal to such a terrible struggle ! " They give way ; insanity comes on, and the miser- able man at last finds the rest in an asylum that he could not find in the world. Another, in the same situation, 35 546 PSYCHOPATHIA SEXUALIS. driven to despair, finds relief in suicide. It cannot be known how many of the suicides of young men are to be attributed to this combination of circumstances. " I do not think that I am in error when I declare that at least one half of the suicides of young men are due to such conditions. Even in those cases where urn- ings are not persecuted by a heartless villain, but where a happy relation between two men exists, discovery, or even the fear of it, very often leads to suicide. How many officers, how many soldiers, having such relations with their subordinates or companions, in the moment when they have beheved themselves discovered, have sought to escape the threatened disgrace by means of a bullet ! And it is the same in all callings. " Therefore, if it must be admitted that, among urn- ings, more mental abnormafities and more insanity are actually observed than among other men, yet this does not prove that the mental disturbance is a necessary ac- companiment of the urning's condition, and that the latter induces the former. "According to my firm conviction, hy far the greater number of cases of mental disturbance or abnormal dis- position observed in urnings are not to be attributed to the sexual anomaly ; but they are caused by the existing notions concerning urnings, and the resulting laws, and dominant pubhc sentiment concerning the anomaly. Any one with an adequate idea of the mental and moral suffer- ing, of the anxiety and care that the urning must endure ; of the constant hypocrisy and secrecy he must practise in order to conceal his inner instinct ; of the difficulties that meet him in satisfying his natural desire,— can only be surprised that more insanity and nervous disturbance does not occur in urnings. The greater part of these abnormal states would not be developed if the urning, fike another, could find a simple and easy way in which to satisfy his sexual desire,— if he were not for ever troubled by these anxieties !" UNNATURAL ABUSE — SODOMY. 547 De lege lata, as far as the urning is concerned, the paragraph with reference to pederasty should not be apphed ivithout the jjroof of actual pederasty; and psychical and somatic abnormalities should be examined by experts with respect to an estimate in the individual of the ques- tion of guilt. De lege ferenda, the urnings wish a repeal of the para- graph. The jurist could not consent to this, if he is to remember that pederasty is much more frequently a disgusting vice than the result of a physical and mental infirmity ; and that, moreover, many urnings, though driven to sexual acts with their own sex, are yet in nowise compelled to indulge in pederasty, — a sexual act which, under all circumstances, must stand as cynical, disgusting, and, when passive, as decidedly injurious. Whether for reasons of expediency (difficulty of fixing the guilt, encouragement of blackmail, etc.), it would not be op)portune to strike from the statutes the legal punishment of the male-loving man is a question for the jurists of the future} My reasons for abolishing the laws above referred to are the following : — (1) The offences referred to in these laws generally spring from an abnormal psychical condition. (2) Only a most careful medical examination can dis- tinguish cases of sheer perversity from those of patholo- gical perversion. As soon as the individual is charged with the offence he is socially ruined. (3) The majority of urnings are the victims of a perverse instinct of abnormal quality. In quahfying the sexual instinct they are irresistibly forced by physical compul- sion. (4) Many urnings are incapable of considering their sexual instinct as unnatural ; on the contrary, their own appears to them the natural act, and that permitted by law as contra naturam. The moral means of correction 1 Cf. the author's pamphlet "Der contrar Sexuale vor dem Straf- richter". Leipzig and Vienna (Deutiko), 2 Aufl., 1895. 518 PSYCHOPATHIA SEXUALIS. which might prevent the sexual transgression are there- fore wanting. (5) The definition as to what constitutes an immoral offence is defective, and allows the judge too much latitude In Germany, for instance, the interpretation of § 175, growing more subtle and ingenious every day, gives direct proof of the uncertainty of its proper legal under- standing. The deed in itself ought to be decisive in this matter. and the verdict should be in accordance with it. (As a rule, the motive is scarcely ever scrutinised.) But how is this to be estabhshed ? For the deed is, as a rule, committed in secret and in the absence of witnesses. (6) Theoretical criminal reasons for the retention of the paragraph are never advanced. It does not deter from crime and has no corrective influence, for patho- logical manifestations are not removed by penal remedies. Decidedly it is not an atonement for a criminal act which can only under certain and mostly false presumptions be considered as criminal, and thus may lead to acts of gross injustice. It must be remembered that in many civilised countries this paragraph no longer is in vogue, that in Germany it only exists as a concession to pubhc morality, whilst the latter is based on false principles, and frequently mixes up perversion with perversity. (7) In my opinion, public morality and youth are suffi- ciently protected, in Germany at any rate, by other paragraphs of the statutes ; and I incline to the belief that paragraph 175 does more harm than good, in so far as it favours and abets blackmail — one of the basest and vilest vices. Of course, the blackmailer may be punished, but he has always the one chance in his favour, that his victim will never resort to the extreme measure of appeahng to the law. If it comes to the worst the scoundrel is con- fined to prison for a short time without running the risk of losing the honour which he never possessed, whilst his UNNATURAL ABUSE — SODOMY. 549 victim has lost all, i.e., his good name and the respect of others, is thus ruined and often brought to self-destruction. (8) If the German law-maker should deem public morality endangered by the abrogation of § 175, surely the extension of § 176, 1, to male persons as well should be sufficient (at present this paragraph deals only with im- moral acts committed on females either with force or under threats). The "Code penal frangais " has such a paragraph. Eventually the age of fourteen years mentioned in this paragraph 176, 3, and beyond which immoral actions committed on youthful persons go unpunished, might be raised to a higher figure. This would also benefit the female portion of society, who scarcely possess at the age of fifteen sufficient maturity of mind and judgment to protect themselves against the evil. Moreover by this act a more efficient protection would be given to youn^ people in general (say up to the end of the sixteenth year) than is now granted by § 175, which after all is only directed against pederasty (and according to more recent interpretation against other actions of a coitus-hke nature) whilst it regards onanism and other immoral acts with impunity. Perverse people but seldom endanger the morality of the young by pederasty, but much more fre- quently by other acts of immorahty. Beyond a certain age, say eighteen, when a sufficient degree of moral and intellectual ripeness has been attained, the law has neither the right nor the duty to impugn immoral act^ which are committed inter mares, portis clausis and consenm mutuo. The individual himself is responsible for such acts, for they do not violate either public or private interests. What has been said de lege lata concerning congenital sexual inversion and its relation to the law is also appli- cable to the acquired abnoraiality. The accompanying neurosis or psychosis should have much diagnostic and forensic weight with reference to the question of guilt. It is of high psychopathological and, under circum- stances, also of criminal intei'ost that individuals of anti- 550 PSTCHOPATHIA SEXUALIS. pathic sexuality when unfortunate in their love affairs, or when meeting with deception on the part of the be- loved, are subject to all those psychical reactions in the shape of jealousy and vindictiveness which occur in the love affairs between man and woman ; nay, often ever lead to deeds of violence to revenge the affront or to punish the robber of happiness. Nothing else could prove more clearly the constitu- tionality of these inverted sexual feelings ; their dominat- ing power over sense, thought and aspiration, and their complete substitution for hetero-sexual normal feeling and development. A case of such unrequited and betrayed love is the following taken from recent American criminal acts, the report of which was sent to me by Dr. Bocch of Troppau. Case 204i A sexually inverted girl kills the girl she loves because she was rejected. In January, 1892, Alice M., a young girl belonging to one of the best famihes of Memphis, Tennessee, U.S.A., killed in the public street of that town her girl friend, Freda W., also of the best society. She made several deep gashes in the neck of the girl with a razor. The trial ehcited the following facts : — Alice inherited taint from her mother — an uncle and several cousins in the first degree were insane — the mother herself was psychopathic, had jjuerijeral dementia after each confinement, the worst attack following the birth of the seventh child, i.e., Alice, now a prisoner — afterwards she declined mentally suffering from dementia persecutoria. A brother of the accused suffered from mental derange- ment for some time after an alleged sunstroke. Alice is nineteen years of age, of medium height, not pretty. The face is childHke and " almost too small for her size," and asymmetrical, the right facial side is more developed than the left, the nose " of striking irregular- ity," the eye piercing. She is left-handed. UNNATURAL ABUSE — SODOMY. 551 With the beoinning of puberty, severe and continued headaches were of frequent occurrence ; once a month she suffered from epistaxis, often up to within the very latest period from attacks of tremor. On one occasion she lost consciousness during one of these attacks. Alice was a nervous, irritable child, and very slow in physical development. She never enjoyed children's or girls' games. When she was four to five years old she took much pleasure in tormenting cats, suspending them by one leg. She preferred her younger brother and his games to her sisters ; she vied with him in spinning tops, playing baseball and football, or shooting at targets, and in many silly pranks. She loved to climb trees and roofs, and was very clever in this sport. Above all things she loved to amuse herself in the stable among the mules. When she was six to seven her father had bought a horse, and she took great delight in feeding and tending it, and rode about the paddock astraddle on its back hke a boy, with- out a saddle. Later on she would also groom the horse and wash his hoofs. She would lead him along the street by the halter, gear him up in the buggy, and became quite an expert in harnessing him up when required. At school she was slow and faulty, incapable of con- tinued occupation with the same subject, did not grasp things easily, and had no memory. For music and drawing she had not the slightest talent, and hated feminine occupations. She never cared for reading, and could bear neither books or newspapers. She was stub- born and capricious, and was considered by her teachers and friends as an abnormal being. When a child she did not care for boys, and had no companions among them ; later on she never cared for men, and had no lovers. She was quite indifferent towards the young men, even abrupt, and they looked upon her as being " cracked ". But " as far as she can remember" she had an extra- 552 PSYCHOPATHIA SEXUALIS. ordinary love for Freda W., a girl of her own age, daughter of a friend of the family. Freda was a tender and sweet girl ; the love was mutual, but more violent on the part of Alice. It increased from year to year until it became a passion. A year previous to the catastrophe Freda's family moved away to another town. Alice was steeped in sorrow ; a very tender love correspondence now ensued. Twice Alice went to visit Freda's family, during which time the two girls, as witnesses attest, showed " disgust- ing tenderness " for each other. They were seen to swing together in a hammock by the hour, hugging and kissing each other — " they hugged and kissed ad 7iaiiseam'\ Alice was ashamed of doing this in public, but Freda upbraided her for this. When Freda paid a visit in return, Alice made an attempt at killing her ; she tried to pour laudanum down her throat 'whilst asleep. The attempt failed because Freda woke up in time. Alice then took the poison herself before Freda, and was taken violently ill. The reason for the attempted murder and suicide was that Freda had shown some interest in two young men, and Alice declared she could not live without Freda's love, and again " she wanted to kill herself in order to find release from her tortures and make Freda free ". After recovery they both resumed the amorous correspondence, even with more fervour than before. Soon after this Alice proposed marriage to Freda. She sent her an engagement ring, and threatened death if she proved disloyal. They were to assume a false name and fly to St. Louis, Alice would wear men's clothes and earn a living for both ; she would also grow a moustache, if Freda were to insist upon it, as she felt confident that by shaving frequently she could succeed in this. Just before the attempted elopement the plot was discovered and prevented ; the " engagement ring " was returned together with other love tokens to Alice's mother, and all intercourse between the two girls was stopped. UNNATUEAL ABUSE — SODOMY. 558 Alice was completely broken up. She lost her sleep, refused food, became listless and confused (at the shops had the purchased goods put down to the name of her beloved). The ring and other love tokens — among them a thimble of Freda's filled with the latter's blood — she concealed in a corner of the kitchen, where she spent hours in contemplating these objects, now bursting into peals of laughter, now into floods of tears. " She became emaciated, the face assumed an anxious expression, the eyes showed " a peculiar strange lustre ". When she learned of an intended visit by Freda to Memphis she firmly resolved to kill her if she cannot possess her. She stole a razor from her father and care- fully concealed it. In the meantime she started a correspondence with Freda's admirer, simulating friendship for him in order to find out his relations to Freda, and kept herself informed about them. All attempts to see her or hear from her made by Alice during Freda's sojourn in Memphis failed. She waylaid Freda in the street and once almost succeeded in carrvino- out her purpose had not an accident prevented her. On the very day, however, when Freda was leaving town and on her way to the steamboat Alice overtook her. She felt mortally hurt because Freda, although walk- ing alongside of the buggy in which she herself was riding, never spoke a word to her, but only gave her a glance now and then. She jumped from the vehicle and cut Freda with the razor. When Freda's sister tried to beat her off she became frantic and blindly cut deep gashes into the poor girl's neck, one reaching almost from ear to ear. Whilst everybody was busy about Freda she drove off furiously through the streets. When reaching home she immediately told her mother what had happened. She could not comprehend the awfulness of the deed ; she was cold and unmoved at the consequences pointed out to her. But when she heard of the death and the 554 PSYCHOPATHIA SEXUALIS. funeral of her beloved Freda and realised her loss she burst into tears and passionate wailings, kissed the picture of the dead girl and spoke as if she were not dead but still alive- During the trial her callous behaviour struck every one ; the deep sorrow of her own people did not affect her in the least ; she showed absolute indifference to the ethical points of her deed. At moments, however, when her passionate love for Freda and her jealousy woke up, she yielded to boundless grief and emotion. ''Freda has broken her faith ! " "1 have killed her because I loved her so ! " The experts called in the case found her mental development on a level with that of a girl of thirteen to fourteen years. She comprehended that no children could have sprung from her " union " with Freda— but that a " marriage " be- tween them would have been an absurdity she would not admit. She absolutely denied that sexual intercourse be- tween the two (even mutual masturbation) ever took place. But nothing definite about this point or about her vita sexualis per acta could be learned. A gynascological examination of her person was not made. The verdict was insanity (" Memphis Medical Monthly, 1892). Cultivated Pederasty. * This is one of the saddest pages in the history of human delinquencies. The motives that bring to pederasty a man originally sexually normal and of sound mind are various. It is 1 For interesting histories and notes, v. Krauss, " Psychol, des Ver- brechens," p. 174 ; Tardic2i, " Attentats " ; Maschka, " Handb.," iii., p. 174. This vice seems to have come through Crete from Asia to Greece, and, in the times of classic Hellas, to have been widespread. Thence it spread to Rome, where it flourished luxuriantly. In Persia and China (where it is actually tolerated) it is widespread, as it also is in Europe (c/. Tar- dieu, Tarnowsky, et al.). CULTIVATED PEDEEASTT. 655 used temporarily as a means of sexual satisfaction faute de mieux — as in infrequent cases of bestiality — where absti- nence from normal sexual indulgence is enforced.^ It thus occurs on shipboard during long voyages, in prisons, in watering-places, etc. It is highly probable that, among men subjected to such conditions, there are single indi- viduals of low morals and great sensuality, or actual urn- ings, who seduce the others. Lust, imitation, and desire further their purpose. The strength of the sexual instinct is most markedly shown by the fact that such circumstances are sufficient to overcome repugnance for the unnatural act. Another category of pederasts is made up of old rou^s that have become supersatiated in normal sexual indulg- ence, and who find in pederasty a means of exciting sensual pleasure, the act being a new method of stimula- tion. Thus they temporarily renew their power, that has been psychically and physically reduced to so low a state. The new sexual situation makes them, so to speak, relatively potent, and renders pleasure possible that it is no longer found in the normal intercourse with women. In time power to indulge in pederasty also flickers out. The individual may thus finally be reduced to passive pederasty as a stimulus to make possible tem- poral}^ active pederasty ; just as, occasionally, flagellation or looking on at obscene acts {Maschka's case of mutilation of animals) is resorted to for the same purpose. The termination of sexual activity expresses itself in all kinds of abuse of children — cunnilingtis , fellare, and other enormities. This kind of pederasts is the most dangerous, since they deal mostly with boys, and ruin them in body and soul. In reference to this, the experiences of Tamoiosky {op. ^ Lombroso (" Der Verbrecher, p. 20 et seq.) shows that also, in case of animals, intercourse with the same sex occurs where normal indulgence is impossible. 556 PSYCHOPATHIA SEXUALIS. cit., p. 53 et seq.), gathered from society in St. Petersburg, are terrible. The places where pederasty is cultivated are institutes. Old roues and urnings play the role of seducers. At first it is difficult for the person to carry out the dis- gusting act. Fancy is made to assist by calHng up the image of a woman. Gradually, with practice, the un- natural act becomes easy, and at last the individual, like one debased by masturbation, becomes relatively impotent for women, and lustful enough to find pleasure in the perverse act. Such individuals, under circumstances, give themselves for money. As Tardieu, Hofmann, Simon and Taylor show, such fiends are not infrequently found in large cities. From numerous statements made to me by urnings, it is learned that actual prostitution and houses of prostitution for male-loving men exist in large cities. The arts of coquetry used by these male prostitutes are noteworthy — ornament, perfumes, feminine styles of dress, etc., to attract pederasts and urnings. This imitation of feminine peculiarities is spontaneous and unconscious in congenital and in some acquired cases of (abnormal) antipathic sexual instinct The following lines are of interest to the psychologist, and may give the officers of the law important clues con- cerning the social life and practice of pederasts : — Goffignon, " La Corruption a Paris," p. 327, divides active pederasts into " amateurs,'' " cntreteiieurs'' and " sou- tencurs ' ' . The "amateurs" {"rivcttes") are debauched persons, frequently of congenital sexual inversion, of position and fortune, who are forced to guard themselves against detec- tion in the gratification of their homosexual desires. For this purpose they visit brothels, lodging-houses, or the private houses of female prostitutes, who are usually on good terms with male prostitutes. Thus they escape blackmail. Some of these " amateurs " arc bold enough to indulge CULTIVATED PEDEEASTY. 557 their vile desires in public places. They thus run the risk of arrest, but in a large city little risk of blackmail. Danger is said to add to their secret pleasure. The " entreteneiirs " are old sinners who, even with the danger of falling into the hands of blackmailers, cannot deny themselves the pleasure of keeping a (male) mistress. The "souteneurs" are pederasts that have been punished, who keep their "jesus," whom they send out to entice customers {"/aire chanter lea rivettes "), and who then, at the right moment if possible, appear for the purpose of plucking the victim. Not infrequently they live together in bands, the mem- bers, in accordance with individual desire, living together as husbands and wives. In such bands there are formal marriages, betrothals, banquets and introductions of brides and grooms into their apartments. These " souteneiirs " train up their " jcszts ". The passive pederasts are " petits jesus," " jestts," or " aunts ". The "petits jesus" are lost, depraved children, placed by accident in the hands of active pederasts, who seduce them, and reveal to them the horrible means of earning a livelihood, either as " entretenus" or as male street-walkers, with or without " souteneurs ". The slyest and choicest "petits jesus'' are those trained by persons who instruct these children in the art of female dress and manner. Gradually they emancipate themselves from teacher and master, in order to become "fcmnies entrctemces," not infrequently by means of anonymous denunciation of their " soziteneurs " to the police. It is the object of the "souteneur" and the "petit jesus " to make the latter appear young as long as possible by means of all the arts of the toilet. The limit of age is about twenty-five years ; when they all become "jesus " and " femvics entretemtes ," and are then often sustained by several "souteneurs". The "jesus" 558 PSYCHOPATHIA SEXUALIS. fall into three categories : " filles galantes," i.e., those that have fallen again into the hands of a "souteneur"; "pier- reuses " (ordinary street- walkers, hke their female col- leagues) ; and " domestiques ". The " domestiques " hire themselves out to active pederasts, either to gratify their desires or to obtain " petits jesus" for them. A sub-group of these " domestiques " is formed by such of them as enter the service of " petit s jesus" as " fcmmes de chamhre ". The principal object of these "domestiques" is to use their positions to obtain compromising know- ledge, with which they later practise blackmail, and thus assure themselves ease in their old age. The most horrible class of active pederasts is made up of the " aufits," — i.e., the " soutenetirs " of (male) prosti- tutes, — who, though normal sexually, are morally de- praved, and practise pederasty (passive) only for gain or for the purpose of blackmail. The wealthy "amateurs" have their reunions and places of meeting, where the passive ones appear in female attire, and horrible orgies take place. The waiters, musicians, etc., at such gatherings are all pederasts. The " filles galantes" do not venture, except during the carnival, to show themselves in the street in female attire; but they know how to lend to their appearance something indicative of their calling by means of style of dress, etc. They entice by means of gesture, peculiar movements of the hands, etc., and lead their victims to hotels, baths, or brothels. What the author says of blackmail is generally known. There are cases where pederasts have allowed their entire fortune to be wrung from them. That these monstrosities of large cities in the shape of " petits jesus" are not only the productions of profes- sional training, but rather of a degenerated mental condi- tion is apparent from the researches made by Laurent (" Les bisexues," Paris, 1894). He describes on page 175 CULTIVATED PEDERASTY. 559 of bis book under tbe title of " Hermapbroclitisme artifi- ciel " manifestations of " effemination " and " infantilisme ". Tbey refer to boys who with incipient puberty show no further development of the frame and the genital organs, have no growth of hair about the face or pubes, do not change the voice and are retrograde in their mental faculties. Often it happens that in such cases secondary physical and psychical female characteristics of sexuality are developed. A post mortem of such " petits garroches " (Brouardel) reveals a small bladder, mere rudiments of the prostate, absence of the ischio and bulbo cavernosi muscles, infantile penis, and a very narrow pelvis. They are beyond doubt heavily tainted individuals who have experienced at the time of puberty a sort of rudi- mentary sexual change. Laurent (p. 181) makes the interesting remark, that from the ranks of these " Infantiles " and "Effeminates " the professional passive pederasts (" petits jesus") are recruited. It is evident, therefore, that these human monstrosities are predestmed for and trained, so to speak, in their abomi- nable career by degenerative and anthropological factors. The following notice from a Berlin (National ?) news- paper, of February, 1884, which fell into my hands by accident, seems suited to show something of the life and customs of pederasts and urnings : — " The Woman-haters' Ball. — Almost every social element of Berhn has its social reunions — the fat, the bald-headed, the bachelors, the widowers — and why not the woman- haters ? This species of men, so interesting psychologi- cally and none too edifying, had a great ball a few days ago. ' Grand Vienna Fancy Dress Ball,' — ran the notice. The sale of tickets is very rigorous ; they wish to be very exclusive. Their rendezvous is a well-known dancing-hall. We enter the hall about midnight. The merry dancing is to the strains of a fine orchestra. Thick tobacco- smoke, veiling the gashghts, does not allow the details of the 560 PSYCHOPATHIA SEXUALIS. moving mass to become obvious ; only during the pause betv\^een the dances can we obtain a closer viev7. The masks are by far in the majority ; black dress-coats and ball-gowns are seen only now and then. " But what is that ? The lady in rose-tarletan, that just now passed us, has a lighted cigar in the corner of her mouth, and puffs like a trooper ; and she also wears a small, blonde beard, lightly painted out. And yet she is talking with a very decollete ' angel ' in tricots, who stands there, with bare arms folded behind him, likewise smoking. The two voices are masculine, and the conver- sation is likewise very masculine ; it is about the ' d tobacco smoke, that permits no air '. Two men in female attire ! A conventional clown stands there, against a pillar, in soft conversation with a ballet-dancer, with his arm around her faultless waist. She has a blonde ' Titus- head ' sharp-cut profile, and apparently a voluptuous form. The brilliant ear-rings, the necklace vnth a medallion, the full, round shoulders and arms, do not permit a doubt of her ' genuineness,' until, with a sudden movement, she disengages herself from the embracing arm, and, yawning, moves away, saying, in a deep bass, ' Emile, you are too tiresome to-day ! ' The ballet-dancer is also a male ! " Suspicious now, we look about further. We almost suspect that here the world is topsy-turvy ; for there goes, or, rather, trips, a man — no, no man at all, even though he wears a carefully trained moustache. The well-curled hair ; the powdered and painted face with the blackened eyebrows ; the golden ear-rings ; the bouquet of flowers reaching froan the left shoulder to the breast, ornament- ing the elegant black gown ; the golden bracelets on the wrists ; the elegant fan in the white-gloved hand — all these things are anything but masculine. And how he toys with the fan ! How he dances and turns and trips and lisps ! And yet kindly Nature made this doll a man. He is a salesman in a large sweet shop, and the ballet- dancer mentioned is his ' colleague '. CULTIVATED PEDERASTY. 561 " At a little corner-table there seems to be a great social circle. Several elderly gentlemen press around a group of decollete ladies, who sit over a glass of wine and — in the spirit of fun — make jokes that are none too deli- cate. AVho are these three ladies ? ' Ladies ! ' lausrbs my knowing friend. ' Well, the one on the right, with the brown hair and the short, fancy dress, is called " Butterrieke," he is a hairdresser ; the second one — the blonde in a singer's costume, with the necklace of pearls — is known here by the name of " Miss Ella of the tight- rope," and he is a ladies' tailor , and the third — that is the widely celebrated " Lottie ".' " But that person cannot possibly be a man ? That waist, that bust, those classic arms, the whole air and person are markedly feminine ! " I am told that ' Lottie ' was once a bookkeeper. To-day she, or, rather, he, is exclusively ' Lottie,' and takes pleasure in deceiving men about his sex as long as possible. * Lottie ' is singing a song that would hardly do for a drawing-room, in a high voice, acquired by years of practice, which many a soprano might envy. ' Lottie ' has also ' worked ' as a female comedian. Now the quon- dam bookkeeper has so entered into the female role that he appears on the street in female attire almost exclu- sively, and, as the people with whom he lodges state, uses an embroidered night-dress. " On closer examination of the assembly, to my as- tonishment, I discover acquaintances on all hands : my shoemaker, whom I should have taken for anything but a woman-hater — he is a ' troubadour,' with sword and plume ; and his 'Leonora,' in the costume of a bride, is accus- tomed to place my favourite brand of cigars before me in a certain cigar-store. ' Leonora,' who, during an inter- mission, removes her gloves, I recognise with certainty by her large, blue hands. Eight ! There is my haber- dasher, also ; he moves about in a questionable costume as Bacchus, and is the swain of a repugnantly bedecked 36 562 PSYCHOPATHIA SEXUALIS. Diana, who works as a waiter in a beer-restaurant. The real ' ladies ' of the ball cannot be described here. They associate only with one another, and avoid the woman- hating men ; and the latter are exclusive, and amuse themselves, absolutely ignoring the charms of the women." These facts deserve the careful attention of the police, who should be placed in a position to cope with male prosti- tution, as they 7iow do with that of women. Male prostitution is certainly much more dangerous to society than that of females ; it is the darkest stain on the history of humanity. From the statements of a high police official of Berlin, I learn that the police are conversant with the male demi- mofule of the German capital, and do all they can to sup- press blackmail among pederasts — a practice which often does not stop short of murder. The foregoing facts justify the wish that the law-maker (»/ the future 7nay, for reasons of utility, at least, abandon the prosecution of pederasty. With reference to this point, it is worthy of note that the French Code does not punish it so long as it does not become an offence to public decency. Probably for politico-legal reasons, the new Italian Penal Code passes over the crime of unnatural abuse m silence, as do the statutes of Holland and, as far as I know, Belgium and Spain. In how far such cultivated pederasts are to be regarded as mentally and morally sound may remain an open ques- tion. The majority of them suffer with genital neuroses. At least in these cases there are the stages of transition to acquired pathological antipathic sexual instinct (see p. 273), The responsibility of these individuals, who are certainly much lower than the women who prostitute themselves, cannot, generally speaking, be questioned. The various categories of male-loving men, with respect to the manner of sexual indulgence, may be thus char- acterised in general : — CULTIVATED PEDEEASTT. 563 The congenital urning becomes a pederast only excejj- tionally, and eventually resorts to it after having practised and exhausted all the possible immoral acts with males. Passive pederasty is to him the ideally and practically adequate form of the sexual act. He practises active pederasty only to please another. The most important point here is the congenital and unchangeable perversion of the sexual instinct. It is otherw^ise v^^ith the pederast by cultivation. He has once acted normally sexually, or at least had normal inclinations, and occasionally has intercourse with, the opposite sex. His sexual perversity is neither congenital nor unchangeable. He begins with pederasty and ends in other perverse sexual acts, induced by weakness of the centres for erection and ejaculation. At the height of his power, his sexual desire is not for passive, but for active pederasty. He yields to passive pederasty only to please another; for money, in the role of a male prostitute; or as a means, when virility is declining, to make active pederasty still occasionally possible. A horrible act, that must be alluded to, in conclusion, is pcedicatio rmdierum} and even uxorum. Sensual indi- viduals sometimes do it with hardened prostitutes, or even with their wives. Tardieu gives examples where men, usually practising coitus, sometimes indulged in pederasty with their wives. Occasionally fear of a repeti- tion of pregnancy may induce the man to perform and the woman to tolerate the act. Case 205. Imp^itation of pederasty that tvas not proved. Resume from the legal proceedings : — 1 Cf. Tardieu, " Attentats," p. 198 ; Martineau, " Deutsche Med. Zeitung," '1882, p. 9; Virchoiu's "Jahrb.," 1881, i., p. 533; Coutagne, "Lyon Medical," Nos. 35, 36. Eulenhxirg in '' Zillzer's Klin. Plandb. d. Ham- u. Sexual-organe," iv. Abtheil. p. 45, relates cases of his own experience, in which women brought actions for divorce on the ground that the husband, in order to avoid ofTspring, practised pcedicatio only. 564 PSYCHOPATHIA SEXUALIS. On 30tb May, 1888, Dr. S., chemist, of H., in an anonymous letter, was accused by his stepfather of liavjng immoral relations with G., aged nineteen, the son of a butcher. Dr. S. received the letter, and, astounded by its contents, hastened to his master, who promised to proceed discreetly in the matter, and to ascertain from the authori- ties what was being said about this matter by the public. On the next morning, G.. who lived in the house of Dr. S., was arrested. At the time he was sick with gonorrhoea and orchitis. Dr. S. tried to induce the authori- ties to release G., and advised caution, but he was refused. In his statement to the judge, S. said that he became acquainted with G. on the street, three years previously, and then saw no more of him until the fall of 1887, when he met him m his father's shop. After November G. supplied Dr. S.'s kitchen with meat — commg in the evening to get the order, and bringing the meat the next morning. Thus S. gradually got well acquainted with G., and came to have a very friendly feehng for him. When S. fell ill and was, for the most part, confined to his bed until the middle of May, 1888, G gave him so much atten- tion that S.' and his wife were much attracted to him on account of his harmless, child-hke and happy disposition. Dr. S. showed and explained to him his collection of curi- osities, and they spent the evenings pleasantly together, the wife also being usually present ; besides, S. and G. experimented in making sausages, jelly, etc. In February, 1888, G. fell ill with gonorrhoea. Dr. S., being his friend, and having studied medicine for several terms, took care of G., procured medicine for him, etc. In May, G. being still sick, and, for several reasons, inclined to leave home, S. and his wife took him into their own home to care for him. S denied the truth of all the suspicions that had been raised by this relation, and defended himself by pointing to his hfe of previous respectability, his educa- tion, and to the fact that G , at the time, was suffering with a disgusting, contagious disease, and that he himself CULTIVATED PEDERASTY. 565 had a painful affection (nephritic calculus, with occasional attacks of colic). Opposed to this statement of Dr. S.'s must be men- tioned the facts that were brought out in court, and which led to conviction in the first trial. The relation of S. to G. had, by reason of its obvious- ness, given cause for remark by private individuals, as well as by those in public houses. G. spent almost all his evenings with S/s family, and, finally, came to be quite at home there. They took walks together. Once, while out on such a walk, S. said to G. that he was a pretty fellow, and that he (S.) was very fond of him. On the same occasion, there was also talk of sexual matters, and also of pederasty. S. said he touched on these subjects only to warn G. With reference to the intercourse at home, it was proved that occasionally S., while sitting on a sofa, euibraced G., and kissed him. This happened in the presence of the wife, as well as of the servant-girls. When G. was ill with gonorrhoea, S. instructed him in the method of using a syringe, and, at the time, took the penis in his hand. G. testified that S., in answer to his question why he was so fond of him, said, " I don't know myself". When, one day, G. remained away, S., with tears in his eyes, complained of it to him when he re- turned. S. also told him that his marriage was unhappy, and, in tears, begged G. not to leave him ; that he must take the place of his wife. From all this resulted the just accusation, that the relation between the culprits had a sexual direction. The fact that all was open and known to everybody, accord- ing to the complaint, did not speak for the harmlessness of the relation, but more for the intensity of the passion of S. The spotless life of the accused was allowed, as well a* his honesty and gentleness. The probability of an unhappy marriage, and that S. was of a very sensual nature, was shown. During the course of the trial, G. was repeatedly ex- 566 PSYCHOPATHIA SEXUALIS. amined by the medical experts. He is scarcely of medium size, pale, and of powerful frame ; pen' • and testicles are very perfectly developed (large). In consonance with the accusation, it was found that the anus was pathologically changed, in that there were no wrinkles in the skin about it and the sphincter was relaxed ; and it was presumed that these changes pointed to the probability of passive pederasty. The conviction was based on these facts. The judg- ment passed recognised that the relation existing between the culprits did not necessarily point to unnatural abuses, any more than did the physical conditions found on the person of G. However, by reason of the combination of the two facts, the court was convinced of the guilt of both culprits, and held it proved : " That the abnormal condition of G.'s anus had been caused by the frequently repeated introduction of the penis of S. and that G. voluntarily permitted the performance of this immoral act on him- self ". Thus the conditions of § 175, E. St. G. B., seemed to be covered. In passing sentence there was considera- tion of S.'s education, which made him appear to be G.'s seducer ; in G.'s case, this fact and his youth were given weight ; and the previous respectability of both was held in view. Thus Dr. S. was sentenced to imprisonment for eight months, and G. for four months. The culprits appealed to the Supreme Court at Leip- zic^, and prepared themselves, in case the appeal should be denied, to collect evidence sufficient to call for a new trial. They subjected themselves to examination and ob- servation by distinguished experts. The latter declared that G.'s anus presented no signs of indulgence in passive pederasty. Since it seemed of importance to those interested to make clear the psychological aspect of the case, which CTLTIVATED PEDERASTY. 567 was not touched on at the trial the author was intrusted with the examination and observation of Dr. S. and G. Results of the Personal Examination, from 1 1th to loth December, 1SS8, in Graz. — Dr. S., aged thirty-seven ; two years married, without children. Ex-director of the City Laboratory of H. He comes of a father who is said to have been nervous, owing to great activity ; who had an apoplectic attack in his fifty-seventh year, and died, at the age of sixty-seven, of another attack of apoplexy. His mother is hving, and is described as a strong person, who has been nervous for years. Her mother reached quite an old age, and is said to have died of a cerebellar tumour. A brother of the mother's father is said to have been a drinker. The paternal grandfather died early, of softening of the bram. Dr. S. has two brothers, who are in perfect health. He states that he is of nervous temperament, and has been of strong constitution. After articular rheumatism, which he had in his fourteenth year, he suffered with great nervousness for some months. Thereafter he often suffered with rheumatic pams, palpitation, and short- ness of breath. These symptoms gradually disappeared with sea-bathing. Seven years ago he had gonorrhoea. This disease became chronic, and for a long time caused bladder difficulty. In 1887 he had his first attack of renal cohc, and he had such attacks repeatedly during the winter of 1887 and 1888, until 16th May, 1888, when quite a large renal calculus was passed. Since then his condition had been quite satisfactory. While suffering with stone, during coitus, at the moment of ejaculation, he felt severe pain in the urethra and the same pain when urinating. With reference to his life, S. states that he attended the Gymnasium until he was fourteen, but after that, owing to the results of his severe illness, he studied privately. He then spent four years in a chemist's shop, and then studied medicine for six semesters at the Uni- 568 PSYCHOPATHIA SEXUALIS. versity, serving, in the war of 1870, as a voluntary hos- pital assistant. Since he had no certificate of graduation from the Gymnasium, he gave up the study of medicine, and obtained the degree of doctor of philosophy. Ther. he served in the Museum of Minerals in K., and later as assistant in the Mineralogical Institute of H. Thereafter he made special studies in the chemistry of food-stuffs, and five years ago became director of the City Laboratory. He makes all these statements in a prompt, precise manner, and does not think long about his ansv^ers ; so that one is more and more led to think that he is a man who loves and speaks the truth — the more, since, on the following day, his statements are identical. With reference to his vita scxualis, Dr. S., in a modest, delicate and open way, states that in his eleventh year he began to have a knowledge of the difference of the sexes, and for some time, until his fourteenth year, was given to onanism. He first had coitus at eighteen, and thereafter indulged moderately. His sensual desire had never been very great, but, until lately, the sexual act had been normal in every way, and accompanied by gratifying pleasurable feeling and full virility. Since his marriage, two years ago, he had cohabited with his wife exclusively. He had married his wife out of love, and still loved her, having coitus with her at least several times a week. The wife, who was also at hand, confirmed these statements. All cross-questioning with reference to a perversion of sexual feeling toward men Dr. S. answered repeatedly in the negative, to repeated examination, and that without contradiction or any thought of the answers. Even when, in order to trap him, he is told that the proof of a perverse sexual instinct would be of avail in the trial, he sticks to his statements. One gains the important impression that S. has not the slightest knowledge of the facts of male-love. Thus it is learned that his lascivious dreams have never been about men ; that he is interested only in female nudity ; that he liked to dance with ladies, etc. CULTIVATED PEDEEASTY. 569 No traces of any kind of sexual inclination for his own sex can be discovered in S. With reference to his rela- tions with G., Dr. S. expresses himsalf exactly as he did at his examination before the court. In explanation of his partiality for G., he can only say that he is nervous, and a man of feeling and great sensibility, and very sensitive to friendliness. During his illness he had felt very lonesome and depressed ; his wife had frequently been with her parents ; and thus it had happened that he had become friendly with G., who was so gentle and kind. He still had a weakness for him, and felt remarkably quiet and contented while in his society. He had had two such close friendships previously : when he was yet a student, with a corps-brother, a Dr. A., whom he also embraced and kissed ; later, with a Baron M. When it happened that he could not see him for a few days, he became depressed, and even cried. He also had a similar feeling and attachment for animals. Thus he had mourned the loss of a poodle that died a short time ago, as if it had been a member of the family ; he had often kissed the animal. (On relating this, the tears came to his eyes.) His brother confirmed these statements, with the remark, with reference to his brother's remarkable friendship for A. and M., that in these instances there was not the slightest suspicion of sexual colouring or relation. The most careful and detailed examination of Dr. S. gave not the slightest reason for such a presumption. He states that he never had the slightest sexual feeling for G., to say nothing of erection or sexual desire. His partiality for G., which bordered on jealousy, S. ex- plained as due merely to his sentimental temperament and his inordinate friendship. G. was still as dear to him as if he were his son. It is worthy of note that S. stated that when G. told him about his love adventures with girls, it had hurt him only because G. was in danger of injuring himself and 570 PSTCHOPATHIA SEXUALIS. ruining his health by dissipation. He had never felt hurt himself by this. If he knew a good girl for G., he would be glad to rejoice with him and do all he could to promote their marriage. S. states that it was first in the course of his legal examination that he saw how he had been careless in his intercourse with G., by causing gossip. His openness he explained as due to the innocence of the friendship. It is worthy of note that S.'s wife never noticed any- thing suspicious in the intercourse between her husband and G., though the most simple wife would instinctively notice anything of that nature. Mrs. S. had also made no opposition to receiving G. into the house. On this point she remarked that the spare-room in which G. lay ill was on the second floor, while the living apartments were on the fourth ; and, further, that S. never associated alone with G. as long as he was in the house. She states that she is convinced of her husband's innocence, and that she loves him as before. Dr. S. states freely that formerly he had often kissed G., and talked with him about sexual matters. G. was much given to women, and in friendship he had often warned him about sexual dissipation, particularly when G., as often happened, did not look well He had once said that G. was a handsome fellow ; it was in a perfectly harmless relation. The kissing of G. had been due to inordinate friend- ship, when G. had shown him some particular attention, or pleased him especially. In the act he had never had any sexual feeling. When he had now and then dreamed of G., it was in a perfectly harmless way. It appeared of great importance to the author to form also an opinion of G 's personality. On 12th December the desired opportunity was given, and G. was carefully examined. G. is a young man, aged twenty, of delicate build, whose development corresponds with his years ; and he CULTIVATED PEDERASTY. 571 appears to be neuropathic and sensual. The genitals are normal and well developed. The author thinks he may- be permitted to pass over the condition of the anus, as he does not feel called upon to pass judgment upon it. Pro- longed association with G. gives one the impression that he is a harmless, kind, and artless man, who is light- minded, but not morally depraved. Nothing in his dress or manner indicates perverse sexual feeling. There cannot be the slightest suspicion that he is a male courtesan. When G. is introduced in medias res, he states that S. and he, feehng their innocence, had told the matter as it actually was, and on this the whole trial had been based. At first, S.'s friendship, and especially the kissing, had seemed remarkable, even to him. Later he had con- vinced himself that it was merely friendship, and had then thought no more about it. G. had looked upon S. as a father-like friend ; for he was so unselfish, and loved him so. The expression " handsome fellow " was made when G. had a love-affair, and when S. expressed his fears about a happy future for G. At that time S. had com- forted him, and said that his (G.'s) appearance was pleas- ing, and that he would make an eligible match. Once S. had complained to him (G.) that his wife was inchned to drink, and burst into tears. G. was touched by his friend's unhappiness. On this occasion S. had kissed him, and begged for his friendship^ and asked him to visit him frequently. S. had never spontaneously directed the conversation to sexual matters. G. once asked what pederasty was, of which he had heard much while in England ; and S. had explained it to him. G. acknowledges that he is sensual. At the age of twelve he had l)een made acquainted with sexnal matters by schoolmates. He had never masturbated, had first had coitus at the age ot eighteen, and had since visited brothels frequently. He had never felt any inchnation 572 PSYCHOPATTTIA SEXUALIS. for his own sex, and had never experienced any sexual excitement when S. kissed him. He had always had pleasure in coitus normally performed. His lascivious dreams had always been of women. With indignation, and pointing to his descent from a healthy and respectable family, he repels the insinuation of having been given to passive pederasty. Until the gossip about them came to his ears, he had been innocent and devoid of suspicion. The anal anomalies he tries to explain in the same way that he did at the trial. Auto-masturbation in another denies. It should be noted that Mr. J. S. claims to be no less astonished by the charge against his brother of male-love than those more closely associated with him. Yet he could not understand what attached his brother to G. ; and all the explanations which S. made to him concerning his relation to G. were vain. The author took the trouble to observe Dr. S. and G., in a natural way, while they were dining, in company with S.'s brother and Mrs. S., in Graz. This observation revealed not the slightest sign of improper friendship. The general impression which Dr. S. made on me was that of a nervous, sanguine, somewhat overstrained in- dividual, but, at the same time, kind, open-hearted, and very emotional. Dr. S. is physically strong, somewhat corpulent, with a symmetrical, brachycephahc cranium. The genitals are well developed ; the penis somewhat beUied ; the prepuce shghtly hypertrophied. Opinion. — Pederasty is, unfortunately, not infrequent among mankind to-day ; but still, occurring among the peoples of Europe, it is an unusual, perverse, and even monstrous manner of sexual gratification. It presumes a congenital or acquired perversion of the sexual instinct, and, at the same time, defect of moral sense that is either original or acquired, as a result of pathological influences. Medico-legal science is thoroughly conversant with C^ULTIVATED PEDERASTY. 573 the physical and psychical conditions from which this aberration of the sexual instinct arises; and in the concrete and doubtful case it seems requisite to ascertain whether these empirical, subjective conditions necessary for pederasty are present. It is essential to distinguish between active and passive pederasty. Active pederasty occurs : — I. As a non-jyathological phenomenon : — 1. As a means of sexual gratification, in case of great sexual desire, with enforced abstinence from natural sexual intercourse. 2. In old debauchees, who have become satiated with normal sexual intercourse, and more or less impotent, and also morally depraved ; and who resort to pederasty in order to excite their lust with this new stimulus, and aid their virility that has sunk so low psychically and physi- cally. 3. Traditionally, among certain barbarous races that are devoid of morality. II. As a pathological phenomenon : — 1. Upon the basis of congenital sexual inversion, with repugnance for sexual intercourse with women, or even absolute incapability of it. But, as even Casper knew, pederasty, under such conditions, is very infrequent. The so-called urning satisfies himself with a man by means of passive or mutual onanism, or by means of coitus-Hke acts {e.g., coitus inter femora) ; and he resorts to pederasty only very exceptionally, as a result of intense sexual de- sire, or with a low or lowered moral sense, out of desire to please another. 2. On the basis of acquired pathological sexual inver- sion : — (a) As a result of onanism practised through many years, which finally causes impotence for women with continuance of intense sexual desire. (i) As a result of severe mental disease (senile dementia, brain-softening in the insane, etc.) in which, as expeii- 574 PSYCHOPATHIA SEXUALIS. ence teaches, an inversion of the sexual instinct may take place. Passive pederasty occurs : — I. As a non-pathological phenomenon : — 1. In individuals of the lowest class, who, having had the misfortune to be seduced in boyhood by debauchees, endured pain and disgust for the sake of money, and be- came depraved morally, so that, in more mature years, they have fallen so low that they take pleasure in being male prostitutes. 2. Under circumstances analogous to those of I., 1 — as a remuneration to another for having allowed active pederasty. II. As a patJiological phenomenon : — 1. In individuals affected with sexual inversion, with endurance of pain and disgust, as a return to men for the bestowal of sexual favours 2. In urnings who feel toward men like women, out of desire and lust. In such female-men there is horror femina and absolute incapability for sexual intercourse with women. Character and inclinations are feminine. The empirical facts that have been gathered by legal medicine and psychiatry are all included in this classifi- cation. Before the court of medical science, it would be necessary to prove that a man belonged to one of the above categories in order to carry the conviction that he was a pederast. In the life and character of Dr. S., one searches in vain for signs which place him in one of the categories of active pederasts which science has established. He is neither one forced to sexual abstinence, nor one made impotent for women by debauchery ; neither is he con- genitally male-loving, nor alienated from women by mas- turbation, and attracted to men through continuance of sexual desire ; and, finally, he is not sexuahy perverse as a result of severe mental disease. In fact, the general conditions necessary for the occur- CULTIVATED PEDERASTY. 575 rence of pederasty are wanting in him — moral imbecility or moral depravity, on the one hand, and inordinate sexual desire on the other. It is likewise impossible to classify the accomplice, G., in any of the empirical categories of passive pederasty ; for he possesses neither the peculiarities of the male pros- titute nor the clinical marks of effemination ; and he has not the anthropological and clinical stigmata of the female-man. He is, in fact, the very opposite of all this. In order to make a pederastic relation between the two plausible medico-scientifically, it would be requisite for Dr. S. to present the antecedents and marks of the active pederasts of I., 2, and G., those of the passive pederasts of II., 1 or 2. The assumption lying at the basis of the verdict is, from a psychological standpoint, legally untenable. With the same right, every man might be considered a pederast. It remains to consider whether the explana- tions given by Dr. S. and G. of their remarkable friend- ship are psychologically valid. Psychologically it is not without parallel that so senti- mental and eccentric a man as S. — without any sexual excitement whatever — should entertain a transcendental friendship. It suffices to recall the friendship of school- girls, the self-sacrificing friendship of sentimental young persons in general, and the partiality which this sensitive man sometimes showed even for domestic animals — where no one would think of sodomy. With S.'s mental char- acter his extraordinary friendship for the youth G. may be easily comprehended. The openness of this friendship permits the conclusion that it was innocent, much rather than that it depended upon sensual passion. The defendants succeeded in obtaining a new trial. The new trial took place on 7th March, 1890. There was much evidence presented in favour of the accused. The previous moral life of S. was generally acknow- ledged. The Sister of Charity who cared for G. in S.'s 576 PSYCHOPATHIA SEXUALIS. house, never noticed anything suspicious in the inter- course between S. and G. S.'s former friends testified to his morahty, his deep friendship, and his habit of kissing them on meeting or leaving them. The anal abnor- malities previously found on G. were no longer present. Experts called by the court allowed the possibihty that they had been due simply to digital manipulations ; their diagnostic value in any case was contested by the experts called by the defence. The court recognised that the imputed crime had not been proved, and exonerated the defendants. Lesbian Love.^ "Where the sexual intercourse is between adults, its legal importance is very slight. It could conje into con- sideration only in Austria. In connection with urningism, tliis phenomenon is of anthropological and clinical value. The relation is the same, mutatis mutandis, as between men. Lesbian love does not seem to approach urningism in frequency. The majority of female urnings do not act in obedience to an innate impulse, but they are developed under conditions analogous to those which produce the urning by cultivation. These " forbidden friendships " flourish especially in penal institutions for females. , Kraussold {oj). cit.) reports : " The female prisoners often have such friendships, which, when possible, extend to mutual manustupration. " But temporary manual gratification is not the only purpose of such friendships. They are made to be endur- ing — entered into systematically, so to speak — and intense 1 C/. Mayer, '' Friedreich s Blatter," 1875, p. 41; Krausold, " MelaD- cliolie und Sclmld," 1884, p. 20 ; Andronico, " Archiv di psich. scienze penali ed antliropol. crim.," vol. iii., p. 145; Chevalier, " L'inversion sexuellc," Paris, 1SU3, p. 217 (searching description of " sapphic love " in modern Paris). LESBIAN LOVE. 577 jealousy and a passion for love are developed v^hich could scarcely be surpassed between persons of opposite sex. When the friend of one prisoner is merely smiled at by another, there are often the most violent scenes of jealousy, and even beatings. " When the violent prisoner has been put in irons, in accordance with the prison regulations, she says ' she has had a child by her friend '." We are indebted to Parent- Duchatelet (" De la prosti- tution," 1857, vol. i., p. 159), for interesting communica- tions concerning Lesbian love According to this experienced author, repugnance for the most disgusting and perverse acts (coitus in axilla, ore, inter mammas, etc.) which men perform on prostitutes is not infrequently responsible for driving these unfortu- nate creatures to Lesbian love. From his statements it is seen that it is essentially prostitutes of great sensuality who, unsatisfied with intercourse with impotent or per- verse men, and impelled by their disgusting practices, come to indulge in it. Besides these, there are prostitutes who let themselves be known as given to tribadism ; persons who have been in prisons for years, and in these hot-beds of Lesbian love, ex abstmentia, acquired this vice. It is interesting to know that prostitutes hate those who practice tribadism,— just as men abhor pederasts ; but female prisoners do not regard the vice as indecent. Parent mentions the case of a prostitute who, while intoxicated, tried to force another to Lesbian love. The latter became so enraged that she denounced the indecent woman to the police. Taxil (op. cit., pp. 166, 170) reports similar instances. Maiitefjazza ("Anthropol. culturhistorische Studien," p. 97) also finds that sexual intercourse between women has especially the significance of a vice which arises on the basis of unsatisfied hypercesthesia sexualis. o/ 578 PSYCHOPATHIA SEXUALIS. In many cases of this kind, however, aside from con- genital sexual inversion, one gains the impression that, just as iu men {vide supra)^ the cultivated vice gradually leads to acquired antipathic sexual instinct, with repugnance for sexual intercourse with the opposite sex. At least Parent's cases were probably of this nature. The correspondence with the lover was quite as sen- timental and exaggerated in tone as it is between lovers of the opposite sex ; unfaithfulness and separation broke the heart of the one abandoned ; jealousy was unbridled, and led to bloody revenge. The following cases of Lesbian love, by Mantegazza, are certainly pathological, and pos- sibly examples of congenital antipathic sexual instinct : — (1) On 5th July, 1777, a woman was brought before a court in London, who, dressed as a man, had been married to three different women. She was recognised as a woman, and sentenced to imprisonment for six months. (2) In 1773, another woman, dressed as a man, courted a girl and asked for her hand ; but the trick did not succeed. (3) Two women lived together as man and wife for thirty years. On her death -bed the " husband " confessed her secret to those about her. Coffiijnon {op. cit., p. 301) makes later statements worthy of notice. He reports that this vice is, of late, quite the fashion, partly owing to novels on the subject, and partly as a result of excessive work on sewing-machines, the sleeping of female servants in the same bed, seduction in schools by depraved pupils, or seduction of daughters by perverse servants. The author declares that this vice ("saphism") is met more frequently among ladies of the aristocracy and prostitutes. He does not differentiate physiological and pathological cases, nor, among the latter, the acquired and congenital cases. The details of a few cases, which are certainly LESBIAN LOVE. 579 pathological, correspond exactly with the facts that are known about men of inverted sexuality. The saphists have their places of meeting, recognise each other by peculiar glances, carriage, etc. Sapliistic pairs like to dress and ornament themselves alike, etc. They are then called " petites scetirs". Chevalier very drastically characterises the perversity and distinguishes it from the perversion in the following words (cf. " L'inversion sexuelle," p, 268, Paris, 1895): — "... que Ton soit pederaste ou lesbienne par surexci- tation des sens epuises, par avilissement mercantile, par besoin d'mie •' trompe la faim,' par faiblesse d'esprit ou dilettantisme ; il ressort de cette analyse que I'anomalie ne nait pas avec I'individu, que I'enfance I'ignore, qu'elle ne se montre guere d'un seul coup, mais peu a peu, gradu- ellement, a un certain age, apres des pratiques sexuelles normales, qu'elle n'est ni permanente, ni absolue, qu'elle se concilia avec la pleine conscience et I'integrite de I'intelligence, qu'elle peut s'amender et disparaitre, qu'elle ne s'accompagne primitivement d'aucune tare physique ou psychique saillante, qu'elle n'a pas d'autre criterium objectif que le fait lui-meme, qu'elle n'est ni fatale ni irresistible dans ses impulsions, qu'elle constitue enfin un etat particulier d'origine plus sociale qu'individuelle. " Defaut d'instinctivite, de spoutaneite, d'incoercibilite, J'imutabilite, absence ou posteriorite des defectuosites organiques et mentales correlatives, acquisition tardive et artificielle, premeditation des actes, conscience ; genese d'ordre mesologique, necessite d'une initiation prealable, et surtout nulle trace d'heredite, ce sont bien la les carac- teres de la passion pure, du vice sans alliage. Somme toute : rien de pathologique ; ou doit done prevenir, ou peut dene reprimer." 580 PSYCHOPATHIA SEXUALIS. 8. Necrophilia,^ (Austrian Statutes, § 306.) This horrible kind of sexual indulgence is so monstrous that the presumption of a psychopathic state is, under all circumstances, justified ; and Maschkas recommendation, that the mental condition of the perpetrator should always be investigated, is well founded. In any case, an abnormal and decidedly perverse sensuality is required to overcome the natural repugnance which man has for a corpse, and permit a feeling of pleasure to be experienced in sexual congress with a cadaver. Unfortunately, in the majority of the cases reported, the mental condition was not examined ; so' that the question whether necrophilia is compatible with mental soundness must remain open. But any one having know- ledge of the horrible aberrations of the sexual instinct would not venture, without further consideration, to answer the question in the negative. 9. Incest. (Austrian Statutes, § 132 ; Abridgment, § 189 ; German Statutes, § 174.) The preservation of the moral purity of family life is a product of civihsation ; and feehngs of intense dis- pleasure arise in an ethically intact man at thought of lustful feeling toward a member of the same family. Only great sensuality and defective ideas of laws and morals can lead to incest. Both conditions may, in tainted families, be opera- tive. Drinking and a state of intoxication in men ; weak- mindedness which does not allow the development of the feeling of shame, and which, under certain circumstances, is associated with eroticism in females — these facilitate the occurrence of incestuous acts. External conditions 1 Cf. Maschka, " Hdb.," iii., p. 191 (good historical notes) ; Lcgrand, "La folie," p. 521. INCEST. 581 which facilitate their occurrence are due to defective separation of the sexes among the lower classes. As a decidedly pathological phenomenon, the author has found incest in states of congenital and acquired mental weakness, and infrequently in cases of epilepsy and paranoia. In many of the cases, probably a majority, it is not possible, however, to find a pathological basis for the act which so deeply wounds not only the tie of blood, but also the feeling of a civilised people. But in many of the cases reported in Hterature, to the honour of humanity, the presumption of a psychopathic basis is possible. In the Feldtmann case {Marc-Ideler, vol. i., p. 18), where a father constantly made immoral attacks on his adult daughter, and finally killed her, the unnatural father was weak-minded and, besides, probably subject to periodical mental disease. In another case of incest between father and daughter {loc. cit., p. 247), the latter, at least, was weak-minded. Lombroso {" Archiv. di Psi- chiatria, viii., p. 519) reports the case of a peasant, aged forty-two, who practised incest with his daughters, aged, respectively, twenty-two, nineteen, and eleven ; he even forced the youngest to prostitute herself, and then visited her in a brothel. The medico-legal examination showed predisposition, intellectual and moral imbeciUty, and alcoholism. There was no mental examination in the case reported by Schilrmeyer (" Deutsche Zeitschr. fiir Staatsarznei- kunde," xxii , Heft 1.), in which a mother laid her son of five and a half years on herself, and practised abuse with him ; and in that given by Lafarque (" Journ. Med. de Bordeaux," 1874), where a girl, aged seventeen, laid her brother, aged thirteen, upon herself, brought about 7ne7n- broriim conjunctionem, and performed masturbation on him. The following cases are those of tainted individuals : — Legrand (" Ann. med. -psych.," May, 1876) mentions a 582 PSYCHOPATHIA SEXUALIS. girl, aged fifteen, who seduced her brother into all manner of sexual excesses on her person ; and when, after two years of this incestuous practice, her brother died, she attempted to murder a relative. In the same article there is the case of a married woman, aged thirty-six, who hung her open breast out of a window, and indulged in abuse with her brother, aged eighteen ; and also the case of a mother, aged thirty-nine, who practised incest with her son, with whom she was madly in love, became pregnant by him, and induced abortion. A second case published by Kolle and taken from a criminal psychiatric opinion of the psychiatric clinic of Zurich refers to incest committed by a father on his im- becile adult daughter. This man suffered from chronic alcoholism. Through Casper we know that depraved mothers in large cities sometimes treat their little daughters in a most horrible fashion, in order to prepare them for the sexual use of debauchees. This crime belongs elsewhere. 10. Immoral Acts with Persons in the Care of Others as Wards ; Seduction (Austrian). (Austrian Statutes, § 131 ; Abridgment, § 188 ; German Statutes, § 173). Allied to incest, but still less repugnant to moral sen- sibility, are those cases in which persons seduce those entrusted to them for care or education, and who are more or less dependent upon them, to commit or suffer vicious practices. Such acts, which especially deserve legal punishment, seem only exceptionally to have psycho- pathic significance.. INDEX. Adultery, 16. Amor leshicus, 476, 576. — acquired 576. Anaesthesia sexualis, 54. — congenital, 54. — acquired, 61. Androgyny, 325, 384. Anthropophagy, 82. Aphrodisia, 31. Antipathic sexual instinct, 269. — acquired, 272. — congenital, 339. — treatment of, 431. — complications with other perver- sions, 428. — diagnosis of acquired, 431. — — of congenital, 433. — explanation of, 330. — in the male, 339. — in the female, 390. — prognosis of, 431. — prophylaxis of, 433. — therapy by suggestion, 435. — symptoms of neuropathic taint, 326. Animals, violation of, 539. Beast fetichism, 267. Bestiality, 539. — difference between zooerasty and, 539. Blackmailing, 548. Body, violation of, caused by fetichism, 517. by sadism, 507. Bondage, 193, 513. Boys, love for, 375. Celibacy, 15. Christianity, position of woman in, 5. Climacteiium, 15. Coitus, 41. Coquetry, 16. Corpses, violation of, 90, 476. Crimes, sexual, 472. — character pathological, 476. — responsibility in, 475. Cruelty and lust, 76, 82. — endured and lust, 115. Cunnilingus, 476. Defemination, 284. Levicittia paralitica, 450. — periodical, 461. — mental due to apoplexy, 449. — due to injuries to the head, 450. — due to lues cerebralis, 451. — consecutive to psychoses, 449. — paretic, 451. Despoilers of hair, 229. Development, psychical impediments of 445. Effemination, 373. Ejaculation, centre of, 46. — affections of, 46. Epilepsy, 453. Erection, 29. Erection centre, affections of, 46. Erogenous zones, 40. Eviration, 284. Exhibitionists, 477. — Epileptics, 481. — hereditary degenerates, 487. — neurasthenics, 484. — acquired, mental debility of, 478. Fanaticism, religious, 9. Fellare, 476. Fetich, 18. — animals, 267. — apron, 241. — costume, 235. — ear, 223. — eye, 22, 223. — foot, 21, 221. — fur, 255. — gloves, 21. — hair, 228. despoilers, 229. — hand, 21, 214. — handkerchiefs, 243. — in vi'oman, 25. — kid gloves, 264. — material, 255. — mouth, 223. — odour, 22. — physical defects, 223. — relations of otlier sexual perversion 21.5. (583) 584 INDEX. Feticli shoe and foot fetiehism as latent masocliisiii, 1,'')9. — shoes. '21, 222, 248. — silk, 255. — skin, 226. — skirts, 253. — soul, 21. — velvet, 255. — voice, 21 Feticliism, 18, 207. — as an acquired perver.sion, 211. — of beasts, 267. — erotic, 18. — explanation of, 207. — essence of, 209. — of the hair, 228. — of things and clothes, 235. — of parts of the body, 209. — physiological, 18. — religious, 18. — robbery, theft, 517. — violation of the body, 517. Flagellation as aphrodisia, 35. • — caused by masochism, 132. sadism, 95. Flagellants, 35. Fondness of dress, 16. Frottage, explanation of, 496. Frotteurs, 496. Friendship, 13. Gynandry, 325, 393. Hair duspoilers, 229. Hermaphrodism, psychical, 342. — psycho-sexual, 324. Homosexuality (vide Antipathic sexual- ity), 357. llyperfB.sthesia sexual, 69. Hypersesthetic zones, 40. Hy.steria, 467. Impotence, 13. — psychical due to fetiehism, 21Z Immorality, 521. Inp.est, 580. Insanity among the Scythians, 290. Instinct, sexual, 1, 27. — — control of, 40. — — in children, 48 ■ — — in old age, 50. Inversion, sexual, 276. koprolagnia, 178. Love, 15. — lor boys, 375. — for dress and finery, 17. — passionate, 2. — platonic, 13. — sappliic, 391, .576. Lust, murder, 82, 476, 500. — passive, 148. — in the sexual act, 42. Maltreatment of women, 95. Mania, 465. Masochism, 115, 513. — and antipathic sexuality, 206. — as original abnormality, 202. — of Baudelaire, 157. — desire for maltreatment and huniili ation, 117. — essence of, 115. — explanation of, 191. — — by Binet, 156. — flagellation, 132. ! — I'oot and shoe fetiehism, 159. — ideal, 150. — Koprolagnia, 178. — latent, 159, 178. — ol Jean Jacques Rousseau, 154. — symbolical, 148. — and sadism, analogy, 202. — — in the same individual, 205. — relation to sexual bondage, 195. — in woman, 187. Masturl)ation, consequences of, 273. — impulsive, 484. ■ — mutual, 476. Matrimony, 16. Maturity, sexual, 26. Melancholia, 467. Menopause, 15. Mental debility consequent upon psy- chosis, 449. due to specific disease, 451. Menstruation, 27. Metammyhosis sezualis 2>a'{i/)oia, 292 316. Modesty, 3, 16. Monogamy, 5. Morality, temporary decline of, 7. Mujerados, 291. Necrophilia, 580. Neurasthenia, 484. Neurosis, sexual, 44. — cerebral, 46. — peripheral, spinal, 45. Nose, relation to sexual spheres, 31. Nymphomania, 465. Olfactory sense and sexual spheres, 31 PcBdicatio mulieruin, 563. Pagism, 126. Paradoxia, sexual, 48. Paraesthesia of sexual in.stinct, 75. Paranoia, 469. Pederasty, 475, 539. — ■ active, 573. — not pathological, 554. — passive, 574. Perfumes, 31. Perversion, 75. Perversity, 75. Physiology of .sexual life, 26. Polygamy, 4. INDEX. 585 Polygamy of Christian princes, 4. Prostitution of men, 562. Psychology of sexual lilu, 1. — dilference between man and woman, 15. Psychopathia sexualis periodica, 463. Puberty, 26. Rape, 500. Pieligion and sensuality, 10. Robbery due to fetichism, 517. Sadism, 76. - and antipathic sexuality, 206. — of any object, 106. — boy whipping, 107. — corpse delilers, 90. — defilement of female persons, 152. — essence of, 115. — maltreatment orwomen, 95, 5C7. — and masochism, analogy, 202. in the same individual, 206. — lust murder, 82. — symbolical, 105. — in woman, 187. Sadistic acts perpetrated on animals, 109. .Satyriasis, 465. Scythians, dementia, 290. Sexual instinct, absence of, 269. — — perversions of, 445. basis of sesthetio sentiment, 12. in childhood, 48. in old age, 50. as pliysiological process, 40. psychical inhibitory, 446. Sexual instinct, elements in development of, 446. — — social, 1. — life, pathological in hy.steria, 467. periodical dementia, 461, — — mania, 465. melancholia, 467. — — paranoia, 469. Seduction, 582. Skopzi, 14. Sodomy, 539, 540. Statues, defilement of, 499. Sweat, 31. Theft, caused by fetichism, 517. Unnatural abuse, 539. Urnings, 325, 357. — forensic, 541, 547. — sexual acts of, 341. Violation, 530 — of statues, 499. — of animals, 539. — of wards, 582. Virginity, 324, 391. Vita sexualis, morality, 2. Voyeurs, 499. Woman, 4. — position in Christian Church, 4. — — in I.slam, 5. Zones, erogenous (hyperaestatic), 40 Zooerasty, 539. — definition of, 539, Zoophilia erotica, 267. University of California SOUTHERN REGIONAL LIBRARY FACILITY 305 De Neve Drive - Parking Lot 17 • Box 951388 LOS ANGELES, CALIFORNIA 90095-1388 Return this material to the library from which It was borrowed.