gonorrhoeal prostatitis, the long-kept-up congestion of the prostatic
urethra and of the colliculus leads to general reflex excitability,
to a high degree of nervousness, cerebrasthenia, and neurasthenia.
The colliculus being an organ which finds its analogue in the female
uterus, its constant irritation will show phenomena in men, usually
found in intensely hysterical women only.
The impotent men generally change their entire psychic nature. They
become timid, morose, solitary, melancholic, hypochondrical and
despondent. They are discontented, peevish, ill-humored, and evince
either blunted or inordinate sexual desires. They show profound
agitation at the slightest excitement. The patients are troubled
with insomnia or unrefreshed sleep and with a feeling of heaviness
on rising. The mind is enfeebled and the memory impaired. The mental
debility and dulness cause inability to collect their thoughts and
thus enfeebles the mind in its power of concentration. The patients
suffer from vertigo, singing in the ears, from a feeling of fulness in
the head, from asthenopia, depression, anxiety and irritability. They
often suffer from palpitation of the heart, sick headaches, coldness
of the hands and feet, dull heavy feelings, a sense of fatigue and a
loss of flesh. They also complain of creeping sensations in the loins,
of pricking in the back, of twitching and jerking of the muscles, of
muscular weakness, of lumbar pain and asthma. The intestinal canal
shows a general derangement, as coated tongue, poor appetite, sense of
weight in the epigastrium after eating, flatulence, sluggishness of the
bowels and constipation. The general health of the patient is broken,
the countenance is vacant and the gait feeble.
Besides the general symptoms, the genito-urinary organs are especially
affected in atonic impotence. The external genitals show a certain
flaccidity, shrinkage, paleness of the mucous membranes and a
diminution of the sensibility and electrical irritability. The skin
of the penis is cold, shriveled and somewhat insensible to electrical
stimulation. The electrical irritability of the skin of the two halves
of the scrotum is of a different degree, the right half being sometimes
more sensitive than the left.
The testicles are often very painful and tightly drawn up against the
external abdominal rings. The spermatic cord often shows an enlargement
of the veins (varicocele). The vas deferens and the ampulla are in a
state of inflammation.
The seminal vesicles are plainly felt indurated, nodular and distended
with fluid. In a large proportion of cases the repeated congestion
causes a veritable seminal vesiculitis. This inflammation is not seldom
extended to the ejaculatory ducts and occludes the same. Through
this occlusion spermatic colic, i. e., a severe pain in the region
of the vesicles, often seizes the patient, especially after some
sexual excitement, as dancing, caressing, and even flirting. After
such excitement a dull pain in the region of the prostate and in the
perineum as well as in the testicles, spermatic cords and in the rectum
is very annoying to the patient. Ejaculation often removes these pains.
For that reason the patient tries to relieve himself from the painful
sensations by masturbation. Ejaculation also removes the irritations
of the thighs, hips, anus, hypogastric region and in the smalls of the
back.
The entire urethra is often in a state of hyperaesthesia and
paraesthesia, and the prostatic portion shows congestion and not
seldom an inflammation of the mucous membrane. Especially the
colliculus is often in a severe inflammatory condition. There is
thickening sponginess or puffiness of the parts immediately involving
the ejaculatory ducts. The urethra manifests great sensibility. The
introduction of a bougie produces unbearable pains. The withdrawal of
the sound is often followed by several drops of blood. This hypertrophy
and inflammation of the colliculus seminalis is the cause of the
ejaculatio praecox in the beginning of the disease. Later on the
condition provokes weak erections and finally ejaculation with flaccid
member before entrance into the vagina.
The irritation of the urethra causes hypersecretion of the glands of
Littré and Cowper which is manifested by the so-called urethrorrhoea.
In urethrorrhoea the secretion is thin, transparent, perfectly clear
and sticky. The secretion has no spermatic odor and does not stain
the linen, but stiffens it. It is seen as a drop in the morning at
awakening with an erection. The drop is sticky and tenacious. The
meatus urethrae sticks together. The drop is not rarely found in
healthy men after violent and continuous erections. The secretions
show under the microscope nothing beyond free mucous and columnar and
pavement epithelia.
Besides the hypersecretion of the urethral glands, there is also
a hypersecretion of the prostate, especially in patients who
have indulged in excesses in masturbation and in onanism (coitus
interruptus). Masturbation as well as onanism do not give the same
satisfaction as normal coition, hence constant hankering for more and
overindulgence. Prostatorrhoea is often found after gonorrhoea, when
the yellowish drop gradually becomes whitish, flocculent, and finally a
colorless watery drop of clear, slightly viscid fluid. It is best seen
when the lips of the meatus are held apart.
In prostatorrhoea the discharge is never milky, white or purulent as
in pure prostatitis. Microscopically the slowly dried slide shows the
characteristic crystals of sodium chloride, but no spermatozoa. In
prostatorrhoea the orifice of the urethra shows constant moisture. The
copious evacuations occur while straining in the water-closet. The
patients are, as a rule, constipated. The discharge is attended with
peculiar sensations, sometimes of a pleasurable nature, sometimes of
a dropping sensation, weight in the region of the prostate, anus and
rectum. Examination per rectum often shows hard points and nodules in
the prostatic gland.
The most frequent anomaly caused by venereal excesses is spermatorrhoea
and nocturnal pollutions. The excesses provoke a chronic hypertrophy of
the prostatic gland, and this hypertrophy renders the ejaculatory ducts
insufficient.
In spermatorrhoea there is an oozing of semen from the urethra without
erection or pleasurable sensations. The rhythmic muscular contractions,
found in normal ejaculations, are missing here. The failure of the
normal contractions is due to a paresis of the muscular fibres of the
ejaculatory ducts.
Spermatorrhoea usually takes place after micturition or during
defecation. Sometimes spermatorrhoea is caused by the slightest
excitement. The sight of a woman’s bust or of her leg, the touch
of her hand, the smell of her perfume, the glance at a lascivious
painting, or a voluptuous thought may cause a precipitate discharge,
without an erection or with an imperfect erection. The discharge taking
place at a complete relaxation of the ejaculatory ducts, the voluptuous
sensations are, as a rule, entirely absent.
Spermatic discharges sometimes occur in affections of the central
nervous system, where the usual inhibitions through consciousness are
ineffectual.
Microscopically the discharge in spermatorrhoea shows amyloid bodies,
lecithin and prostatic epithelia. The fluid has the seminal odor which
is peculiar to the spermin reaction; the amount of spermatozoa is
somewhat diminished.
The testicles and the skin of patients, suffering from spermatorrhoea,
are less sensitive to electrical stimulation, while the urethra is
hypersensitive.
Nocturnal emissions constitute the other anomaly of ejaculation.
Physiologically all healthy continent men between the ages of fifteen
to fifty, with very few exceptions, have nocturnal emissions at
intervals of about four weeks (male menstruation). The pollutions arise
during sleep and are accompanied by erotic dreams and erections. They
usually awaken the sleeper. Normal pollutions occur only in sleep and
are accompanied by vigorous erections, erotic dreams and orgasm. They
also cause a sensation of relief. When pollutions are frequent, two or
three times a week, they become pathological. They are then followed
by lassitude, dizziness, faintness, dragging pains in the occipital
region, mental depression, disinclination for mental effort, sense of
fatigue, lessening of physical strength, pain in the back and reflex
irritability. The patients are startled at the least noise. They change
color every moment. The eyeballs run unsteadily. There is often found a
disturbance of speech, difficulty in breathing, and palpitation of the
heart.
The following case will best illustrate the symptoms in nocturnal
pollutions:
Mr. A., 25 years of age, was always well and never had gonorrhoea
or syphilis. When a boy he practised stuprum manu in a moderate
degree, as he says. A few years ago he noticed a certain weakness
in erection. The emission took place soon after the entrance into
the vagina and was followed by the immediate flaccidity of the
penis. Sometimes the ejaculation occurred ante portas. The patient,
therefore, gave up trying intercourse. Since then he is suffering from
nocturnal pollutions, which occur every night or at least three to
four times a week. The following day the patient feels very weak, as
to prevent him from performing his usual work in his trade. He suffers
from headaches and pains in the lumbar region and in the legs. He is
engaged to be married and is looking forward with great apprehension
to the approaching time of this momentous event.
Pathological pollutions are caused by a paralysis of the circular
muscular fibres of the ejaculatory ducts. This paralysis may be either
of a purely nervous nature or caused through inflammatory processes.
Atony of the mouths of the ejaculatory ducts not seldom produces
nocturnal pollutions. Sometimes pollutions are also due to a spasm of
the detrusors of the seminal vesicles.
When the seminal vesicles and the ejaculatory ducts are thus affected,
very little is needed to cause a nocturnal emission. Any diurnal
excitement will be followed by nocturnal erotic images and pollutions.
Sleeping on the back, by causing a fluction of blood to the spinal
cord, will also produce pollutions.
Besides the genitals, the urinary system is also greatly affected in
atonic impotence. The hyperaesthesia and hyperaemia of the prostatic
urethra and of the colliculus, usually found in atonic impotence, are
the cause of a continual irritation of the bladder.
The irritation of the neck of the bladder provokes a spasm of the
detrusor vesicae. To this spasm is due the frequent painless impulse to
urinate, by day when under mental activity, and in sleepless nights.
Sometimes the detrusor is in a paretic condition. In paresis of the
bladder the patient has to wait for the urine to come and has to use
abdominal pressure to effect urination. The urine falls without force
perpendicularly from the urethra. There is often desire to urinate, but
never a feeling of satisfaction after urinating. When catheterization
is attempted, there is a powerful resistance at the neck of the
bladder, through a certain spasm of the sphincter.
In spasm of the sphincter of the bladder there is also frequent impulse
to urinate. Not seldom such patients are unable to urinate in the
presence of others. Sometimes the urine cannot be passed at all. The
spasm of the sphincter creates a certain difficulty in starting the
act of micturition. The stream is often interrupted and, at the end, a
dribbling of urine takes place. Through the spasmodic contraction of
the muscular fibres of the sphincter the urethra represents a rigid
open tube in which one end is closed; it thus resembles a pipette which
retains the fluid as long as one end is closed. When the relaxation
takes place, the fluid contained in the urethral tube dribbles out of
the meatus.
In paralysis or paresis of the sphincter the patient urinates often but
in small quantities. In paresis of the sphincter there is no resistance
to catheterization at the neck of the bladder. In the beginning of the
paresis there is incontinence of urine during the night. Later on when
the disease has progressed, and a perfect paralysis has ensued, the
incontinence of the urine is constant even in daytime.
In enuresis nocturna, often found in masturbating children, there is an
imperfect innervation of the sphincter, while the innervation of the
detrusor of the bladder is perfect.
In all these anomalies the urethra is very sensitive. The passage of
an instrument causes unbearable anguish. The patient acts as mad when
the sound is introduced. There is often found a troublesome burning
in the urethra, especially in the fossa navicularis, during or after
micturition.
Besides the frequent urgency to urination, in all these troubles, there
is not seldom an actual polyuria present. The urine is pale, clear,
watery, with low specific gravity, often as low as 1002. The urine
is not seldom loaded with phosphates. Sometimes oxaluria, with high
specific gravities up to 1050, is discovered. Transient glycosuria as
high as two to three per cent. is also found. At times vesical tenesmus
is met with. Sometimes anuria is observed, although the kidneys are in
perfect order.
_The pathology of female impotence._—The same four kinds of impotencies
found in men are also met with in women, with the only difference that
the frequency of one or the other of the impotencies is different in
the different sexes. They are: 1) impotence of voluptas, 2) impotence
of copulation, 3) impotence of reproduction, and 4) impotence of libido.
_Impotence of voluptas._—The entire absence of the sense of sex, or
impotence of voluptas, where the individual has absolutely no sexual
inclination to any individual of the other sex, is more frequently
met with in women than in men. Still even in women this idiopathic
frigidity, this insensibility where the woman is completely frigid by
temperament, is much rarer than is generally believed. In fact, it is
extremely difficult to find a woman who is without aptitude of sexual
emotion.
Physiological frigidity exists in infants and in very old age. After a
regular and satisfactory orgasm the woman is physiologically more or
less anaesthetic for some time. The ablation of both ovaries before
puberty causes total anaesthesia, while the operation after puberty
produces, for a certain time, at least, only an impairment of libido,
or orgasmus retardatus. Congenital degeneration of the ovarian glands
will be accompanied by total absence of the sense of sex. As in
men, the total absence of sexual desire is found in severe cases of
neurasthenia, where the entire nervous system is in a low state of
efficiency. Idiopathic impotence of voluptas is further found in low
idiots and in dementia, where there is lack of understanding of the
opposite sex. The sexual perversity of homosexuality, as a rule, causes
total impotence of sexual desire for the opposite sex. Sometimes the
cause for the anaesthesia lies in the centre, otherwise the patient is
perfectly normal, as in the following case:
The patient, forty years of age, twenty years married, is a highly
cultured lady. She never had a child or was pregnant while living with
her two first husbands. A prominent gynaecologist, who had examined
her several years previously, attributed the cause of her sterility
to an infantile uterus. She has never, in her life, experienced any
sexual desire and seems to be proud of it. She attributes this lack
of passion to her great mental activity. An examination revealed a
pregnancy of about four months.
_Impotence of copulation_, except in the anomaly known as vaginism,
is very rarely found in women. Conjugation is, of course, impossible
in the rare cases of total absence of the vagina. In hypospadia, where
the vaginal orifice is situated within the rectum, vaginal conjugation
is well-nigh impossible. Adhesions of the labia majora or minora, a
rigid imperforated hymen, an extreme vaginal atresia near the orifice
and elephantiasis of the vulva will cause impotence of conjugation.
All acute inflammations of the vulva, vagina, rectum, uterus tubes,
or ovaries may render approach painful and impossible. Urethral
caruncles, urethritis, fissures at the neck of the bladder, rectal
fissures or hemorrhoids may also render conjugation difficult. The
tetanic contraction of the sphincter cunni and the tetanic spasm of the
perineal muscles, constrictor cunni, transversus perinei, sphincter
and levator ani which close tightly the orifices of the vagina and the
entire vaginal canal will also be the cause of impotentia coeundi. The
solitary tetanic contraction of the sphincter cunni, known under the
name of vaginism, will make conjugation impossible until the hymen is
removed. The following case operated by the author illustrates this
anomaly:
Mrs. X., twenty-two years of age, for three months married to a
physician, was unable to be approached by her husband. As soon as
the penis touched the labia, the sphincter cunni contracted so
tightly that there was an utter impossibility to transverse the
virginal portals. During the examination, at the least touch of the
nymphae, the sphincter could be observed contracting, just as seen
in animals after defecation when the sphincter ani contracts. The
ablation of the hymen cured the anomaly. This fact shows that it was
only a reflex-irritation, started at the highly sensitive hymen. The
sphincter itself was perfectly normal.
_Impotence of reproduction._—More frequent than impotence of copulation
is female impotence of reproduction. This anomaly is naturally found in
all those cases where there is impotence of copulation. It is sometimes
met with in excessive acid reaction of the vaginal contents, where the
spermatozoa are killed before they reach the uterus.
When one lip of the cervix is considerably elongated, covering
apron-like the external os, the spermatozoa will not be able to enter
the cervix, and sterility will result. Sterility is also found in the
obliteration of the cervical canal, produced by caustics or scars after
tears during confinements and after curettings. Ectropion, stenosis
of the external or internal os of the cervical canal, endocervicitis,
causing an increased cervical secretion, and the swelling of the plicae
palmatae may prevent the entrance of semen into the uterus and thus
cause impotence of propagation.
The anomalies of the uterus are also sometimes responsible for
sterility. Uterus foetalis and obliterations of the lumen of the uterus
will result in absolute sterility. Uterus infantilis, hypoplasia of the
uterus, atresia of the uterus or polypi, hypertrophic chronic metritis,
degeneration of the uterus or uterine deviations may often be the cause
of sterility.
The anomalies of the tubes which cause sterility are absence of the
tubes, rudimentary tubes, total or even partial obliteration of their
lumen, as in salpingitis nodosa, closing of the ends of the tubes in
bilateral salpingitis, and adherences of the tubes to the neighboring
parts, as found in pelviperitonitis, perimetritis, perisalpingitis, and
perioöphoritis.
The anomalies of the ovaries, causing impotence of procreation, are
absence of the ovaries, hypoplasia of the parenchymatous tissue of
the ovaries, fibrous degeneration of the ovaries, alteration of their
position, as extreme prolapsus and hernia of the ovaries.
All these anomalies may produce either absolute or relative sterility.
In regard to frequency they are of slight significance in comparison
with endometritis and pelviperitonitis after gonorrhoea. The gonorrheic
infection is, therefore, the cause par excellence of the impotence of
procreation in women as in men.
_Impotence of libido._—While in men the common form of impotence is
inability of conjugation, the common form of impotence in women is
failure to experience the orgasm, or the impotence of libido. In this
anomaly two grades may be distinguished, total anaesthesia and partial
anaesthesia or orgasmus retardatus.
In absolute anaesthesia there is not even a vestige of a libidinous
sensation during intercourse. The woman likes caressing, hugging,
kissing, etc., because the potency of voluptas is intact. But there
is no vestige even of the fore-pleasure, or the ant-orgastic libido.
The woman is devoid of sexual sensation, her genitals have no more
excitability for pleasurable sensations than her fingers. Hence no
desire for coition exists. On the contrary, there is, as a rule, a
pronounced disinclination to the act. Where there is complete absence
of pleasurable feelings, the act becomes naturally loathsome to the
individual. If coition is granted it is done either from a sense of
duty or for gain.
Physiological anaesthesia exists in children until puberty, and in
adults in old age. Even after menstruation has set in, the girl is, as
a rule, anaesthetic in regard to libido, although she may be erotic.
“The girl has to be kissed into a woman.” After the climacterium the
woman generally becomes again more or less anaesthetic. Some women may
continue to experience libido years after this period, and may manifest
symptoms of great sexual excitement as seen in the following case:
Mrs. X., married to an elderly man, looked upon the marital relations
more as a duty than as a pleasure during her entire married life. But
since the climacterium has set in, the rare approaches of her husband
are impatiently awaited and they cause her great sexual excitement and
satisfaction, never experienced before during the entire period of her
active sexual life.
Such cases are extremely rare. Generally there is a close connection
between the activity of the generative glands and the degree of libido.
After a regular and satisfactory coition the woman is, physiologically,
more or less anaesthetic for some time. The length of the neutral
period varies in different individuals. Intense mental activity,
emotional depression and long sexual continence also diminish the
sensual pleasure.
Apart from this temporary anaesthesia, there are many women who are
impotent to experience libido throughout their lives. There is a total
absence of pleasurable feelings during coition or any other kind of
sexual stimulation.
A young lady, twenty-two years of age, complains that while during the
time of her engagement she greatly enjoyed her fiancé’s caresses and
became sexually excited when fondled by him, since her marriage she
is unable to experience any libido in coition, although her husband is
possessed of great potency. The patient is a beautiful brunette, with
fiery eyes, and is a picture of health. Examination shows a uterus
infantilis.
The potency of voluptas in this case is wholly intact. The patient
enjoys being fondled and caressed. The cause of the impotency of libido
lies in the periphery, although uterus infantilis is seldom accompanied
by impotence of libido.
In some cases the woman is normally developed in every respect,
menstruates regularly and is frequently quite prolific. The power of
procreation is sometimes even very great. The woman is generally quite
erotic and falls in love easily. Yet she never experiences the least
libido.
A young lady, twenty-eight years of age, mother of two healthy
children, was sent by her family physician from Chicago to consult the
author for her impotence of libido. The husband stated that he is sure
of his wife’s attachment to him. She enjoys his company and likes to
be caressed by him. Still during the eight years of their married life
she never showed the least sign of libido at coition. She remains cold
and indifferent, and only submits conjugationi to please her husband.
The examination showed the genitals to be in perfect order.
In the following case, too, no cause whatsoever could be found for the
anaesthesia in regard to libido.
Mrs. L., twenty-nine years of age, is seven months married. Her
menstruation set in when she was fifteen years of age and was always
regular of about six days’ duration. At that time she began to satisfy
herself by manusturpation and found some libido in the manipulation.
But soon she read in a book about the ill effects of this practice and
stopped it.
In the beginning of her married life coitus caused her great pain,
which diminished by degrees after a few weeks. At present, coition
causes her only disgust. The day after she feels tired and weak.
The examination shows a feminine habitus, breasts well developed,
clitoris normal. The hymenal rests are very sensitive to the touch.
The painful sensation and the feeling of disgust increase when the
anterior vaginal wall is touched. The uterus is enlarged to the size
of a goose-egg, the cervix is soft, and the external os narrowly
closed. Diagnosis, two months’ pregnancy.
In this case some traces of libido were present at the time of puberty,
which later on entirely disappeared. In some cases the patient is very
prolific, as the following history shows:
The author recently performed a perineorrhaphy on an otherwise healthy
woman, mother of five children, who confided in him that she has never
experienced the slightest libido in intercourse. Yet, she added, if
her husband would not take precautions, she would give birth to a
child every year, as was the case in the beginning of their married
life.
Anaesthesia in women is, as a rule, due to inexcitability of the
genital nerves and to lack of excitation at the centre of libido.
Sometimes anatomical anomalies of the genitals may cause impotence
of libido. The integrity and the free exercise of the generative
organs are necessary for the integrity of the libidinous feeling,
although sexual pleasure is experienced at the nervous centres, and
the generative organs play only a secondary part. The vaginal bulbi
and their muscle, the constrictor cunni, the intermediary net of veins
between the bulbs and the clitoris, and the free part of the latter,
the glans of the clitoris, must functionate normally in order to give
full satisfaction in intercourse.
Hence diminution or extinction of the sense of libido will be caused
by castration, degeneration of the ovarian glands, marasmus, sexual
excesses and overindulgence in alcoholic beverages or cocaine.
In the following case the erotic feeling increased in such a degree
after the castration, probably through the extinction of the libido,
as to deceive the family physician and lead him to make the diagnosis
nymphomania.
Miss X., a school teacher, over thirty years of age, was always
chaste and indifferent not only to any carnal pleasure, but also to
male company. On account of a uterine fibroid, a total extirpation
of uterus and ovaries was performed. Since the operation the patient
complains of great sexual excitability she had never experienced
before the operation. She is so excited sexually that she is possessed
of the almost imperative impulse to kiss every male person she meets
on the street, and but for her position, she would have long ago
yielded to this impulsive desire.
In another case of diminution of the potency of libido, only uterine
inflammation and pregnancy could be discovered.
Mrs. M., thirty-five years of age, four months married, had always
suffered pain in the back during menstruation. The patient complains
that she only experienced libido twice since she has been married.
Since the last experience in the first weeks of her married life,
she has no pleasure at all. Coition, though not painful, causes her
a disagreeable feeling. An examination revealed anteflexio uteri,
enlargement and catarrh of the cervix, erosions and a three months’
pregnancy.
In the following case castration caused inability to experience libido.
Mrs. M., thirty-five years of age, for the last fifteen years married
but sterile. When she was only two years married she began to suffer
from attacks of headaches and vomiting, which repeated almost every
other day. Her menstruation was regular. After having tried all the
stomach specialists in the city without finding any relief from the
vomiting spells, she consulted a gynaecologist, and he promptly
found an ovary to be the cause of all her troubles. She had been
previously operated upon for gall stones, which were not found and
for appendicitis, when the presumably diseased appendix was removed.
She now submitted to ovariectomy on the left side. Three months after
the operation the vomiting spells returned, and she submitted again
to a removal of the right ovary. But even this double castration did
not relieve her. When she first consulted the author she was still
suffering from these spells, especially before menstruation, which is
still present although irregular. The patient declares that previous
to the ovariotomies she experienced full libido and was able to
induce orgasm. After the second ovariotomy this potency was lost. She
gets excited during coition, but the orgasm cannot be produced. The
following day she feels nervous and weak.
In another case of impotence of libido nothing else but anteflexio
could be discovered.
Mrs. H., twenty-four years of age, four years married, was confined
by the author a year ago of a healthy girl. The patient complains of
never having experienced any libido. Before her confinement coition
caused her great pain and misery. Since her confinement she suffers no
more pain during the act, but libido is still absent. She complains
of great dryness of the parts, so that vaseline has to be used to
facilitate walking. At the examination there was found redness of the
vulva, catarrh and erosion of the cervix and anteflexio.
In the following case of anaesthesia the author could discover no other
cause but general weakness.
Mrs. W., twenty-six years of age, was always pale and weak.
Menstruation set in at twelve years of age. At nineteen she was
married, and ten months later gave birth to her first child. Four
years later gave birth to another child. For the last year she
complains of stomach trouble and weakness, pain in the back and
abdomen. Menstruation is now four to six days ahead of time and
lasts five days. She never experienced orgasm but twice. Both times
the intercourse was followed by pregnancy. Other times coition only
excites her but never brings full satisfaction. The following day she
suffers from severe headaches. An examination only revealed a catarrh
of the cervix. The patient received a tonic, and the husband was given
some hygienic rules to observe in initu. Five weeks later the husband
informed the author that the anaesthesia had disappeared.
Sometimes sexual anaesthesia is the result of a hard confinement
producing lesion of the muscle bulbo-cavernosus or of the erectile
tissue of the bulbs themselves. The blood is then prevented from
leaving the bulbs and from entering the corpora cavernosa of the
clitoris. In this way the erection of the clitoris, which is more or
less necessary for the full and normal inducement of the orgasm, is
rendered impossible.
The author recently treated a young lady, twenty years of age. She
had her first menstruation when she was sixteen years old and was
always regular. She had been married eighteen months, and her baby was
eight months old. The patient called to be treated for leucorrhoea,
but her husband called the following day and stated that his wife has
no pleasurable feeling during initus since her confinement. Before
this event, she found perfect gratification. An examination revealed
nothing but a catarrh of the cervix and a slight enlargement of the
left ovary.
Roubaud also relates the confidences of a patient who wished se
stuprare manu a few days after her confinement, but could not, with
all her manipulations, induce the desired orgasm. The normal potency
returned only after a long rest.
The number of women afflicted with the anomaly of impotence of libido
is considerable. It is claimed by many authorities that ten to twenty
per cent. of all women are afflicted with this anomaly. The symptoms
of total anaesthesia are subjective and objective. There is first the
statement of the husband about his wife’s indifference and coldness
during the conjugal embrace. The woman complains of lack of orgasm
and ejaculation and of the immediate flowing off of the sperma after
coition. The peristaltic contractions of the vaginal walls, beginning
at the vaginal orifice, and the aspirating movements of the uterus, as
they take place in the normal woman, during the orgasm, are missing
here. Hence the sperma is immediately discharged from the vagina.
One of the most conspicuous objective symptoms is a relaxation of the
entire genital tract. The glans of the clitoris is often undeveloped
or wholly adherent to the prepuce. In some women old lacerations of
the perineum are present. The genital muscles, the levator ani and
constrictor cunni as well as the perineum, are languid and withered.
The mucous membrane of the entire genital tract is in a state of
hypersecretion, as in true chronic inflammations. The vagina is wide
and flabby, the walls are lacking elasticity. The portio vaginalis
uteri is flabby and pointed. The uterine walls are weak and soft, and
the cavity is wide. The uterus is extremely movable and generally lies
in retropositio, the relaxation of the uterine ligaments allowing it to
fall downward and backward. The patient’s general health is often poor,
she is anemic, nervous and weak. Sometimes there is only hypoplasia of
some of the genital organs, otherwise the woman enjoys good health.
Women suffering from anaesthesia may without sacrifice refuse their
favors to their husbands and render them submissive to their will and
henpecked. Single women, having no pleasure in and hence no desire for
conjugation, if they are not induced to give themselves for pecuniary
considerations, easily remain virtuous and seem to be very proud
of this enforced purity. Even among married women there are wives
who pride themselves on repugnance or distaste for their conjugal
obligations. They speak of their coldness and the calmness of their
senses as though they were not defects but great virtues. Yet the sour,
shallow, sexless shrew is surely an imposture as a wife. Her marriage
is nothing else but a fraud. In congenital anaesthesia the therapy is
valueless, although electricity by Apostoli’s method and massage may
be tried in uterus infantilis and in undeveloped ovaries. In prolific
women the only advice the physician may give is that, in harmony with
Ovid’s recommendation,
“Tu quoque cui Veneris sensum natura negavit,
“Dulcia mendaci gaudia finge sono.”
for the sake of matrimonial peace, simulation of libido and orgasm is
a justifiable fraud. Even to resort to some lubricant to simulate the
secretion from the Bartholinian and cervical glands is permissible.
The man is easily deceived in this respect. He does not in any way
feel the ejaculation of the woman. He only surmises her orgasm by her
bearing during the culmination of the libido.[AY] The woman also does
not feel immediately the male ejaculation, but she perceives it soon
by the increase of moisture. Then the effect naturally increases the
excitement, as the following case shows:
A young woman of twenty-two, who has practised stuprum manu from
her early childhood, confided to the author that she derived more
libidinem de stupro manu quam de initu. Yet, she added, after some
abstinence from regular initus, although she is fully indulging in her
favorite pastime, she has a veritable sitim seminis.
Patients afflicted with congenital impotence of libido are very seldom
seen by the physician. They are not aware of their anomaly, and being
otherwise normal and in full possession of the power of procreation,
they never ask for treatment. The physician learns of such cases only
by chance. It is different in acquired impotence of libido. Here the
patient knows what she has lost, and the physician is often asked
for advice and for a remedy. Hence the study of this anomaly is very
important for the physician, although this impotence has not the same
importance in women as it has in men, where it causes impotence of
copulation and destroys the marriage relations of the couple.
_Orgasmus retardatus._—The other grade in the impotence of libido is
partial anaesthesia, in which the patient is able to experience the
ant-orgastic pleasure, but cannot induce real orgasm. The intensity of
the pleasurable feeling does not reach the sudden climax and does not
diminish abruptly. The climax is never reached, and the ant-orgastic
libido decreases gradually and slowly, it dies away. In idiopathic
partial anaesthesia, where the anomaly is congenital, the patient has
never experienced an orgasm, and hence is not aware of her anomaly.
It is different in the acquired form of partial anaesthesia or in the
so-called orgasmus retardatus. The sexual excitement of the woman
suffering from orgasmus retardatus is never abated, her libido is
unimpeded, but the potency of experiencing orgasm is diminished or
entirely absent. The following extracts of a letter from a patient
suffering from a certain degree of orgasmus retardatus well illustrates
the complaints of this class of patients:
I have been married over a year now, and have never experienced any
satisfaction in initu. The glands seem to secrete the fluids, and
the cupido congressus is there, but no satisfaction. I am always
sleepless and nervous afterwards and sometimes suffer from headaches
the following morning. I am at times bothered with leukorrhoea. When a
child faciebam stuprum manu, but not since my sixteenth year of age,
and I am at present twenty-five years old. I have never been pregnant.
The following case is extremely interesting, because the patient is
able to induce orgasm only in one certain position. In all other
positions she is impotent of experiencing libido. In March, 1908, the
patient consulted the author about her anomaly. Being a highly educated
woman (she was a school teacher before she married) she was asked to
write in a letter the history of her case, and the following are the
contents of her letter:
I am forty-one years of age, eleven years married, have two children,
one ten, the other eight years old. I began to menstruate at the age
of thirteen and was always regular, the menstruation lasting three to
four days. The flow was always scanty.
As a child I was sad and dreamy. I can recall times when I would
weep, I scarcely knew for what. When I was nearing puberty coepi me
stuprare manu. No one taught me. I could not help it; I did not know
what I did it for (I was reared on a farm). The method was sitting
on a chair and moving to and fro. I must have continued till I was
eighteen or nineteen years old. I stopped it long before I knew it was
wrong, long before I have ever read it in books. No one told me it was
wrong. I was a good girl in the eyes of every one.
At the age of twenty I went to college. I think the reason I stopped
stuprum manu was that my mind was greatly engrossed in my studies.
True, I often had the desire, but the association with the opposite
sex would lessen it. I was fond of men in a silent way. I never, even
though in their company, was familiar with them.
When twenty-three years of age I met one towards whom I was changed.
I could not keep away from his presence. I remained a virgin till we
married, when I was thirty years of age. I had known him seven years,
but only saw him often, say three or four times a week, for the last
two years. We spent only one or two evenings each week together. I
allowed and deeply enjoyed all caresses, but they were not of the lewd
fashion. I must have been excited sexually, for I would experience
excessive humorem ut in initu.
At the age of forty-one, libidinem capio ex initu, yet experience
no orgasm save in the position “vir infra,” and in this position
very, very little sensation till the orgasm comes. I am fond of the
concarnatio, but aside from the position just mentioned, I have not
the least libido inter initum. It is a pleasure, you know, to give,
but my own libido is wanting in any of these positions. My husband
prefers alios positus to the one in which I have orgasm; præbente
majorem libidinem.
Multum humesco in initu. Quamquam comisceor quot noctibus præferrem
longum quam parvum temporis spatium concarnationi.
I am never ill, no aches or pains. The only premonition I have of the
approach of the menses is a fulness and tenderness of the breasts. I
menstruate very regularly.
Believe me when I say that once only in the seven years I knew the one
I eventually married—I must have been twenty-three and a half years
old, when I had spent hours in his company, with no more familiarity
than a kiss at parting—I was so excited ut pulvillum premerem usque
ad orgasmum. I could not have helped it, no matter what had occurred.
Often I have been excited thus, but I never before or since did the
same.
I never yielded to desire, though gently pressed to do so. Had I been
urged beyond my power of endurance I cannot tell what I would have
done. Yet I trust my virtue was due to a predominance of will-power
and not a lack of passion.
I cannot say the lapse of years has changed my desires or lessened
what I call my passions. I am affectionate by nature, but I trust my
emotions are more than affection.
The patient makes these last remarks because she is unable to bring
in accord her own feelings with the diagnosis frigidity,[AZ] received
from several physicians whom she had consulted. She herself knows well
that she is passionate enough to exclude any possibility of frigidity.
Hers is a typical case of orgasmus retardatus of a slight degree (for,
in the position “vir infra” orgasm is possible, for in this position
coition lasts considerable longer), due probably to masturbation but
mostly to the tactile eroticism, practised during the seven years of
her engagement.
In pronounced orgasmus retardatus the sexual impulse is very vivid,
but the patient can never find the acme of gratification in coition.
It may often require hours concarnationis continuæ before the orgasm
is induced, and sometimes it may never be experienced. While there is
a strong desire and a theoretical ability to induce the orgasm,—the
patients are able to experience the orgasm in all its intensity by
masturbation—in practice it is seldom or never attained, because
the male will always reach the acme of coition before the woman has
arrived at this point. Her nervous system remains, therefore, excited
to the highest pitch and brought to a state of expectancy which is not
realized.
This lack of orgasm may also happen in normal women. The woman is
generally slower to reach the height of the venereal paroxysm than
the man. Ab initio commixtionis, she experiences a certain degree of
libido that is of greater intensity than that of the man, i. e., the
ant-orgastic libido is of higher value in women than in men. But this
libido is not developed to its utmost extent, the orgasm, as rapidly as
it is with the man. Still in the normal woman normal conditions will
finally ensue after some experience—it is known that in women lustful
feelings are not always brought about by the first contact,—while the
conditions are entirely different in the partially impotent woman.
No one man, except he be a eunuch, is ever able to satisfy her in
a natural way. Her nervous system remains in a constant state of
excitement to the highest degree, analogous to satyriasis in men. Her
active potency appears to the superficial observer to be increased, it
is almost inexhaustible. The following case will illustrate this point:
A young lady, twenty-one years of age, for six months pregnant with
her first child, showed at the examination normal internal genital
organs, but small nymphae and an undeveloped clitoris. The patient
coepit stuprum manu facere, tres annos nata, femora commissa fricando
ultro citroque aut pulvillum aut aliam rem inter ea. As far as she
can remember she always felt humorem in genitalibus suis after
such manipulations. She practised stuprum manu several times daily
until her marriage. Her husband left her in the first months of her
pregnancy and she began to indulge in her favorite practices. “In
coitione usitata frictiones continuas poscit”, and can endure them for
hours. She claims to have the feeling of becoming wet several times
during the “copulatione longa et continua,” but the libido does not
materially increase cum humorem sentiat. The intensity of the libido
remains always the same. She is continually uttering endearing words
to her mate and is begging him, ne patiatur ejaculationem cito venire.
She remains excited “postquam frictiones cessaverunt” and is always
showing her disappointment when the penis “retractus est.” After a
little while, her excitement gradually subsides, and the patient falls
asleep. When she awakes she immediately “coitionem iterum poscit.”
Here we have a case of a partially impotent woman whose anaesthesia and
slight development of the clitoris was in all probability the result
of her early practice of masturbation. The orgasm cannot be induced,
but the ant-orgastic state is accompanied by libido of a considerable
degree. The glands furnish enough secretion to give the feeling of
moisture; there is no real ejaculation as in normal congressus.
While the totally anaesthetic woman has no natural desire for
coition, and in this respect resembles the woman who is suffering
from idiopathic frigidity or impotence of voluptas, the woman with
the power of experiencing libido, but afflicted with the anomaly of
orgasmus retardatus, has an intense desire for conjugation. She seeks
it oftener than the normal woman, for the reason that her desire is
seldom satisfied. She demands, therefore, commixtionem continuam per
horas et pæne quot noctibus. Such a Messalina is able commisceri
centies in una nocte and yet be unsatisfied. Even if she had it in
her power, like Katherine of Russia, to order cubili suo a whole
regiment of soldiers quot noctibus, she would still remain unsatisfied.
This anomaly, for these reasons, may often be confounded with the
perversion of nymphomania, where a normal orgasm is induced with every
copulation, but where an immediate reawakening of desires, after normal
satisfaction, takes place. Through the similarity of the symptoms
of orgasmus retardatus and nymphomania great mistakes in treatment
have often been committed. The wisdom of amputating the clitoris
in a case of nymphomania is very questionable, but the advice to
amputate it in a case of impossible or retarded orgasm and permanently
damage the already weakened nerves is a mistake that borders almost
to malpractice. For the amputation of the clitoris will impede the
inducement of the orgasm even to a greater extent than before. The
genital apparatus, which was weakened by excesses in venere or in
narcotics, is now irreparably destroyed for all time.
The case of Barrus shows what clitoridectomy may sometimes do. The
patient, a young woman, stuprum faciebat manu more or less, all her
life, and finally after suffering from several attacks of nymphomania
decided to have the clitoris amputated. The result was not only
failure to relieve the alleged nymphomania, but even an increase in
its severity, causing a shameless and, almost literally, continuous
indulgence in the habit.
The cause of orgasmus retardatus is almost always self-abuse, either
in form of masturbation, mental erethism, or tactile eroticism. The
excitability of the clitoris is so increased through these practices
that it refuses to transfer its excitability upon the internal genital
organs for the inducement of orgasm by coition. The ant-orgastic
pleasure is hence intact or even increased, but the orgasm is seldom or
never provoked.
The unsatisfied intercourse will in the long run cause a number
of nervous troubles which take the form of hysteria or assume the
character of neurasthenia. The unsatisfied initus repeatedly practised,
in not leading to the acme of libido and to the relief from the
congestion by the ejaculation, is the cause of chronic hyperaemia and
stasis. This leads, in its farther progress, to chronic inflammations
of the tissues, which are known under the respective names of metritis,
perimetritis, parametritis, endometritis, salpingitis and ovaritis.
The labia are tumefied and dry, the meatus urinarius inflamed and the
urethra pouted out. The clitoris is elongated, inflamed and often
abraded. The external genitals are in a state of burning heat. The
vaginal mucous membrane is hard and excoriated, the cervix is congested
and the external orifice inflamed.
Apart from these pathological changes caused by the failure or the
retarding of the orgasm, the anomaly is of grave social importance.
The woman with whom orgasm is impossible generally repels her husband.
Her nerves never being exhausted, as in the normal woman (it is little
known that a woman is more affected and fatigued by a real orgasm than
a man), spatium congressus may last as long as the vaginal epithelia
can endure it, which means a considerable length of time. This is
mistaken by the husband for increased potency. He believes her to
be more potent than he is, and, in the long run, a man dislikes a
lascivious woman. What he wishes is a modest woman who never asks for
conjugal embrace when he is not disposed to it, and at times even knows
gently and tactfully to refuse her favors when they are asked. Orgasmus
retardatus is hence not simply a question for the physician; it is a
matter of serious social importance.
The correct treatment for this anomaly is, in the first place, total
abstinence from sexual excitement in any form, and then strengthening
of the nerves by tonics, hydrotherapeutics and electricity by
Apostoli’s method.
_Orgasmus praecox._—The exact opposite to orgasmus retardatus is the
anomaly of orgasmus praecox. In men, suffering from this anomaly where
ejaculation occurs before the penis has time to enter the vagina,
the precipitated orgasm has the same effect as the real impotence of
concubitus. In women suffering from orgasmus praecox, the orgasmus is
induced as soon as the mentula reaches the vestibule.
In some women the excitability of the genital nerves reaches such a
degree that the mere touch of the gynaecologist’s finger during an
examination will immediately induce orgasm. Since erection ceases in
both sexes after the orgasm, this anomaly is of great importance in
men, because the conjugal embrace cannot be consummated. In women, on
the other hand, with their passive rôle during concarnatio, and with
whom erection of the clitoris is not requisite for sexual congress, the
act may be continued as in the normal woman. The anomaly is hence of
less importance in women. Still it has some bearing upon the woman’s
fecundity. In the ideal commixtione the female orgasm ought to take
place immediately after that of the male, so that aspiration of some
amounts of sperma could be effected. In the anomaly of orgasmus praecox
the spermatozoa have to rely upon their own power of motion to reach
the interior of the uterus. The anomaly may, therefore, sometimes
lead to sterility. Otherwise medical aid is never sought for. The
pathological condition is extremely rare, anyway.
In the same way the anomaly of a diminished frequency is of no
importance to the physician when occurring in women. He may be asked
for advice when it is met in men, for it may lead to some incongruities
in the matrimonial life of the couple, especially when the wife is of a
sensual nature. But a woman who is able even very rarely to experience
orgasm will never seek the advice of her physician.
CHAPTER XVII
HYPERAESTHESIA
Sexual hyperaesthesia signifies an abnormal intensity of the sexual
instinct. The intensity of the impulse of voluptas varies in different
individuals, and the line of demarkation between the physiological
and the pathological increase of the impulse is not always distinctly
pronounced. With some individuals the intensity may reach a high degree
and still be within the physiological bounds. This is especially the
case where the intensity of experiencing libido is correspondingly
increased. But when there is a conflict between the two potencies,
the potency of voluptas and that of libido, the least exaggeration in
the intensity of voluptas becomes pathological. Such an anomaly where
there is a decrease of the intensity of libido and at the same time an
increase of a higher or lesser degree in the intensity of voluptas, is
the phenomenon of mixoscopy. Mixoscopy thus stands upon the border-land
of anaesthesia and hyperaesthesia.
_Mixoscopy._—Literally, mixoscopy means assisting or rather looking at
animals or at persons while they are in concarnatione. In this degree
the anomaly is a very rare occurrence. In a broader sense, however,
mixoscopy means every active interest in the erotic relations of others
in so far as this interest bears an erotic character. In this broader
sense, mixoscopy is a widely spread anomaly.
The mixoscopic complex or the system of connected ideas, having a
strong emotional tone and displaying a tendency to produce or influence
thought or action in a definite direction, is more or less present in
every person, especially in its youth. All the world loves the lover,
when the world is allowed to assist at the scene of the love-making and
partake of the erotic delights of the lover. When the lover is alone,
nobody notices him. This love to assist at erotic scenes is based
upon the desire of procuring for oneself sensual gratification in an
indirect way, by the aid of a third party, with whom one identifies
himself and in whom one submerges his ego so as to experience this
person’s emotions.
The erotic scenes may not be of the gross and the vulgar variety.
Every desire to assist physically or mentally at scenes with an
erotic coloring, even of the most refined, airy and ethereal nature
has a mixoscopic foundation. Mixoscopy is responsible for the avidity
of youth to devour novels and to assist at plays which generally
revolve upon erotic plots. Especially the desire of those readers
who are so impatient as to read the last chapter first to see if
it ends in marriage, is only the refined way of satisfying the
craving for mixoscopy. The gratification is secured by the reader’s
identification of himself or herself with the hero or heroine. It is
often self-deception of many a youth or maiden when they are petting
themselves and boasting of their love of belles-lettres, as though all
their reading is done in the interest of education and culture. The
reader deceives himself and unconsciously changes the egotistic desire
into the refined longing for mental improvement, rationalization.
Thus in a slight degree mixoscopy is a normal phenomenon. It is
especially found in women, in their eagerness and talent for
match-making. In the interest of others, woman is allowed to display
the activity for sensual gratification which modesty denies her to
develop in her own interest.
Mixoscopy becomes pathological when it degenerates into panderism
or bawdry for the sole purpose of sensual gratification. The main
motives of catering for the lust of others, by aiding and patronizing
an existent love-affair or by calling such an affair into being, says
Meller (O. Sexual Probleme, 1912, p. 480), are of three different
kinds. There is 1) the pecuniary motive or the motive of avarice,
found in the professional matchmaker and in the procurer; 2) there
is the motive of toadyism, the sycophant will descend so low in his
degradation even to the point of becoming the pander or bawd of his or
her superior; 3) the erotic motive, when the pander or bawd acts out
of love of the subject. The first two motives are more or less to be
counted among the vices, the third motive has a pathological basis.
When an erotic interest is at play only, the activity of the pander
or bawd becomes pathological in nature. It is found in persons who
through old age, disease, ugliness, poverty, shyness, etc., cannot
themselves share in the enjoyments of love and who, by assisting
at the gratification of lust by others, try to procure themselves
an opportunity of experiencing a certain part of the pleasure by
identifying themselves with or entering into the spirit of those whom
they aided to the lust.
The emotions connected with mixoscopy or the bawdry complex is oftener
found in women than in men. There are even mothers who aid and favor
the love-affairs of their daughters, where no material advantage could
in any way accrue to themselves or to their daughters, simply out of
lust which they expect to experience when being present at or thinking
of the erotic incidents between their children and their lovers. The
following history well illustrates this point:
Mrs. O., forty-five years of age, married for the last twenty-five
years, never had a child. She was operated upon a few years after she
was married, and uterus and ovaries were removed at that operation.
Twenty years after her castration, when the impotence of libido must
have been complete, a nephew of hers, nineteen years old, came to live
with his aunt and uncle. The aunt soon induced the mere boy to engage
himself with a young lady of twenty-three years of age. Although the
aunt well knew that certain legal obstacles prevented the boy from
marrying the young lady, still, in order to enjoy the love-making of
the young people, she did not rest until she effected the engagement.
When the young fiancée left for the West where she was to stay for a
considerable length of time, the aunt induced the boy to dissolve the
engagement and procured him another young lady with whom he again had
to become engaged. When the nephew left for a foreign country where he
was to stay several years, the castrated aunt had no use any longer
for the second fiancée either, began to quarrel with her and finally
forbade her to enter her house.
These actions plainly show that her interest in the young people was
founded upon the selfish longing to participate in their pleasure at
the lovers’ dalliance, caressing, kissing, etc., which, as an old
castrate, she could not experience any longer. Hers was, therefore,
the kind of bawdry from love of the subject. It was the only way
this voluptuous woman—but impotent of experiencing libido—could yet
partake of any sexual pleasure by identifying herself with the female
lovers of her young nephew. She had no other advantage to gain by her
match-making.
Panderism or bawdry presumes a complete absence of jealousy of any
kind. Patients, suffering from this anomaly, love to assist at erotic
scenes, enacted between females among themselves where the emotion of
jealousy is absent.
The love of sensual people to look at obscene pictures or to read
obscene books is also based upon the impulse of mixoscopy. Sometimes
the intensity of the desire to assist at erotic scenes reaches such a
degree that the patients hire furnished rooms in fornicibus observandi
causa actiones between the inmates and their callers, through holes in
the walls of adjoining rooms, and thus participate in their libido.
To this impulse of mixoscopy may also be attributed the indulgent
behavior of many a husband towards the family friend. If the world
is ignorant of their wives’ relations, and ridicule is avoided, some
husbands not only close their eyes to their wives' doings but even
favor their flirtations. The history of the following case shows how
far a husband can go in his indulgence, as to himself procuring a lover
for his wife:
Mr. E., twenty-four years of age, decides to leave his country and go
to America. While waiting a few days for his boat to clear the port,
he spent one evening in a restaurant. After sitting there for some
time, he noticed a couple entering the same hostelry. The woman was
about thirty years of age, the man about twenty-five her senior. The
couple soon left the place. About an hour later the man returned, sat
down at the same table where E. was sitting and soon entered into a
conversation with him. In the course of their talk, the old man asked
E. whether he would like to have female company for the evening.
Upon the affirmative answer, the old man took E. to an aristocratic
apartment in a distinguished part of the city. There E. met with the
young lady he saw entering the restaurant, et cum ea pernoctavit, the
old man spending all this time in an adjoining room. The following
day the old man prevailed on E. to give up the trip to America for a
while and stay with them. E. stood this idle life for six months, but
finally his rôle as a commaritus or rather as a fornicator came home
to his conscience and he left for America. While he was staying there
he learned that the elderly man and the young woman were husband and
wife. E. gave the author the assurance that during the entire six
months the husband, this he is positively sure, never approached his
wife sexually. He left her to E. without manifesting the least trace
of jealousy.
The only explanation for such a strange phenomenon is that the husband
was impotent and that the only way for him to experience at least some
pleasure from his wife was by identifying himself with the lover. Such
cases represent the extreme degree of mixoscopy.
_Erotomania._—The increased sexual desire in hyperaesthesia is not
always directed upon the physical gratification. Sometimes it is more
of an ideal nature, as in erotomania.
Physiological erotomania is often found in individuals of both sexes,
especially in young girls, at the time of puberty. Many a youth and
maiden are highly erotic, at this period, although, if reared in purity
and attended with vigilance, they never think yet of the physical
contact.
The erotomaniac individual’s love is of a platonic nature. Erotomania
constitutes a diseased form of ideal love. The physical sexual appetite
is generally foreign to the erotomaniac. The object of the individual’s
love occupies the mind only. It is a continual obsession of the spirit.
The erotomaniac individual makes an abstraction of the physical
personality of the adored. It is pursuing an ideal. The erotomaniac
is the victim of a mental exaltation which moves the lover to write
poetry and love-letters to the object of his or her dreams, without
ever sending them off. If possible the erotomaniac follows his or her
lover, but never addresses a word to him or her. The erotomaniac wishes
to be in possession of the beloved being, to be wedded to the beloved
one, but it never thinks of the sensual part. It is after the mental
possession of the beloved one.
The love of the erotomaniac individual rests upon a vague and hazy
ideal. It is the purest love possible. The relation is sacred and
beautiful. It is a kind of cult. The beloved object is a divinity whom
the patient worships upon his or her knees and whom he and she takes
care not to profane even by a carnal kiss.
The following case of a fellow-worker in the pathological institute of
a university in Switzerland is not uninstructive in this respect:
While working over the microscope at the same table, the young
physician told the author the following story of his life when he
was a boy of sixteen. He was at that time attending college in a
middle-sized city in Germany. One day a college friend took him to his
home, where he saw his friend’s sister, a young lady of twenty-three
years of age, and immediately fell in love with her.
Although he was, already at that time, far enough advanced in the
ways of the world to see the hopelessness of his love, still the
incongruity between the ideal and reality was entirely forgotten. He
was altogether oblivious of the material world and imagined himself
floating in the realms of the spirits, while dreaming of exquisite
harmonies.
Day and night he saw before him the object of his adoration. He was
filled with ecstasy over her perfection which was greatly exaggerated
and only existed in his imagination. For now, with a clearer judgment,
he can see distinctly that she must have had noticed at that time
his childish emotions and, out of vanity, was somewhat playing with
them. In his diaries he finds pledges of perennial veneration and
worship and vows of eternal resignation. His memoirs are filled with
descriptions of his hopes and fears, joys and sorrows, wishes and
despairs.
While in her company, he became entirely unconscious of the flight
of time; when she was talking about the most trivial incidents, he
imagined that he was listening to the music of the spheres. Every
word, every motion of her was able to awaken in him either excessive
joy and excitement or to throw him into a state of despair and rob him
of his appetite and sleep for a number of days.
Happily, the young lady soon married a judge, and this marriage broke
the boy’s spell. It may be added that the hero of our story, now a
promising pathologist, is still of a very nervous temperament, and
though possessed of a strictly logical mind, he loves to frequent
spiritualistic séances and to participate in spiritualistic practices.
The erotomaniac woman shows often characteristics not always found
in men. She is generally well satisfied with herself and extremely
vain. She is, as a rule, in love with a person of high social and
intellectual position. He is a prince, a celebrated statesman, a
victorious general, a famous actor, a brilliant preacher, or a great
scientist. In religious mania, it is not seldom a saint who inspires
the erotomaniac woman with a chaste love. Sometimes a picture or a
statue may become the object of her adoration.
As a general rule, the wish for the possession of a certain man is
provoked by his character, by his intellectual, moral or physical
qualities. If the man she fancies fails to attain to the standard of
her ideals she nevertheless attributes to him all the charms her mind
is able to conjure up. A case recorded by Reuardin is a good example of
erotomania in women.
The patient, a well-educated lady, thirty-two years of age, notices
some time after her marriage a man of higher social standing than her
husband. She at once falls in love with this man, begins to grumble at
her low social position, and speaks of her husband only with contempt.
Her beloved one only has all the best qualities. No one is above
him. She writes letters to him, in which she reveals the most ardent
passion and, at the same time, the chastest emotions. Sometimes she
is found in ecstasy, with eyes fixed upon some chimerical vision, the
pupils in a state of hallucination and the lips murmuring the beloved
one’s name. She recoils from her husband’s caresses, refuses to share
his bed, to sit near him, speak to him and to see him. Her whole
life is centered in her love; her eyes are constantly fixed upon the
beloved image. Finally she becomes entirely insufferable and commits
so many extravagances that her husband is forced to separate from her
and later on to send her to an asylum.
Ball distinguishes two categories of erotomaniacs. Some are discreet
lovers. They never accost the object of their love and do not even
feel the need to approach the divine hearth, whence the spark started
that inflamed their hearts. It is a pure immaterial fire that feeds on
itself. The other category, the indiscreet lovers, feel the necessity
to impart the knowledge of their passion to the object that gave it
rise.
_Satyriasis and nymphomania._—Contrary to erotomania, the sexual
impulse in satyriasis and in nymphomania is directed upon the physical
side of love. In these cases the impulse of detumescence is greatly
increased. The desires are directed upon the physical, pleasurable
titillations of the sexual organs.
The dividing line between the normal and pathological increase of
libido is not readily found. The libido sexualis normally varies
in different individuals. Married life bridles, as a rule, sexual
desire, while intercourse with different persons increases it. Total
sexual abstinence may cause in certain individuals, with a neurotic
taint, increased sexual desire, continuous excitement, diseased,
unconquerable impulse for sexual congress, and the preoccupation of the
entire attention upon the sensual act.
The immediate reawakening of desire after normal satisfaction and
the excitation of libido by the sight of persons and things which
in themselves should have but indifferent or no sexual effects, are
decidedly abnormal.
If the increase of the impulse is only moderate, so that increased
frequency of conjugal embrace is able to appease somewhat the
increased desire, the anomaly generally finds expression in a desire
for female respectively male society, in the reading of erotic or
obscene literature, in dancing, flirting, etc. But if the increase of
the sexual desire has reached the degree of true satyriasis in men or
nymphomania in women, the anomaly is characterized by an irresistible
exaltation and an insatiable appetite for sexual gratification. At the
mere sight of a woman satyriasis gets into such a state of excitement,
as to experience real orgasm.
Satyriasis is not seldom confounded with priapism. But the latter is in
no respect a psycho-sexual anomaly at all. It is a nervous trouble of
one of the genital organs and has nothing in common with satyriasis. On
the contrary, in priapism the potencies of voluptas as well as that of
experiencing libido are generally decreased, as Tarnowsky’s case shows
(L’instinct sexuel, p. 150).
Benj. Tarnowsky observed a case of priapism in a soldier which
had lasted for over two years and had prevented the patient from
absolving his active military service. The complete erection of the
organ continually existed in a chronic state and never ceased for a
moment. The organ did not wilt even after several coitions, which, in
the beginning of his sickness, were tried by the patient in order to
free himself from the annoying state of affairs. In the course of his
sickness, coition, and especially ejaculation, caused him such violent
pains that commixtio was never tried again. Voluptuous thoughts and
sexual desire had entirely disappeared. Even the thought of coition
caused the patient disagreeable sensations.
Priapism, therefore, if it were at all a disease of a sexual nature,
would more properly belong among the anomalies of sexual anaesthesia.
Satyriasis, on the other hand, is a psycho-sexual anomaly of increased
sexual desire. Scarcely has the desire been appeased, when it returns
with the same force and vigor as before. The following case may serve
as an illustration of such class of cases.
Mr. X., a soldier, twenty-three years of age, in prostibulum
meretricem visit, qua concubit, pretium usitatum resolvit et
relinquit. Scarcely did he reach the door of her room, cum voluptas
resurgeret. Itaque revenit, iterum eam comprimit, resolvit et
relinquit. This time he managed to descend half the stairs, cum
voluptas experrecta esset. Qua re redit, actionem repetit, resolvit et
relinquit. But he had no time to come down the stairs, cum concitatus
esset. Quo modo sexies ad puellam reveniebat, until he had no more
money for her services and had to leave her, but not yet entirely
satisfied.
Such a case represents a true sexual neurosis of insatiable lust.
In the pronounced cases of satyriasis, the individual is the
personification of sexuality. In his proximity everything turns upon
sex. Nothing is suffered to prevail but sexual emotions. Every glance,
motion or word of his has a sex coloring. He is nothing but a demoniac
sex-creature. Every word he utters has an obscene emotional tone. His
exclamations of surprise, fear, anger, etc., are all borrowed from
the realm of sex. He is a screaming vortex of lubescent lubricity. A
continual lustful scent exudes from him. He is perennially in quest
for sexual gratification. He tries to excite every woman he comes in
contact with and is himself excited by her. Moral consideration is an
unknown quantity for him. The inhibitions, normally emanating from the
cerebral centre, are destroyed in him. He is continually bent on new
sensations.
This picture of the evil spirit of satyriasis is still surpassed by
nymphomania. The woman suffering from nymphomania is more excessive in
her demands than the man afflicted with satyriasis.
The border-line between the normal and pathological increase of libido
in women is also somewhat blotted. A considerable piece of sexuality
dwells in the feminine soul of every woman. It is only covered by
inhibitory counter-emotions. But we recognize her true sexuality by
its pathological exaggeration. Never is there uncovered in insane
men such an abundance and monstrosity of the sexual imagery as in
insane women. In dreams and in the dusky twilight of insanity men and
women abandon themselves to their true impulses and desires without
the restraining influences of conventionality. The normal woman has
learned by education to hide her true sexual feelings and was forced
by tradition to produce in a quite extraordinary way the impression
that she herself is nearly non-sexual, and her sexuality is only a
concession to the man. But judging from her sexual emotions in abnormal
states, the intensity of woman’s sexuality is of a higher degree than
that of the man’s, and herein lies woman’s superior morality. Morality
is the arrest of the instincts by the intellect. The intensity of her
desires being greater, her higher chastity is more laudable. In certain
periods, such as pregnancy and lactation, when woman is really more or
less non-sexual, her chastity has no merit. But in the other states of
her life when woman’s desires possess a higher degree of intensity, her
chastity is of a superior kind.
Thus the determination, when the normal increase of woman’s sexual
desire ceases and the abnormal state begins, is wrought with great
difficulty. Sexual inclination is normally increased immediately before
and after the menses. Still it may be laid down as a rule that an
overweening sexual desire in a woman, considering her natural modesty
and coyness, should arouse suspicion of its pathological significance.
The nymphomaniac woman seeks to attract men by indecent language, by
lascivious conduct, by personal adornment, perfumes, talk of marriage,
by the exhibition of her feet, legs, neck, breasts and other parts
of her body, and, at the height of her excitement by invitation ad
congressum, aperto stupro manu, nudatione muliebrium et motionibus
initus pelve. She is often seen in the physician’s office and desires
gynaecological examinations for the gratification of her excitement.
Such a case was recently observed by the author.
The patient, about forty years of age, was suffering from endometritis
and came to the office for treatment. At the first touch of the
introitus vaginae by the finger, the patient suddenly agitata est.
She tightly closed her eyes, the respiration became panting, the
abdominal muscles contracted, which made the combined examination
impossible, her face became red, her entire body was seized by a
convulsive tremor, and her pelvis made omnes motiones commixtionis
vehementis. At the end of one or two minutes the paroxysm ended with
a deep sigh, and the examination could be continued. The attacks were
repeated at the beginning of every treatment, and the same had to be
discontinued. Without offending the patient, she was told that she
needs a curettage. This advice caused her to stay away from the office.
In the pronounced cases of nymphomania, the woman will accept the
embraces of any man and will solicit even boys. To him who yields
to her wiles she brings misery and calamity. She is an object of
attraction and carries ruin in her lap for those who become the
slaves of her eroticism. A piece of destructive sexuality dwells in
the bosom of these women, something of the Delilah-nature, for all
who come in contact with them. They consume men’s strength and vigor
physiologically and psychologically.
The nymphomaniac woman is not able to free herself from the thraldom
of eroticism. Her sexual instinct is irresistible and untamable.
Nymphomania leads the sufferer to any degradation, to the practice
assidui stupri manu and even to bestiality.
Magnan mentions the case of a lady of forty-seven years of age, who
from her early childhood manifested excessive voluptas. She was always
nervous, eccentric, and of a romantic disposition. When she was
only ten years old she began to practice concarnationem. At the age
of nineteen she got married, but although her husband was sexually
perfectly normal, he could not satisfy her often enough. Qua re
jugiter cum aliis viris commiscebatur, and although this infidelity
made her entirely unhappy and miserable, she was powerless to overcome
her insatiable desires.
In another case of Magnan, the patient had a passion for men from
her earliest youth. She was of good family, well bred, of pleasant
disposition, and exceedingly modest. As a little girl she was the
terror of the family. Scarcely was she alone with any male, child
or adult, statim aperiebat muliebria et poscebat satisfactionem
voluptatis, even going so far as to lay hold of the person. Marriage
did not cure her intense desire. She loved her husband passionately,
yet indiscriminately petebat placationem voluptatis a quovis viro with
whom she happened to be alone, were he her servant, laborer, or even
school-boy. This insatiable passion continued to possess her after
she had become a grandmother. At the age of sixty-five she was yet
recklessly passionate as before.
The anomaly of nymphomania is generally due to a cerebral lesion. Hence
little relief can be afforded by the removal of the clitoris or the
ovaries, or by any other therapeutic measure. The affection shows all
the stigmata of degeneration and moral insanity. The nymphomaniac woman
belongs to the type of the “deliquenta nata.”
Nymphomania is often found in periodical insanity. The case of Anjel is
a good illustration.
The patient, near the climacteric period, is nowise of a passionate
nature, sexually, but after a hystero-epileptic attack has the impulse
to embrace and kiss boys, about ten years of age et contrectare
virilia. She has no desire for coition while suffering from the
attack. In the intervals she is very modest.
This paedophilia in women, suffering from hyperaesthesia, is not rare.
The patients are intensely excited by young boys, while they possess
only normal inclination toward adults.
Magnan’s case is interesting in this respect. The patient was a lady
twenty-nine years of age. For eight years she had a strong desire
complexus venerei with one of her five nephews. First her desire
went toward the oldest boy, when he was five years of age. Then 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 ejaculation
and orgasm.
The case of Kisch is interesting for the coincidence of paedophilia
with traces of homosexuality.
The patient is thirty years of age, married nine years, but sterile.
Coition gives her not only no pleasure, but on the contrary, it
causes her a feeling of disgust. But she feels irresistibly impelled
contrectare pudibilia of children, no matter whether male or female.
These manipulations induce ejaculation and orgasm. At the time of her
menstruation this impulse is stronger than her power of resistance.
In Krafft-Ebing’s case the patient, a teacher, thirty years of age
and of strict morality, enticed a boy of five who happened to play
nearby, under the promise of money and food ut veniret in cubiculum.
“Ibi genitalibus pueri aliquamdiu lusit, denique introductionem penis
in vaginam tentavit.”
In hysterical women hyperaesthesia sexualis is of frequent
occurrence.[BA] Giraud’s case is of great interest, showing how far the
aberration may proceed.
The girl, a domestic servant, was always moral before her illness.
When she began suffering from hysterical attacks, amato liberos in
fidem suam commissos exhibebat ad constuprandum et noctu spectatores
rerum turpium eos faciebat, while the whole household was asleep under
the influence of narcotics. When she was discovered and driven out
of the house, the formerly modest girl became shameless and finally
meretricium fecit.
Another type of hyperaesthesia which borders on a real psychosis, is
represented by one of Schrenk-Notzing’s cases.
The patient would become sexually excited to a high degree at the
mere sight or touch of a man, et se satiebat congressu imaginali aut
stupro manu fricando femora ultro citroque. For a long time attacks
of genital erethism were brought on every morning. Once it happened
in the physician’s office. Notwithstanding the presence of three
male witnesses, she threw herself on a lounge and, in hysterical
convulsions, se feminavit several times before their eyes.
Brouardel relates the case of a girl of sixteen who would lie in the
ditch of a highway and, aperiens muliebria lacessebat præterientes
viros ad concarnationem. Nothing could be done to make her desist and
she had to be sent to a house of correction.
In another case, the daughter of a physician, a friend of Brouardel’s,
ran away from her father’s home at the age of sixteen and in fornicem
iniit in Paris to appease her sexual desires. Nothing could induce her
to return home.
This case throws some light upon the etiology of prostitution. Not
all prostitutes are driven to their degrading trade by idleness or
necessity, as some philanthropists or socialists would like to make
us believe. Not a few choose this life to satisfy their nymphomaniac
desires.
Trélat tells of a young girl, the daughter of a professor who, at
the age of fifteen, milites noctu fenestra cubiculi admittebat ad
satiandam voluptatem.
The best and most careful rearing of girls, suffering from nymphomania,
can not save them from downfall. In their wild passion, casting all
moral and social considerations aside, they throw themselves into the
arms of sin. The more they abandon themselves to the gratification
of their lust, the greater is the desire of their morbidly excited
nerve-centres for lecherous satisfaction. Every indulgence increases
the desire and lessens the capacity, as Horace truly says:
“Crescit indulgens sibi durus hydrops.”
The woman loses control of her passions, and can not restrain herself
from stuprum manu aut concubitus. She becomes absorbed in sexual
gratification, as seen in the case reported by Reti:
The patient lived happily with her husband until after the birth
of her first child. From that moment she became a slave of her
insatiable lust. An irresistible craving suddenly took hold of her, an
indomitable lust seized her to embrace men. She felt a morbid itching
in muliebribus, an inexplicable excitement, a burning desire for
sexual gratification. In the beginning her husband tried to satisfy
her until he discovered his impossibility to do so. She did not allow
an hour of the day to pass without demanding gratification from her
husband. He was terrified to see her premere muliebria to the edge
of the table or against the door or any other hard subject, in order
to satisfy her sensual appetite. When she became worse from day to
day, her husband took her to the hospital for examination. At the
introduction of the speculum, a morbid contraction of the constrictor
cunni muscle occurred suddenly. The touch of the carunculae
myrtiformes provoked intense pain. After surmounting the obstacle,
however, the pain ceased and a blissful rapture appeared. “Now! Now!”
exclaims the patient, when the entire speculum was within the vagina.
A convulsive movement seized her entire body, a thrill went through
her, et motiones vehementis congressus fecit.
Some nymphomaniac women have illusions of coition. Such a case has been
reported by Rosse.
A comely young woman who suffered from nymphomania practised stuprum
manu to excess and declared one day that several persons, among them
her clergyman, se constupraverunt. The sexual excitability in this
case was exaggerated to such an extent that the mere sight of a man,
even of the attending physician, suggested a repetition of the act to
provoke the venereal spasm. So persistent was the habit that on tying
her hands se feminavit with her heel. To prevent this her feet were
secured, but she succeeded in bringing about an orgasm fricando femora
ultro citroque ita ut clitoridem excitaret. The patient died at a
retreat.
If the hyperaesthetic woman is unable to satisfy her desires she shows
all the symptoms of general neurasthenia. Especially does she suffer
from neuralgia of the ovaries. The case of Rohleder is the best example
of the disturbances unsatisfied nymphomania may cause.
The patient, a girl of eighteen, and a member of a family of good
social standing, was engaged to be married. Until she was sixteen and
a half years of age she was always well. At that time she made the
acquaintance of her intended. Then a great change took place in her
disposition. She became very nervous and moody. Now she was very gay,
but a moment later became deeply melancholy. Her menstruation was
regular, but at that period she suffered great pains at the ovaries,
especially before the menses set in. When she met with her fiancé
her pains increased so that they caused convulsions. She could find
some relief stupro manu. After she got married, all the symptoms
disappeared.
_Masturbation._—The anomaly of masturbation is the most common sexual
aberration, and if found in the very young it assumes the dignity of a
perversity. In the adult, masturbation, if practised with moderation,
can not be considered pathological. According to Paget masturbation
causes no more nor less harm than normal coitus, if practised with the
same frequency and under the same conditions with regard to health, age
and circumstances.
Prof. Oscar Berger (Archiv f. Psychiatrie, Vol. VI, 1876) says
masturbation is such a frequent manipulation that out of a hundred boys
and girls ninety-nine have temporarily been addicted to it, and the
hundredth, the so-called pure individual, is concealing the truth. Moll
quotes a physician as saying: “Whoever denies having masturbated, has
often only forgotten it; whoever claims of never having masturbated is
still doing it.”
Now, giving due allowance to the exaggeration of these authors in the
heat of the discussion, the truth remains that the greater part of
humanity has one time or another practised autoeroticism. If what the
quacks and ignoramuses tell us about its dangers be true, humanity
ought to have passed into oblivion long ago, or at least ought to have
entirely degenerated. But we are all still alive, hale and healthy,
hence moderate masturbation can not have the disastrous effects which
some authors are pleased to describe.
Erb (Handbuch für Rückenmarkkrankheiten, p. 163) says, the effects
upon the nervous system in a man must be essentially the same, whether
the frictions of the glans take place in the vagina or are carried out
in any other way. The nervous shock of ejaculation remains the same,
and the nervous excitement ought to be greater where the female is
used. Hence masturbation, moderately practised, exercises no direct
destroying effects upon a good constitution.
Moderate masturbation seems to be almost a natural phenomenon. Even
among animals various forms of spontaneous solitary sexual excitement
are observed.
Dogs masturbate by rubbing the organ with their hind-feet, or by
crossing the hind-legs or lambendo fascinum lingua.
The stag, when in heat, rubs his penis against trees until he effects
ejaculation.
Porocz saw in a zoological garden an elephant, who was in the habit of
masturbating himself so often that he undermined his health and had to
be sold.
Prange (Revue vétér. 1856) describes a stallion that with his
mentulato fascino could reach his forelegs and thus rub the organ
against them. In this way he induced three to four ejaculations daily.
The author observed a baboon in the zoological park se constuprantem
by quickly and repeatedly pulling with his fore-foot or hand the
prepuce until ejaculation took place.
Masturbation is further found among peoples of nearly every race,
however natural the conditions are under which men and women live.
Masturbation was known among all races at every period of history.
It is reported that the great Cynic Diogenes practised autoeroticism
publicly in his tub.
Schools, academies, educational institutions, dormitories of colleges,
factories or prisons are hot-beds of masturbation. Prof. Schiller
published the observations in a certain gymnasium (collegiate high
school) where the boys had holes in the pockets of their trousers ad
stuprum mutuum faciendum during the lessons, in the presence of their
professors.
Thomalla knows of a boarding school where bets are made among the boys
on the skill of their exercitatio stuprosa. The boy who can induce the
ejectio seminis the quickest receives the prize.
Walter Benseman (Public School and Gymnasium) describes the most
deplorable conditions existing in a great many boarding schools in
England.
In France, Deville and Tarnowsky found the spread of masturbation in
schools, colleges and pensionates to be enormous.
Male masturbation, as a rule, is effected by fricando glandem manu.
Hence such mishaps, as often happen in woman, are of rare occurrence.
Still many queer objects were found in the male urethra or bladder,
such as quills, pencils, penholders, blades of straw, knitting needles,
pieces of bougies or of catheters, ear-spoons, tooth-picks, all
introduced for masturbating purposes. Senn removed in a young man,
nineteen years of age, a stem of a plant from the bladder, which was
introduced into the bladder for autoerotic purposes. The author removed
a pencil from the pars membranacea of a boy of eighteen, through an
incision in this part.
Such cases are exceedingly rare in the male. As a rule, autoeroticism
in men is accomplished by the hand alone, hence the name
“masturbation.” In some cases neither the hand nor any other means
is needed to obtain the desired end. The fancy of concarnatio alone
will produce the orgasm, as in the following case, told the author in
confidence:
A young man, twenty years of age, while sitting behind an attractive
young lady in theatre, was in the habit of allowing his fancy free
rein by imagining himself of being in complexu venereo with his fair
neighbor. This thought alone sufficed to induce ejaculation and
orgasm. One Sunday while sitting near a fair worshipper in church, he
got so excited that he had to practise ideal congressum cum ea during
the sermon.
The causes of masturbation are different at the different periods
of the individual’s life. In early childhood, a neuropathic
predisposition, eczema, pruritus, phimosis, accumulation of smegma,
early retiring and late rising, spicy food and exciting drinks,
absolute ignorance of sex and seduction by vicious servants will be
the principal causes for autoeroticism. During the time of school-life
seduction is the cause par excellence of masturbation. Self-abuse is
widely spread in schools. No institution is free from it. In nearly
every school there is at least one lecherous boy who is apt to be
peculiarly fascinating to his fellows and who will promulgate the
habit. In some schools the evil reaches a wide extension. The tradition
of the school and the material of the pupils is of great influence.
Particularly dangerous, as hatcheries and divulgers of the evil, are
those institutions in which numerous pupils are present who have
passed the normal age by several years. They come, as a rule, from the
country to enter the advanced classes. The time of puberty is another
period favorable for acquiring the habit of masturbation. When the
genital centres are fully developed, the individual gets a conscious
realization of its sexual power, and the psychological reactions of
animal passion manifest themselves in the desire to cause a relaxation
and a discharge of the nervous tension and of the physical genital
congestion. The opportunity for the natural discharge being connected
with great difficulties, especially for the girl, there is danger that
the child will resort to masturbation to be relieved from the nervous
tension and the material congestion.
During the post-puberty period which in men reaches to the
twenty-fourth year and in women to the twentieth year of age, the
extension of the masturbatic practices gradually decreases, and by
the time manhood and womanhood have been reached, masturbation has
almost entirely disappeared. Its presence after this period may be
considered pathological except it is practised out of necessity as in
the following case:
Mr. A., thirty-five years old, married twelve years, father of two
healthy children, was always well. Three years ago he left his native
country and came to America. Faute de mieux, he began to practise
autoeroticism inordinately and continued in this practice until he
became a nervous wreck, showing all the symptoms of neurasthenia
besides impotence and nocturnal emissions.
In this case the patient became perfectly well after his wife arrived
in this country.
While moderate masturbation at certain periods of life is almost
a natural phenomenon, masturbation practised inordinately is the
most disastrous psycho-sexual disease. There is in the first place
general neurasthenia, with all its accompanying symptoms, as
photopsias, glistening and dazzling before the eyes, photophobias, dry
conjunctivitis, particularly found among masturbating girls and old
maids, and functional sexual disturbances, as diurnal pollutions and
spermatorrhoea. Other symptoms are indolence, lack of energy, shyness
in demeanor, want of self-reliance, disinclination to study, incapacity
of serious work, shortness of memory, absent-mindedness, unsteadiness
of character, hypochondria and melancholia.
The children become peevish and irritable, they are reserved in
conversation, apathetic in manner, hesitating in actions, slovenly in
dress, and contradictory. Cerebral anemia is of common occurrence among
those addicted to excesses in masturbation. Vertigo is hence a common
symptom, and fainting spells are not rare. Girls especially are liable
to be affected by syncope. Palpitation and arythmia of the heart is
very common. Perspiration breaks forth on the slightest exertion, and
the slightest exercise occasions shortness of breath. Neuralgia of
the testicles, ovaries and the bladder is frequently found in these
patients. The patient is frequently seized with the desire to pass
water. The calls to urinate are particularly frequent in the morning
hours, while in the afternoon and in the night-time the calls are less
urgent. Particular danger of long-continued masturbation lies in the
development of impotency in men and frigidity in women.
One of the most disastrous effects of excessive masturbation, an effect
which has also a sociological bearing, is that it renders the patient
unfit for marriage, not only because it is so often the cause of
impotence, but because the dreams which accompany the masturbatic acts
are not realized in marriage, and the patient returns to his former
pastime.
Another most harmful effect of excessive masturbation is the weakness
of the will which becomes more and more pronounced until it finally
ends in aboulia. The patient is affected by a complete inability to act
as he feels.
“Video meliora proboque,
“Deteriora sequor.”
_Masturbation in women._—In former times masturbation was considered an
exclusively male vice. Very few even among the profession dreamt of the
widely-spread masturbatic practices in the female sex. Nowadays we have
progressed. We have learned that even in this respect perfect equality
reigns among the sexes. Even female animals make no exception to the
rule.
Mares rub themselves against objects. Stags, in the rutting season,
when they have no mates, rub themselves against trees. Mammary
masturbation is found in certain females like the dog or cat. Apes are
given to masturbation even in freedom and use their hands.
Female masturbation is further found among peoples of every race and
every clime and in every period of history.
Among the ancients the Lesbian women are said to have used ivory
fascini or golden ones, covered with silken stuffs or linen, in
solitary sexual gratification. Aristophanes relates the use by the
Milesian women of the “olisbos,” an artificial leather mentula.
The Hebrew women also knew the use of the artificial phallus, as stated
by Ezekiel (xvi, 17). ותעשי לך צלמי זכר ותזני בם “Et fecisti tibi
imagines masculinas et fornicata es in eis.”
Fritsch found masturbation common among the young women of the Nama
Hottentots. It is regarded there as the custom of the country. The same
is the case among the Basutos and the Kaffirs.
The Spaniards found the women in the Philippines addicted to
masturbation. It was customary to use an artificial fascinum and other
abnormal methods of sexual gratification.
Jacobs found among the Balinese masturbation to be a common practice.
The women employ a wax fascinum, to the use of which they devote many
hours of solitude.
Throughout the East masturbation is prevalent, especially among young
girls. In Cochin-China it is most practised by married women.
The Japanese women use two hollow balls of the size of a pigeon’s egg.
One is empty, the other contains a small, but heavy metal ball, or some
quicksilver, so that if the balls are held in hand side by side there
is a continuous movement. Pila inanis primo in vaginam immittitur eo
modo ut uterum tangat, deinde altera inducitur. The slightest movement
of the pelvis or the thighs causes the metal or the mercury ball to
roll, and the resulting vibration produces a prolonged voluptuous
titillation, a gentle shock, as from a weak electric inductive
apparatus. Pilae in vagina arboris lana retinentur. The women then
delight to swing themselves in hammocks or rocking chairs, the delicate
vibrations of the balls slowly producing the highest degree of libido.
Thus the phenomenon of spontaneous sexual emotion is found in animals
as well as among savages, and in every period of human history. No
wonder that the conditions of modern civilization, with its artificial
mode of living, render auto-erethism a frequent occurrence.
The extent of this practice among women may be judged from the
occasionally resulting mishaps that reach the surgeon’s hands. Bananas
are often used feminandi causa. Country girls often use cucumbers in
stuprando.
The author once removed a carrot from the vagina, which a young woman
had used to obtain erotic gratification.
In another case, while trying to dilate the cervical canal preliminary
to curettage for persistent leucorrhoea, he found a hair-pin in the
canal which, as the girl afterwards confessed, had slipped out of her
hand while tickling the external os of the cervix.
At another occasion, as house-physician in a European surgical clinic,
the author assisted in the removal of a hair-pin from the bladder of
a young woman, which was used to produce a tickling sensation of the
clitoris, and which accidentally slipped into the urethra, and then
entered the bladder.
Other objects removed by surgeons are pencils, bodkins,
knitting-needles, crochet-needles, penholders, quills, etc.
Some women produce sexual excitement by frictions against the corner of
a chair, table, etc.
Morris relates of a lady, a devout church member, who never had
allowed herself to entertain any sexual thoughts referring to men.
Tamen se stuprabat every morning while standing before the mirror by
rubbing against a key in the bureau drawer.
One of the most common means to produce voluptificam titillationem,
that is even found in use by children, when scarcely more than infants,
is the voluntary pressure of the thighs. They are placed together and
firmly crossed while the pelvis is rocked, so that the sexual organs
are pressed against the inner and posterior parts of the thighs.
Townsend records five cases of thigh friction in children less than one
year old.
The manipulation of the sewing machine with the body on the edge
of the seat is sometimes used by young women as a means to produce
sexual excitement, leading to orgasm. Horseback riding is sometimes
employed as a means for inducing orgasm and ejaculation in women. The
stimulation caused by bicycle riding is not seldom prolonged by women
until orgasm is induced.
Besides masturbation by means of tactile excitation, ideal
auto-erethism is widely spread among women. The votaries induce sexual
libido by means of lustful conceptions and thoughts. The mere thought
concubitus induces orgasm and ejaculation in such women. Such women are
able to practice auto-erethism at all times and in all places. While
riding in crowded cars and upon the most serious occasions, in churches
and in other sacred places, the mere libidinous thought of being in
concarnatione induces orgasm. These voluptuous dreamers may stuprare
without any visible manipulations while conversing with their friends
or listening to a sermon.
A young lady of twenty-five prefers to ride in crowded street
cars and, if possible, refuses to accept a seat when offered by a
sympathetic man, but remains standing before him, holding on to the
strap. She then indulges in ideal auto-erethism by fancying herself
of being in concarnatione viri ante se sedentis, cujus genua tentat
quam sæpessime tangere suis genibus. At one occasion while riding in a
crowded car and standing before a man who was interested in reading a
book, pressit suis genibus viri genu during the orgasm in such a way
that the man, a physician, looked up to see what was going on. The
glowing face was in a state of extreme excitement. The staring eyes
were fixed on one point, the hands holding the strap were trembling.
Respiration was panting and the countenance distorted to a veritable
grimace.
With some women even lustful thoughts are not required to induce
sexual libido. They are found among women who are the victims of
sexual repression. They restrain themselves from attaining orgasm
in the natural way for moral or social reasons. Occasionally the
internal stimuli overmaster them and bring about a sexual paroxysm, in
the absence of any external stimulus and without resorting to ideal
congressus.
Sérieux records the case of a woman, fifty years of age, who lived a
chaste life. At times violent crises of sexual paroxysms would come
on without any accompaniment of voluptuous thoughts or any mechanical
help.
In some patients orgasm may be induced by means of sensory impressions,
as by listening to music or the sight of nature in the country, and by
the taste and touch of things which have no bearing upon the sexual
parts whatever.
Schrenk-Notzing records the case of a female masturbator who induced
orgasm without any tactile manipulation, simply by listening to music
or while regarding paintings that displayed nothing of a lascivious
character.
Another of his patients became sexually excited by the sight of the
grandeur of nature, as by the sea, or high mountains.
With another of his patients the mere sight of a specially strong and
sympathetic man immediately brings on orgasm.
In Ellis’ case the patient, while still a young girl, whenever a
certain artist, whom she admired, touched her hand, felt erections
and moisture in muliebribus. When her uncle’s knee once accidentally
came in contact with her thigh, ejaculation took place. Once, casually
seeing virilia, a convulsive ejaculation occurred accompanied by a
delightful sensation, every fibre tingling with an exquisite glow of
warmth.
One of the author’s hysterical patients became greatly excited
sexually whenever she ate liver-sausages.
Another kind of auto-erethism occurs during sleep. Pollutions are
accompanied in sleep by erotic dreams. At the height of the paroxysm
an abundant discharge from the Bartholinian glands takes place. The
orgasm in sleep is an autoerotic process which is entirely normal.
In women who have not yet experienced orgasm in the waking state,
the erotic phenomena during sleep are usually of a very vague kind.
The real orgasm that awakes the sleeper and leaves its traces in
the individual’s consciousness occurs only after orgasm has been
once induced in the waking state. Erotic dreams occur in women more
frequently than is ordinarily thought of nowadays. It was better known
in the darker ages. Hence the wide-spread belief in Lillith and Samaël,
the evil spirits, that visit young maidens and wives and also youths
and husbands while in bed at night in order to seduce them.
Sometimes automatic masturbation is practised during sleep. The patient
awakes to find her finger in the vagina.
If the pollutions occur at long intervals, they cause no direct injury
to a good constitution. But if the women are not robust, and the
pollutions happen too often, these drains are the cause of considerable
nervous depression.
One of the author’s patients, a widow of about forty years of age, is
suffering from almost nightly pollutions. These weaken her so much
that she is seldom able to rise before noon-time.
The same deleterious effects are caused by all other kinds of
masturbatic practices. Even though we agree with Paget that moderate
masturbation is no more harmful than normal intercourse, it can not be
denied that masturbation, since opportunity for it is ever present, is
of far more frequent occurrence than natural sexual indulgence. The
habit, once established, masturbation presents an unconquerable impulse
and a resultant incapacity to control it. It is then the cause of grave
material injuries to the nervous system. It dwarfs the entire female
organism. It makes the girl shy, offish, squeamish, repellent, and
weakens and sickens the emotions of sex-attraction.
One of the author’s patients, a dress-maker, thirty-five years
of age and single, has been suffering from general nervousness,
headaches, palpitation of the heart, frequent urination, anorexia and
constipation. One day she took courage and asked for a remedy for her
excessive autoeroticism. Scarcely does she reach her bed at night
time and gets warm, when the overwhelming desire for autoeroticism
takes a hold of her and, fighting as she may against the impulse, ei
feminandum est manu. These practices were going on nightly for the
last twenty years.
Howard says: The permanent effects left from early masturbation seem
to be much graver in women than in men. As the girl grows, her psychic
life becomes more complicated, her natural romantic nature is fed by
kiss literature and poetry of the decadents, in which perverted passion
is thinly disinfected by erotic mysticism. Under such a stimulating
psychic pabulum a dormant sexual volcano may become active. If it is
only smoldering, suggestive dressing, the dance and wine will soon
bring about the complete explosion. At home in bed, with strange and
abnormal psychic pictures, she will seek relief in stupro manu. If
this state of affairs is kept up for many years, when she marries her
husband is certain to find that he has for a wife a female who has no
use for normal sex activity and who has acquired a perverted taste for
some form of autoeroticism.
It is a curious fact that autoeroticism is frequently practised by
married women living with sexually normal husbands. The gynaecologist
must consider this fact as the possible cause of many female complaints.
A few years ago, the author removed an ovarian tumor and performed a
perinæorrhaphy on a woman of thirty-five, mother of a child of ten
years of age. While in the hospital the nurse complained that the
patient is soiling the wound contrectando muliebria. Three months
after the patient left the hospital she called at the author’s office
for treatment of ulcerations of the labia and nymphae. The clitoris
was found to be one inch long, bluish-red and inflamed, the prepuce
swollen and edematous, the nymphae inflamed and swollen. The author
told the patient that she could not be cured unless she desisted from
autoeroticism which she promised to do. This promise had the value of
a confession that she did indulge in autoerotic practices. Yet she
had a normal husband who very industriously performed his marital
obligations. For before the operation she once asked the author to
tell her husband not to have any connections, or at least, not so
frequently, with her until after the operation.
The female masturbator often becomes excessively prudish, despises and
hates the opposite sex, and forms passionate attachments for other
women. Masturbation is not seldom the cause of a great number of
female complaints. It is often the cause of obstruction and of pains
of menstruation, of ovarian neuralgia, of weakness of the legs and
of sexual irritation. It causes pruritus vulvae, hypertrophy of the
clitoris and labia minora, hyperaemia of the vaginal orifice, fluor
albus, and cervical catarrh. Masturbating women often complain of
general weakness and of palpitation of the heart.
One of the author’s patients, a young masturbator of seventeen,
suffered from painful menstruation, attacks of palpitation of the
heart, from melancholia and fear of death, and at the same time from
suicidal inclinations, which thus revealed the illogical state of her
mind.
Masturbation also causes that form of increased erethism, connected
with female impotency, in which the orgasm no longer occurs during
the conjugal embrace. For this reason the victim prefers solitary
indulgence even after marriage.
In Moll’s case the woman, thirty years of age, mother of several
children, is happily married, loves her husband and is loved in
return. Yet coition does not gratify her in the least. She finds
satisfaction only in solitary stupro manu by which orgasm is induced
in the highest degree. In this way there are times, when the patient
who is a modest, moral woman, practises autoeroticism several times a
day.
To this class of patients belong the cases recorded by Loiman,
Laker, and others. The sexual functions were originally normal and
satisfaction was possible in the normal way. Through excessive
masturbation, however, the nerves became so weakened that normal
coition did not give the desired satisfaction.
In Troggler’s case the woman had practised autoeroticism excessively
from her thirteenth year and found satisfaction fricando et trahendo
clitoridem. When she began to have normal concarnatio at the age
of eighteen, she found that she could not obtain satisfaction for
her excessively increased voluptuous desire except manuali fricando
clitoridis inter coitum.
In Laker’s case of a married woman, twenty-four years of age, the
patient never experienced the least satisfaction in concarnatione with
her husband, while she found the desired effect in autoeroticism,
especially in mutuo stupro manu.
In another of the same author’s cases a woman of thirty-four years
of age practised stuprum manu mutuum and found great satisfaction in
this activity. At the age of nineteen she was married and in spite of
mutual affection she could not experience any libido. This fact did
not prevent her from giving birth to two healthy children.
In another of Troggler’s cases, the woman, twenty-five years of age,
was induced to practise autoeroticism when eleven years of age. On
account of her increased sexual desires she began to have complexus
venereus when fifteen years old. But she could not find the least
satisfaction in congressu, although she practised it with a number of
different men. Only stuprum manu offered her the desired libido.
In Loiman’s case the patient was induced by her friends in the convent
to practise autoeroticism. When fourteen years of age she began to
indulge in stupro manibus mutuo cum pueris of her own age. She married
when nineteen years old and gave birth to her first child a year
later. But she never found gratification in the conjugal embrace. The
second case of Loiman was a widow of thirty-eight who had always been
normal in her sexual functions and gave birth to a child at the age of
twenty-seven. Two years later she lost her husband by death, and from
that time she began “faute de mieux” to stuprare manu. Her voluptas
increased to the point of becoming insatiable. When she has now normal
congressus cum multis amatis she cannot find the desired gratification
unless masturbatur in congressione.
This last case shows that Freud’s explanation of frigidity of
intercourse by the refusal of the clitoris to transfer its sexuality
at the time of puberty does not always hold good. This woman passed
through her normal puberty. The cause of the impotence of libido inter
coitum in these masturbators is rather the increase of the excitability
of the clitoris at the expense of the vaginal mucous membrane and of
the cervix uteri, through the long-continued manual irritation of this
organ. The stimulation from these sources to induce libido is thus
decreased, and the excitation of the glans of the clitoris by the penis
alone during coition is insufficient to induce orgasm.
The immediate causes of the masturbatic practices are generally bad
examples. The practice is first learned from friends in boarding
schools, convents, factories or prisons. Sometimes it is also prurient
curiosity which prudish educators and parents neglect to satisfy
which leads young girls to self-abuse. In congenital hyperaesthesia
the pleasurable titillation may accidentally be induced in complete
ignorance of sexual relations. The following case is quite instructive
in this respect.
A young lady, twenty-four years of age, consulted the author on
account of her extremely enlarged breasts. She stated that eight years
ago she discovered that by a certain manipulation muliebrium she was
able to experience the highest degree of pleasure. For the last eight
years until very recently she continued to enjoy the fruits of her
discovery. She often wished to tell her physician about her wonderful
discovery for the benefit of other young women. One day the author’s
book, “Woman,” fell into her hands, and she learned for the first time
to her great amazement and chagrin that what she was doing was nothing
else but autoeroticism.
This simple story shows that ignorance is not always innocence, as some
misled parents seem to think. Sometimes ignorance is just the cause of
the early practice of sex activity.
_Incest._—Another anomaly which must be attributed to hyperaesthesia
sexualis is incest. Incest, as such, has nothing pathological in its
essence. In the early history of human marriage incest was the rule.
It was practised even in historic times. Abraham was married to his
sister, according to the Bible. Cimon of Athens was also married to his
sister. In the royal house of the Ptolomei it was common for brothers
to marry their sisters to avoid a division of the empire. Cleopatra,
the evil star of Marc Anthony, was married to her brother. But these
few examples were the exceptions, generally, for the last three
thousand years incest has been considered an abomination in the eyes of
God and men. Its practice was constantly inveighed against by Church
and State. It has, therefore, because of these constant suggestions,
become the second nature of man to abhor such practices. Only an
exaggerated sexual desire, coupled with the absence of understanding
for laws and morals, could nowadays lead to incest in any civilized
country. Even in the crowded tenements where all members of the family
of both sexes live and sleep in one room, incest is still a great
rarity, and when such a case happens, it deeply wounds the feelings of
the entire community. Such incestuous immoral attacks are, as a rule,
made by low, brutal men in a state of intoxication or by those who
suffer from weak-mindedness, by epileptics and by paranoiacs. Hence in
every case of incest, we are justified in assuming that the seducer is
suffering from sexual hyperaesthesia. An asylum and castration may be
a more appropriate treatment for such a patient than the treatment in
prison.
The following case came under the author’s observation while he was
house-physician in the Woman’s Hospital of a well-known European
university:
A mother brought her twelve-year-old girl to the skin department
of the general hospital to be treated for a certain rash the child
was suffering from, for some time. The rash was diagnosed there as
pityriasis versicolor, and the child was recommended to go to the
Woman’s Hospital for treatment. At the examination here it was found
that the twelve-year-old child was six months pregnant. Being too
small and delicate, even for her age, to give birth to a full-term
child, it was decided to induce premature labor. Before the operation,
the child was asked for the name of the man who was responsible for
her predicament, and the following was her version of the accident:
One day, while returning from school, she was addressed, on the
street, by a man whom she had never seen before and who asked her
whether she did not know him, her cousin from X. He said that he was
just going to see her parents, his uncle and aunt. On the way he took
her to a candy-store and bought her candy. When leaving the store he
told her that he had forgotten to take along a present for her parents
which he left in his room, and they both went to fetch it. Upon
entering his room, he locked the door and abused her.
Upon hearing the story the indignation of the medical authorities of
the hospital was beyond all description. The police was immediately
notified to hunt for the criminal. A representative from the district
attorney’s office (Untersuchungsrichter) and a detective soon
appeared at the hospital to get more particulars from the child. The
officers of the court seemed to have a much better experience in the
examination of such cases than the doctors, for when they left the
child’s room her story read quite differently.
The girl’s father had a workshop in the business section of the city,
while the family lived in another part. When leaving school in the
afternoon the child used often to visit the father’s shop and take
home the dishes he took along in the morning. One day, while in the
shop with her father, he took her in the back room of the shop and
abused her. Under threat of death these immoral attacks were often
repeated for months afterwards, until one day the unnatural father
noticed that his child conceptavit ab eo. He then made up the story
with the cousin which the child first told the hospital authorities.
The father was arrested, tried, and sentenced to ten years’ hard labor.
This case shows how low the sufferers of hyperaesthesia may fall. The
man was not drunk when he made the repeated attacks upon his child.
The excuse of the defective separation of the living quarters is
also missing, nor does here exist the cause of “faute de mieux,” as
it is sometimes found in widowers living with their adult daughters
in incestuous unions. The man here had a healthy wife. Hence it is
nothing else but a case of sexual hyperaesthesia pure and simple of a
weak-minded individual.
Incest is oftener found in men than in women, yet there are cases
recorded where women were the seducers.
Legrand describes the case of a girl, fifteen years of age, who
seduced her brother to all manner actionum voluptificarum in se.
His other case is that of a woman of thirty-six who, although married,
indulged in abusing her brother, a boy of eighteen. The same woman was
otherwise abnormal, suffering from the anomaly known as exhibitionism,
which is seldom found in women, except among the insane in asylums.
She often exposed her breasts from the window to attract men.
In another case of the same author, a mother, thirty-nine years of
age, practised incest with her own son and ab eo comprehendit.
Tardieu cites a case of a woman whose victim of criminal attack was no
other than her own son, a boy of nine years of age.
CHAPTER XVIII
PARAESTHESIA
Paraesthesia sexualis covers all possible forms of perversion or
perversity of sexual feeling and sexual activity.
Perverse sexual activity with normal feeling and inclination is present
in the anomalies, masochism, sadism, fetichism, and exhibitionism.
_Masochism._—One of the most peculiar phenomena in the perverse
vita sexualis is met with in patients with a desire for unlimited
submission to the will of a person of the opposite sex. This anomaly
was named masochism by Krafft-Ebing after Sacher-Masoch, whose romances
have as their particular object the description of this perversion.
Schrenk-Notzing recommends the name “Algolagnie.” The distinguishing
symptom of masochism is the wish of the patient to suffer pain at the
hands of, and be subjected to force by the beloved person, to be this
person’s complete slave. This mixture of pleasure and pain is one of
the most peculiar and remarkable psycho-sexual anomalies. Pain, whether
real or imaginary, becomes here a source of pleasure. Whether the
subjection is expressed merely in symbolic acts or whether there is
absolute desire to suffer pain at the hands of the beloved one, is a
matter of subordinate importance. The characteristic of the perversion
of masochism is that pain and submission, which to the normal
individual causes a certain degree and anguish, are in these patients
turned into a source of lust.
The submission to pain or subjugation in itself is in no wise
pathognomonic of masochism. It may not be pathological at all. Even
entire sexual bondage is not, properly taken, pathological, if it be
only the means of obtaining or retaining possession of the coveted
person. It is not perversion, if fear of losing the companion and
the desire to keep him or her always amiable, content, and inclined
to love, are the motives for submission. The henpecked man is not a
pervert. It is not abnormality, but cunning if, to satisfy selfish
desires, the person in subjugation performs acts of bondage at the
command of the ruling individual, but in its innermost is rebelling
against this enforced slavery. Sexual bondage becomes pathological only
when in itself the loss of all independent will-power and the unlimited
submission awaken lustful sexual feelings, and this submission is hence
desired. It then represents a pathological degeneration.
In masochism the motive, underlying the suffering of the person in
question, is the charm afforded by the tyranny in itself. The acts
performed at the command of the ruling person are an end in themselves.
The very acts of tyranny are the immediate object of gratification,
not the concubitus that may be received as a recompense. The idea of
being treated as by a master, of being completely and unconditionally
subjected to the will of the lover, of being humiliated and abused by
him or her; this idea in itself is colored by lustful feelings.
The masochistic man has a perfect longing for subjection to any
person whatsoever, especially to a woman. He craves to be dominated,
controlled and abused by somebody. He is not fastidious in his choice.
He revels in the thought of subjugation, without inclination to a
particular woman. The following cases will serve as an illustration of
these types of patients.
A man of forty, happily married, father of three children,
college-bred and wealthy, was as a child already often punished for
his cruelty to small animals. He would delight in tearing out the
wings and cutting off the heads of flies. Later when he attended
school he found great pleasure when he could see boys whipped.
At the time of puberty he began to practice flagellation upon himself.
These practices induced ejaculation and orgasm. Towards the end of
this period he began sese stuprare manu but he could not find any
satisfaction except he imagined himself being whipped by a young woman
in nudas nates.
For the last ten years habet meretricem in a luxuriously furnished
apartment whom he visits once a week and whose duty it is to flog him
in nudas nates until the skin is covered with bloody weals. At this
moment ejaculation occurs. Thereupon he dresses and leaves the woman.
He never has any concarnatio cum ea.
A similar case has been described by Pascal. A man forty-five years
of age was used to visit regularly a priestess of the Venus vulgivaga,
whom he paid ten francs for the following services:
While the windows were darkened, by letting down the blinds, the girl
had to undress him completely. She then bound his feet and hands,
hoodwinked him, and in this helpless condition led him to a lounge
where he remained lying for about half an hour. After this time the
girl loosened his fetters. He then dressed and left her satisfied.
The following case, similar to the author’s first one, is worth
recording for the pronounced masochistic imagery. A young married
man of thirty-five, father of two healthy children, visits regularly
once a month, for the last ten years, fornicem. There he picks out
pulcherrimam puellam to give him a flogging in nudas nates. This
procedure gives him satisfaction. He never has any carnal connection
with the woman. His relation to her is that of the slave to the
mistress whom he would not dare to touch even in his imagination.
During his childhood he had quite remarkable masochistic ideas,
which, however, have never been put into effect by him. As a small
boy he loved to see animals or children whipped. At the time of
puberty he began manu stuprum and during these acts he revelled in
his imagination in scenes of cruel subjugation. He imagined lying
on his abdomen, and a pretty, very strong girl applying a cane or
whip upon his naked back and nates. Post castigationem, puella,
induta solum in interula, ponente in pectore suo pedem nudum, quem
vehementissime osculat et gratias puellæ agit pro castigatione.
Nonnunquam imaginabatur puellam in pectore suo sedere, capite inter
puellæ femora ita, ut vulva tangeret os suum. Tum linguam suam in
vaginam intromisit, labia minora suxit et clitoridem puellæ lambit.
Denique anum osculavit.
The last action in his fancy is symbolical of the highest degree of
humility, which does not shrink back even from the loathsome and
disgusting, but on the contrary, considers it a high honor and favor
to be allowed to approach even this unaesthetic part of the human
anatomy. The anal kiss, for that reason, played a prominent rôle in
the ceremonies of the witches’ vigil. The anal kiss is well known in
fornicibus, frequented by masochists. In men every masochistic desire
is at once recognized as pathological; in women the dividing line
between the normal and pathological masochistic tendencies is not so
easily determined.
It is entirely within the physiological limit that playful taps and
light blows should be taken by the woman for caresses. “Like the
lover’s pinch, which hurts and is desired,” says Shakespeare. In one
of the letters of Abélard to Héloïse, the teacher writes to his pupil
and mistress: “Verbera quandoque dabat amor, non ira magistralis,
quaeque omnium gaudiorum dulcitudinem superarent.” Subordination to a
certain extent is quite a normal manifestation in the loving woman;
with her it is a physiological phenomenon. It is the subordination of
weakness to strength. A certain amount of subordination depends upon
the woman’s passive rôle in procreation. The aggressor always controls
the subjected in love as in war. The element of pleasure found in
passivism and ideal submission is, therefore, peculiar to the feminine
sex. The custom of unnumbered generations also has given her an
instinctive inclination to voluntary subordination.
Ideas of submission are, therefore, in the woman normally connected
with the idea of sexual relations. They form the harmonies of the
tone quality of feminine feeling, says Krafft-Ebing. We women, says
Schiller, can only choose between ruling and serving, but the highest
pleasure power affords is but a miserable substitute if the greater joy
of being the slave of a man we love be denied us. Goethe’s Dorothea
says: In time shall the woman learn to serve in accord with her
destiny, for only by serving she finally gains the reins and the power
that is rightly hers in the household. In fact, intelligent women have
scant respect for slavish men, and exaggerated gallantry is distasteful
to them.
A moderate degree of submission to the wishes and the will of the man
she loves is, therefore, characteristic of the feminine nature and
is not abnormal. Many a young woman worships her husband and wishes
nothing better than to kneel before him. This is done because her
husband means for her the whole sex and his importance to her becomes
very great. But in masochism there exists the desire to be subjected
and abused by any man without any inclination to a particular object of
love. A further pathognomonic symptom of masochism is that, as a rule,
the girl begins to dream of subjugation at a time when she is yet too
young to have any perception of love.
The best examples of female masochism are given in Krafft-Ebing’s two
cases.
The first case is of a girl, twenty-one years of age. From her
earliest youth she fancied herself being whipped. She simply revelled
in these ideas and had the most intense desire to be severely flogged.
This desire originated at the age of five when a friend of her father
laid her playfully across his knees, pretending to whip her. Since
then she had longed for the opportunity of being whipped. To her
great regret her wish had never been realized. She imagined herself
absolutely helpless and fettered. The mere mention of the word cane or
whip caused her intense excitement.
For the last two years she associated these masochistic 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 she loved. She
would kiss his feet, if he would only whip her. She imagines herself
lying before the man of her fancy; he puts one foot on her neck, while
she kisses the other. In the meantime she revels in the idea of being
whipped by him. She takes the blows as so many tokens of love. She
fancies him first as being extremely kind and tender and then, in
excess of his love, he beats her. She also fancies that beating her
for love’s sake gives him the highest pleasure. She often dreams that
she is the beloved man’s slave. The patient never understood that
these manifestations were of a sexual nature.
The second case is that of a woman, thirty-five years of age,
of a greatly tainted family. For some years past she had been
in the initial stage of paranoia persecutoria. This sprang from
cerebral neurasthenia, the origin of which was found to be sexual
hyperexcitation. Since her twenty-fourth year she had been given to
manu stupro, the result of a disappointment from a broken engagement.
To appease her intense sexual excitement, she began the practice of
manu stuprum and of mental erethism by fancying herself to be in
concarnatione.
The story of her youth reads as follows: At the age of six to eight
years she conceived the desire to be whipped. She had never been
whipped nor present when others were thus punished. Hence she cannot
understand how she came to have this strange desire. With the idea of
being whipped she had a feeling of actual delight. She pictured in her
fancy how fine it would be to be whipped by one of her female friends.
She never had any thought of being whipped by a man. She revelled
in the idea only and never attempted any actual realization of her
fancies, which disappeared after her tenth year of age.
Here we have a young masochist whose ideas of humiliation are
associated with her own sex. The reason for the patient’s fancy for
female friends lay in the fact that the masochistic desire was present
in the mind of the child before the psychic vita sexualis had developed
and the instinct for the male awakened. Had the desire lasted until
puberty the association of these ideas with the male would have been
established.