PATHOLOGY
In the previous chapters I have from time to time mentioned some
phenomenon of comparatively rare occurrence; but for the most part I
have described those processes only which are regularly met with, which
cannot be regarded as exceptional peculiarities, and therefore must not
be considered to be pathological manifestations. It is true that much
that has been described comes within the province of the pathological;
for example, many of the active manifestations of the sexual impulse
occurring during the first period of childhood, such as the case quoted
from Féré on page 81. For practical reasons, however, such cases as this
cannot always be dealt with as members of a distinct pathological group.
On the other hand, it is necessary to give a separate consideration to
the pathological aspect of our subject. Many of the cases which must be
grouped as pathological occur in girls. Thus, we meet with cases in
which menstruation becomes established at the age of eight, five, two,
or even earlier.[53] Carus reports the case of a woman whose medical
history showed that she had begun to menstruate at the age of two years,
and that she became pregnant for the first time when eight years old. In
girls from ten to twelve years of age, pregnancy has many times been
observed. A French physician had under observation a girl who when only
three mouths old had well-developed breasts, and in whom only a little
later the pubic and axillary hair grew and menstruation began. When
twenty-seven months old, the child was again seen by the same physician,
and at this time menstruation was proceeding regularly; the features had
now lost the infantile type, and the body as a whole exhibited all the
signs of premature development. A collection of cases made by
Gebhard[54] contains one case in which menstruation was established at
birth; in quite a number of the cases menstruation began during the
first year of life.
A case was reported from New Orleans in which menstruation began at the
age of three months and continued regularly thereafter. This was a case
of premature general growth; at the age of four years the girl was over
4 feet high, and her breasts were the size of a large orange. As a
general rule, in these cases of premature development of the
reproductive organs in girls, the great size of the breasts attracts
especial attention. According to Kisch (_op. cit._, p. 78), these girls
with precocious menstruation and premature sexual development very
commonly exhibit also a comparatively high body-weight, great
development of fat, and early dentition; they look older than their
years, and their genital organs also develop very early, with hair on
the pubes and in the axillæ; the labia majora and the breasts resemble
those of full-grown women, and the pelvis also has the adult form.
Commonly also the sexual impulse develops early, whilst in other
respects the mental development lags behind the physical.
In the post-mortem room, corresponding conditions are occasionally found
in the ovaries; and some writers express the opinion that such premature
sexual development is commoner than would appear from the comparative
rarity of reports on the subject. Unquestionably, examination of the
ovaries of young girls not infrequently leads to the discovery of ripe
ovarian follicles; in one case this happened in the body of a female
infant born prematurely. In a girl five years of age, fifteen follicles
were counted in the ovaries. Liégeois,[55] in post-mortem examinations,
twice found mature ova in girls two years of age.
Similar cases of premature sexual development are occasionally seen also
in boys. For example, Breschet, in the year 1820, reported the case of a
boy three years of age who exhibited all the signs of puberty. His voice
resembled that of a young man of sixteen to eighteen. The length of the
flaccid penis was 9.6 cm. (3-3/4 inches), its diameter at the root was 7.2
cm. (2-3/4 inches); the length of the organ when erect was 13.5 cm.
(5-1/4 inches). In the presence of girls or women the boy's penis became
erect, his whole manner became more vivacious, and his hands were
directed towards the genital organs of these females. Masturbation was
never observed. The boy showed many additional signs of premature
development. For instance, the central incisors of the upper jaw were
cut at the age of three months. Breschet also quotes a case published by
Mead, in which a boy had undergone the puberal development before the
end of the first year of his life; when five years of age, he died of
pulmonary consumption, attended with all the signs of old age. The same
writer records another case, that of a boy five years of age, whose
genital organs were fully developed, who had a well-grown beard, and
exhibited, in short, all the (physical) characteristics of complete
sexual maturity. In accordance with the theoretical views of that day,
more especially as a result of the wide acceptance of the phrenological
doctrines of Gall, it was generally believed that an exceptional
development of the cerebellum (which was supposed by Gall to be the seat
of the sexual impulse) was the determining cause of such premature
awakening of the sexual impulse.
Contrasted with the cases just described, are those in which there is a
retardation of the whole course of sexual development, so that the signs
of sexual maturity are not manifested until an age greatly exceeding the
average "age of puberty." In respect of one symptom or several, many
individuals may remain throughout life in an infantile condition. This
is occasionally seen, for example, in dwarfs. It would be of great
interest, from this point of view, to make a careful study of the sexual
behaviour of dwarfs. In this respect, dwarfs appear to vary greatly.
These differences depend, in part, at least, upon the fact that many
persons are classified as dwarfs who do not, strictly speaking, belong
to this category. This statement applies more especially to those whose
growth has been impaired by rickets; for, properly speaking, those only
should be designated dwarfs who are, though small, generally
well-proportioned; and the term should not be applied to those in whom
the defective stature is consequent on rachitis or some similar disease.
It appears doubtful, however, if the confusion of terms just mentioned
explains all the observed differences in the sexuality of those commonly
spoken of as "dwarfs." From data communicated to me concerning a fairly
large community of dwarfs, living in a single place, and in whom the
dwarfing appears to have no connexion with rickets, it would seem that
in the case of true dwarfs there is considerable variation in sexual
behaviour. This particular group of dwarfs constitute a society of
persons living and working together. Although they are all living in
close association, there seems to be a striking lack of warmth in their
sexual relationships. Notwithstanding the fact that they have been
living together for ten years, they still address one another formally
as "Mr." and "Miss." In the case of the male dwarfs, with one exception
all had fully developed genital organs; the exceptional instance was
that of a member of the community then thirty years of age, in whom the
genitals were rudimentary. All were endowed with normal sexual impulse,
but this was directed towards persons of normal stature. In one of these
dwarfs, an Italian, the genital organs remained undeveloped and hairless
until he attained the age of twenty-eight; then these organs underwent
the normal degree of growth, and at the same time pubic hair appeared.
As already mentioned, the sexual inclinations of dwarfs appear as a rule
to be directed towards fully grown persons, and I knew one dwarf twenty
years of age who never missed an opportunity of pressing up against a
certain very pretty young lady. These observations of my own regarding
the sexual inclinations in dwarfs are confirmed by other cases recorded
in the literature of the subject, although in isolated instances sexual
attraction between a male and a female dwarf has been observed to
eventuate in the birth of a child.
This is the place in which to refer to those cases of which a brief
mention was made in the first chapter, to which von Krafft-Ebing has
given the name of _sexual paradoxy_. Activity of the sexual impulse is
sometimes observed at an age at which this impulse is normally
quiescent. The term applies alike to cases in which the sexual impulse
becomes active in early childhood, and to cases in which the impulse
persists to an advanced age. Whilst the cases in which the phenomena of
contrectation alone occurred have commonly been overlooked, considerable
attention has been paid to those cases in which the sexual impulse
manifests itself by peripheral changes, more especially by premature
impulse towards masturbation or towards actual sexual congress with one
of the other sex. It was shown, however, in the last chapter, that
active manifestations of the sexual impulse during childhood are not
always paradoxical. If we examine cases which have been published as
coming under this latter category (I limit myself here to cases
occurring in childhood, and am not speaking of sexual paradoxy in old
age), we find that they are characterised more particularly by the
strength with which the peripheral sexual impulse manifests itself.
There is, in fact, a marked distinction between cases, according as we
have to do with an occasional general sensation in the genital organs,
or with masturbation to excess and with sexual assaults upon others. But
we must not describe as sexual paradoxy all manifestations of the sexual
life occurring in early childhood. A reference to the last chapter will
show that the cases of sexual paradoxy, when accurately studied, differ
from the normal rather quantitatively than qualitatively. During the
first period of childhood, and more especially during the first few
years of life, a case in which sexual activity in a child threatens the
well-being of members of that child's social environment is so sharply
differentiated from the normal that there can hardly arise even
momentary hesitation regarding the paradoxical nature of the
manifestation. On the other hand, we shall do well to follow von
Krafft-Ebing in excluding from the category of sexual paradoxy those
cases in which sexual excitement is caused solely by peripheral
inflammatory stimuli, balanitis (inflammation of the glans penis),
threadworms, and the like. These are not instances of sexual paradoxy,
because the essential characteristic of the latter is that it originates
centrally, even though its manifestations take a peripheral form.
I will now recount three cases which I regard as pathological in nature,
and as examples of a paradoxical sexual impulse.
CASE 7.--The girl X., six years of age, stated by the mother to be free
from all morbid inheritance, produces the general impression of being a
nervous subject. She is affected with facial muscular spasms, especially
affecting the corners of the mouth, the eyelids, and the neck. Her
mental development, as far as can be judged from my own observations and
from the account given by the parents, is perfectly normal; but
attention is at once attracted by the appearance of premature
development. The mother states that in the second year of life, owing to
the carelessness of a nursemaid, the child fell out of her cradle,
without, however, sustaining any manifest injury. The mother does not
think there is any reason to suppose that the child has ever been led
astray in sexual matters. For the past two years or more, the mother has
noticed that the child likes to press up against articles of furniture
in such a way that her genital organs come into contact with narrow
edges or corners; for example, the back of a chair, and especially a
small portfolio-stand in the room. At first the child did this very
often. Then the mother forbade it, and the father whipped her several
times for doing it; since then it has been done more furtively, but the
mother has none the less often seen it done. When the child is in bed
she plays with the genital organs with her fingers. A definite orgasm
occurs: there are spastic twitchings of the whole body, the eyes
brighten, the respiratory rhythm changes; all these changes, occurring
as they do in association with the artificial stimulation of the genital
organs, combine to prove that we have not to do here with a simple
spasmodic neurosis, but with the artificial induction of the sexual
orgasm. The process is, moreover, confined to peripheral manifestations.
The most careful observation failed to show the existence, in
association with the sexual excitement, of any especially tender
sentiments towards other individuals.
CASE 8.--The boy Y. was brought to see me when he was eight and a half
years of age. From the second year of life he had been noticed to be
subject to masturbatory impulses, attended from the first with erection
of the penis. The practice of masturbation increased to such a degree
that before the boy was four years of age it was found necessary to keep
him separate, as far as possible, from his brothers and sisters to save
these latter from being corrupted by him. But notwithstanding this
precaution, by the time he was five years old he had begun to make
sexual attacks on a sister one year older than himself. He was cunning
enough to arrange matters in such a way that he was alone with his
sister, at times when the usual safeguards to keep him separate from the
other children were suspended--for example, when his parents were away,
and when his governess (who had been made fully acquainted with the
circumstances) was keeping some assignation of her own. (All this was
fully elucidated at a later date. The distressed parents were foolish
enough to imagine that a child with inherited morbid predispositions of
this character could be adequately safeguarded by means of hired help;
they were painfully disillusioned when it appeared that the hired
assistant, instead of watching the child, was pursuing her own
pleasures--a point in which she merely imitated the parents, themselves
earnest pleasure-seekers, deluding themselves with the belief that
everything possible was being done for their child.) Although the
parents had known all about the boy's habit of masturbation for many
years past, it was only through a fortunate accident, and after the
sexual malpractices with the sister had been going on for a long time,
that these at length came to light. It appears that the boy had from
time to time made sexual advances to other girls than his sister. One
day, while playing with the little daughter belonging to a neighbouring
family, he endeavoured to lead this child sexually astray. The little
girl told her parents what had happened, and these latter consequently
refused to allow her to play with Y. any more. This prohibition led Y.'s
parents to inquire into the whole matter with great care. It was then
discovered that for years past Y. had been engaged in sexual misconduct
with his sister, his usual method being to play with her genital organs
with his hands. In the girl, the frequent repetition of this act had
given rise to abrasions and local inflammations.
The following case, the leading features of which are the early age at
which seminal ejaculation occurred, and the marked hyperæsthesia of the
sexual impulse, may also be regarded as an example of sexual paradoxy.
This patient exhibits a number of different perverse modes of sexual
sensibility, some of which have persisted to the present day.
CASE 9.--Z., now thirty years of age, admits prolonged sexual excesses,
and divides his sexual history into two periods: the first period
extends from the age of seven to the age of twelve, before he had
learned the use of alcohol; during the second period, from the age of
thirteen to the age of thirty-years, his sexual excesses occurred under
the influence of alcohol. He gives his own history in the following
terms:--
"In very early childhood my imagination began to exercise itself
pleasurably in the pictured contemplation of the bodies of naked girls.
I can also remember distinctly that my dreams were chiefly concerned
with images of this character. In the later years of childhood (nine to
twelve years) I masturbated to great excess, often five to ten times
daily, sometimes actually while in class at school. Seminal emission had
already begun--I remember this quite distinctly at the age of ten, and
perhaps even at the age of nine years--but the quantity of semen was
very small. I found several schoolmates with similar inclinations to my
own, and with these I practised mutual masturbation. When I was eleven
years old I became acquainted with a boy somewhat younger than myself,
and in this case the proposal for mutual masturbation came from his
side. At that time the thought that there was anything wrong in the
practice had never entered my mind; on the contrary, I was always on the
lookout for boys who would join with me in mutual masturbation. Such
were my sexual habits, until as a boy of thirteen I for the first time
had complete sexual intercourse with a woman, a prostitute.
Thenceforward, for a time, I had intercourse at intervals of from four
to six weeks, continuing in the meanwhile daily masturbation.
Subsequently I sought and found opportunities for intercourse with
women, married and unmarried, about once a week, for money. These almost
daily venereal excesses appeared to have no bad effects on my physical
health; my diet was at the time abundant, if not superabundant. On the
other hand, I lacked effective will-power to make a successful stand
against the promptings of my bodily lusts; nor was I able, though not
devoid of talent, to perform any arduous or enduring mental work. There
ensued also at this early stage a great infirmity of purpose, from which
I still suffer to this day. I would take up now one thing, now another,
at first with fiery zeal, soon to cast it aside in favour of some new
undertaking, to be abandoned with the like precipitation.
"Having command of abundant means, I now, at the age of fifteen, became
enabled to gratify my sexual desires without restraint with dependents
of the other sex; nor did any untoward physical consequences arise to
impose limitations. After a time, ordinary sexual intercourse ceased to
furnish adequate gratification; and I began to excite myself sexually by
contact with special parts of the body, most often the breasts. But the
woman must not, as had formerly been my desire, strip herself completely
nude; for I found the most powerful sexual stimulus was now exerted by
her white drawers. The display, intentional or unintentional, of this
article of feminine attire sufficed to arouse in me sexual feelings. For
this reason I now came to frequent the skating rink, in order to obtain
a sexual stimulus from the glimpse of a woman's drawers when putting on
her skates. But even when a girl was physically beautiful and elegantly
dressed, if her drawers were not white but coloured, she produced in me
no sexual appetite whatever.
"As a result of long-continued excesses, attempts at ordinary
intercourse no longer evoked an adequate sexual stimulus, so that I now
began the practice of cunnilinctus. It was when the woman herself became
excited through the cunnilinctus, that I experienced the highest sexual
gratification. In the intervals, when I had no opportunity for sexual
intercourse, I would endeavour to secure sexual gratification by
exposing my genital organs in the presence of females, or when passing
them in the street--especially female children. I also sought every
possible opportunity of watching female dependents engaged in the act of
urination. This gave me especially great gratification if, when they
were urinating, I could see their white underlinen. I also procured
pornographic literature, and masturbated frequently while reading it."
The next period in this patient's history now begins. But I shall not
recount his case further, since the subsequent episodes have no bearing
on the questions with which we are especially concerned. It will suffice
to remark that Z. now exhibits numerous neuropathic and psychopathic
characteristics. But the various psychopathic symptoms, some of which
are very severe, lie altogether outside our chosen field of study.
Paradoxical sexual impulse is observed also in the lower animals. Weston
reports the case of a colt which when only six weeks old attempted to
serve its mother; when three months old this animal became so
troublesome, owing to its attempts to cover other foals and even calves,
that castration was necessary.[56] The same author describes a case of
masturbation in a foal only two months old; the animal masturbated by
arching the back to an extreme degree, and pushing the hind feet forward
along the surface of the belly on either side of the penis.
Several allusions have been made in passing to the subject of sexual
perversions. A detailed consideration of these manifestations is now
necessary, owing to the fact that perversions exhibit peculiar
relationships to the sexual life of the child, such relationships being
of two distinct kinds. In the first place, perverse modes of sexual
sensibility are very common during childhood; and since erroneous views
on the subject are widely prevalent, the true significance of such
perversions demands very careful study. In the second place, it is
maintained that certain influences affecting the sexual life during
childhood are competent to give rise to permanent sexual perversions. We
will discuss these two questions in the order here stated.
Adult sexual perverts frequently declare that their first experience of
perverse sexual sensibility dates from the eighth year, or even earlier.
Thus, by homosexuals we are told that the homosexual inclination was
felt in very early childhood, in one case directed towards a
school-fellow, in another towards some near relative, or towards a
resident tutor--- or in the case of female homosexuals, towards a
girl-companion or a governess. Moreover, homosexuals often assure us
that the homosexual inclination has been persistent, and that it has
never been interrupted by any manifestation of heterosexual desire. The
assumption that in homosexuals the sexual impulse becomes active earlier
in life than is normal, was one of several considerations by which von
Krafft-Ebing was led to regard homosexuality as a degenerative
phenomenon, consequent upon neuropathic or psychopathic hereditary
taint; and this author held the same view regarding other sexual
perversions--sadism, for instance. In opposition to this opinion,
attention may be drawn to the fact, which was fully considered in the
last chapter, that very commonly indeed the activity of the normal
sexual life can also be traced back into the early days of childhood.
This fact has hitherto to a large extent been overlooked simply for the
reason that recent investigations dealing with the sexual impulse have
in most cases dealt exclusively with morbid manifestations; whilst the
psychologists by profession, whose province it was to study the normal
sexual life, have with few exceptions (Max Dessoir, Binet, Jodl, and
Ribot) completely ignored this field of inquiry. For this reason many
phenomena, _e.g._, early activity of the sexual impulse, and
hyperæsthesia of that impulse, have been assumed to be characteristic of
the perverse modes of sexual sensibility, whereas the like phenomena may
readily be observed in association with a qualitatively normal mode of
sexual sensibility.
The theory of the congenital nature of homosexuality was based for the
most part on the common assumption that the condition is primary and
premature in its occurrence, and that it is exclusive of the opposite
mode of sexual sensibility. But for several reasons the inference is not
justified. For, first of all, for many cases it is incorrect to assume
that the homosexual inclinations are thus exclusive in their character;
as I have previously explained, the adult homosexual's belief that from
early childhood he has never experienced any other than homosexual
inclinations, depends in many instances on an illusion of memory. Owing
to the fact that in consequence of the fuller development of
homosexuality he is no longer interested in the heterosexual, he is apt
to forget any early heterosexual inclinations. Secondly, the primary
appearance of homosexual inclinations does not prove that these
inclinations are congenital; for in homosexuals, as in heterosexuals,
the specialised mode of sexual sensibility is preceded by a period in
which the sexual impulse is undifferentiated; and, in homosexuals and
heterosexuals alike, chance plays a great part in determining which mode
of sexual sensibility first manifests itself. The congenital nature of
heterosexuality is not disproved by the fact that one who in adult life
possesses a normal mode of sexual sensibility, may as a schoolboy have
first experienced sexual desire towards a school-fellow; just as little,
then, does a similar early history in one who in adult life is
homosexual in his inclinations, prove that his homosexuality is
congenital. In the animal world also, before the occurrence of sexual
maturity, the love-games occasionally display a similar confusion of
rôles, so that the sexually immature female animal may attempt to cover
the youthful male. The congenital nature of homosexuality is displayed,
not by the primary appearance of this mode of sensibility, but by the
fact that when the puberal development takes place, the homosexual
sentiments persist, and are not replaced by heterosexuality.
The congenital nature of homosexuality has been assumed more
particularly in those cases which are described respectively as
_effemination_ and _viraginity_. The former name is given by von
Krafft-Ebing to cases in which in homosexual men the entire system of
feelings and inclinations is influenced by the abnormal mode of sexual
sensibility. Such a male homosexual has a strong dislike for smoking and
drinking, and for all masculine sports; on the other hand, he delights
in self-adornment, in art and belles-lettres and even in literary
affectations. The corresponding condition in women was by von
Krafft-Ebing termed viraginity. Such female homosexuals do not merely
experience sexual attraction towards members of their own sex, but they
also exhibit other peculiarities usually characteristic of the male,
such as dislike of ordinary feminine occupations, a neglect of the arts
of the toilet, and a rough and masculine mode of behaviour. They exhibit
inclinations for science rather than for art. They sometimes attempt to
drink and smoke in a masculine manner. Von Krafft-Ebing and many other
writers have assumed that the characteristics of effemination and of
viraginity are displayed in early childhood. We are told that a boy with
these tendencies prefers the society of little girls to that of boys,
that he likes to play with dolls, and to help his mother in her
housework. He takes naturally to cooking, sewing, and darning; and
becomes clever in the selection of feminine dress, so that he can help
his sisters in the choice of their clothes. Contrariwise, the girl who
is destined in later life to display the characteristics of viraginity
will be found frequenting the playground of the boys. Such a girl will
have nothing to do with dolls, but exhibits a passion for the rocking
horse and for playing at soldiers and robbers. It is indisputable that
these descriptions apply to many cases. But it is necessary here to
repeat my previous warning against over-ready generalisation; for we
find that there is quite a number of boys and girls who exhibit during
childhood such contrary sexual qualities and inclinations, and yet
subsequently undergo a perfectly normal, or at any rate a
non-homosexual, development of the sexual life. During the period of the
puberal development, the normal heterosexual characteristics come to
predominate. The non-differentiated character of the sexual life during
childhood forbids us, from the mere existence at this period of life of
such contrary sexual tendencies, to infer that these tendencies will
necessarily persist, and that the subsequent sexual development will
also be of an inverted character. We must point out, in addition, that
from childhood onwards many women and many men fail to exhibit the
psychical tendencies appropriate to _average_ members of their
respective sexes, without this justifying the conclusion that we have to
do with homosexuality. There are heterosexual men who are fond of
needlework; and there are heterosexual women in whom housework and the
care of children, and even in many cases the details of their own
toilet, arouse no interest whatever. Because we observe, in any
individual, certain contrary sexual tendencies of this character, to
draw the inference that in such a case we necessarily have to do with
homosexuality, would be a most disastrous error.
Apart from these considerations, we have, when there is a history of
such tendencies in childhood, to take into account the possibility of
illusions of memory just as much as we have in the cases in which adult
homosexuals assure us that in childhood they never experienced any other
than homosexual inclinations--a matter discussed in the first chapter
(see pp. 5 and 6). A homosexual man, recalling his memories of
childhood, lays especial stress on all that appears to be connected with
homosexuality; he is apt to remember those instances only in which his
conduct exhibited girlish characteristics, and to forget all instances
of an opposite kind. Finally, we have to take into consideration the
various interpretations which are tenable of occurrences during
childhood. An adult homosexual who as a child once did some needlework
for a joke, sees in this later a characteristic of effemination. A girl
who, for lack of companions of her own sex, was accustomed to join in
her brother's sports, comes to believe, when subsequently she has
developed into a homosexual woman, that her conduct in childhood
resulted from congenital perversion, whereas in reality this conduct was
the purely accidental result of her childish environment. On the other
hand, the withdrawal during childhood from the companionship of members
of the same sex is explicable in a converse fashion. Homosexual adults
often tell us that even in boyhood they shunned the company of other
boys, and sought girl companions, to join in the games of these
latter--and they endeavour to explain this conduct on their part as
determined by contrary sexual inclinations in early childhood. Yet, in
many cases, boys avoid those of their own sex, and seek the
companionship of girls, not for the reason just alleged, but solely
because these boys thus early experience erotic stimulation when
associating with girls. In any case, we must carefully avoid
over-estimating the importance of what may appear to be contrary sexual
phenomena during childhood, and we must not be too ready to accept the
occurrence of such phenomena as a proof that sexual perversion had
manifested itself already during childhood. The general possibility of
this occurrence is, of course, not disputed; but the far too common
exaggerations of the matter cannot be too decisively rejected.
The case I have now to describe is that of a woman whose characteristics
during childhood were thoroughly boyish, and who at this time
experienced homosexual inclinations; during the period of the puberal
development, however, the homosexual tendencies disappeared, never to
return.
CASE 10.--Mrs. X., twenty-six years of age, happily married for five
years past, enjoys excellent health, with the exception of pains during
menstruation, has normal intercourse with her husband, experiencing
sexual impulse of full intensity, and a normal voluptuous sensation. The
family history is healthy on the whole; some of the mother's relatives
are described as "nervous"; but in so large a family, otherwise healthy,
this is of trifling significance. Most of her blood-relations are, so
far as inheritable morbid conditions are concerned, thoroughly healthy.
As a girl, X. (whose statements, in so far as I was able to inquire,
were in all important respects substantiated by her mother) was at first
accustomed to seek the companionship of boys only. She was continually
playing with her brothers and their friends, and was always the leader
in their wildest games including war-games, and playing at Indians.
During childhood she was almost always regarded as "the baby," although
she had a sister two years younger than herself, this sister being
altogether girlish in her ways. Very seldom did X. play with anyone but
the boys; when she did on rare occasions seek other companionship, it
was always that of the sister of one of her boy friends. The two girls
had obviously great sympathy each for the other, manifested when they
were as yet only nine years of age, and increasing as the years went on.
The closer her association became with this girl, the more did X.
withdraw from the companionship of the boys, to devote herself to her
girl friend. The association became more and more intimate; and when
they were both thirteen years old their endearments passed from kisses
and embraces to manipulation of the genital organs. In these latter, X.
always played a passive part, not herself touching her own genital
organs nor those of her friend. Occasionally X. would feel drawn towards
some other girl, but such errant inclinations never lasted long. At
about the time when her fondness for the other girl began, that is to
say, during her tenth year, X., who was then accustomed to compassionate
herself for not having been born a boy, began to assume a more
definitely boyish behaviour. Under the pretence of "dressing up," she
used to wear her brother's clothes; occasionally she smoked, although in
her home, and in the circle to which her family belonged, smoking was
disapproved of even in grown women. At the age of fourteen, X. began to
menstruate. The friendship between the two girls continued until the
seventeenth year of life. Then X. gradually "came out," her homosexual
tendencies disappeared, and at the same time her feminine nature became
apparent. The desire to dress up as a man and the desire to smoke passed
away, and have never returned, although X. now moves in circles in which
many women smoke. And, most important fact of all, the homosexual
relations were now completely broken off. The two girls remained on
friendly terms; but alike in X. and in her friend the homosexual
inclinations disappeared, and the improper sexual practices were
entirely discontinued. X. began to flirt, now with one man, now with
another, until when nineteen years old she fell in love with her present
husband, and married him after a two years' engagement.
This case shows that neither the existence of homosexual inclinations
during childhood, nor the simultaneous exhibition of other contrary
sexual mental qualities, necessarily foreshadows the development of
permanent homosexuality. On the other hand, we must not from the
subsequent appearance of heterosexuality draw the conclusion that this
was first acquired _intra vitam_, for it very often happens that
congenital heterosexuality first manifests itself during the period of
the puberal development. In an analogous case, in which the homosexual
and other contrary sexual tendencies and inclinations of childhood have
persisted during the adult sexual life, it would be equally erroneous in
the absence of further evidence to conclude that the homosexuality was
congenital. I recognise the existence of congenital homosexuality, but I
consider that the reality of this condition is established by other
grounds than those just mentioned. This question has been fully
discussed by me elsewhere,[57] and cannot here be further considered.
Many investigators regard homosexuality as an acquired manifestation. In
cases in which the existence of homosexuality can be traced back into
childhood, they explain this on the ground that at a time when the
individual concerned was in a state of sexual excitement, some other
person of the same sex must have made a marked impression upon his
imagination. In this way, they suggest, is effected an association whose
influence endures throughout life. I will here say no more than this,
that this association theory does not suffice to account for the facts.
The deficiencies of the association theory will to some extent become
apparent from the account I am about to give of the other sexual
perversions.
For the dispute to what extent sexual perversions are congenital and to
what extent they are acquired, prevails not only concerning
homosexuality, but also concerning sadism, masochism, sexual fetichism,
&c. In the case also of these latter perversions, some maintain that in
those instances in which the perversion began in childhood, some early
association was the originating cause; whilst others, from the very fact
that the perversion appeared very early in life and was apparently
primary, infer that it must be of a congenital character. For instance,
a man experiences sexual excitement whenever he sees a cook or other
woman kill a fowl; and when revived in memory, the corresponding ideas
exercise a similar exciting influence. On inquiry, we learn that when he
was eight years old he by chance saw a fowl killed, and then immediately
felt strong sexual excitement. Similarly, many masochists and sadists
assure us that their first experience of their peculiarly tinged sexual
excitement occurred during childhood; _e.g._, in the case of the
masochist, when being punished with a whipping, and so on.
Beyond question, the impressions of childhood may result in the
formation of enduring associations. From experiences during childhood
may originate terrors and feelings of disgust which are never
subsequently overcome. A child who for any reason has several times felt
a strong loathing towards some particular article of food, will retain
throughout life a dislike to this same substance. Felix Platter relates
his own experience as follows. When a child, he once saw his sister
slicing rings of "boiled gorge" (_see note_, below.), and sticking these
rings on her finger. The sight was so unpleasant to him that he had to
go away. The disagreeable memory has been so persistent, that ever since
he has been unable to bear the sight, not merely of such "rings of
flesh," but rings of gold, silver, or any other material. A child who
has once been frightened by a dog, may ever after be terrified of all
dogs. An individual may also, by a kind of moral contagion, be affected
by the experiences of others. A child who has seen another child
frightened by a cat, may for this reason acquire an antipathy to cats
lasting for the whole of life. It is upon the undoubted fact of such
experiences as these, that those build their case who maintain that
sexual perversions originate in chance impressions during childhood or
early youth. But weighty reasons can be alleged against any such
generalisation.
_Note on the expression "Boiled Gorge."_--This is a literal
translation of the German _gesottne Gurgeln_, an apparently forgotten
article of diet. Finding no account of it in any German dictionary, I
applied to Dr. Moll, who writes as follows:--"_Gurgel_ denotes a
particular part of the neck, in human beings the front part, comprising
the hyoid bone, the larynx and trachea, the pharynx and the upper part
of the oesophagus, the thyroid body, and the adjoining muscles. As far
as I am aware, this part of the animal body is not now used for food.
Presumably it was so used in Felix Platter's time, but I cannot say if
the 'rings' of which he speaks were cut from the trachea, the
oesophagus, or perhaps the great blood-vessels."--TRANSLATOR'S NOTE.
To return to the instance of the man who is sexually excited by the
sight of fowls being killed, it is true that on superficial
consideration the case may appear to support the theory that we have
here to do with an acquired perversion. We cannot assume that in this
child the complicated image of the killing of a fowl was inborn, and the
first inference will therefore be that his perversion is purely an
acquired one. But on closer examination we perceive that the matter is
less simple than appeared at first sight. First of all we have to
inquire why it is that in this particular instance the sight of the
killing of a fowl induced such a perversion, when in hundreds of other
cases no such result follows the same stimulus. The assumption that in
the particular case there chanced to occur sexual excitement
simultaneously with the sight of the fowl-killing, is altogether
inadequate as an explanation. For, first, this assumption of the
simultaneous occurrence of sexual excitement is in most cases a pure
supposition, quite unsupported by proof. Secondly, even when the two
processes, the sight of the killing, and the sexual excitement, do occur
simultaneously, it is still open to question whether the latter may not
have been determined by the former; that is to say, it may be that the
perverse mode of sexual sensibility previously existed, at least as a
predisposition, and that the connexion between the phenomena is the
reverse of what is supposed. Thirdly, moreover, the chance view of some
occurrence in association with sexual excitement does not suffice to
explain the enduring association of sexual excitement with such an
occurrence throughout the whole of life. Think of persons who have
masturbated during childhood. When they were masturbating, their eyes
have rested on various indifferent objects: underlinen, articles of
furniture, pictures, books, &c.; but this does not induce the association
throughout life of sexual excitement with the sight of any of these
articles.
Apart from these considerations, the fact that some external process,
such as the killing of a fowl, has important relationships with the
content of a subsequent perversion, does not prove that this perversion
is an acquired one. We may rather suppose that in the case of one
endowed with a congenital predisposition to the excitement of the sexual
impulse by the sight of cruelty, the particular cruel act which will
prove the determinant in a particular case, must depend upon the chance
circumstances of the individual's life. On this view, if, in the case
under consideration, the fowl-killing had not happened, at the
appropriate time, to awaken the sexual impulse, it must be assumed that
some other but similar process would have been competent to effect this.
In any case, the association theory alone will not suffice to account
for these cases; and the possibility cannot be excluded that in cases of
sadism there is a specific abnormal disposition of the sexual impulse,
and that the experiences during childhood influence the matter only in
so far as they may determine the special manner in which the sadistic
tendency will subsequently manifest itself. It is, in fact, very
remarkable how often some particular act of cruelty will, in a certain
individual, exercise throughout life a sexually exciting influence: in
one person the desire to strike may be associated with sexual
excitement; in another it may be the desire to stab or to cut; in one
individual sexual excitement results from the sight of a fowl being
killed; in another, when the victim is a fish, and so on. Although we
encounter some in whom the particular cruel act associated with sexual
excitement changes many times during life; yet, on the other hand, we
find that there are many persons in whom sexual excitement is aroused by
some special sadistic practice, and by that alone; and on careful
inquiry we ascertain that even in childhood such an act was associated
with voluptuous excitement.
I will take this opportunity of explaining very briefly that there is
still another possible way of explaining these enduring associations as
being based upon impressions received during childhood, without the
supposition that these impressions of childhood are the exclusive
determinants; this is the assumption that there exists a congenital
weakness of the rudiment of the normal sexual impulse, and that it is
owing to this primary defect that the paths of nervous conduction
involved in the activity of the normal sexual impulse so readily become
impassable.
No further discussion of such disputed problems of the sexual life can
now be attempted. What has been said should suffice, on the one hand, to
prove that the experiences of childhood have important relationships to
the occurrence of sexual perversions; and, on the other, to put the
reader on his guard against numerous exaggerations. I will merely add
that whilst the examples I have given concern only homosexuality and
sadism, similar considerations will be found to apply, _mutatis
mutandis_, to other sexual perversions.
Notes of a few cases will now be given in which more or less perverse
tendencies can be traced back into the days of childhood, at least in so
far as the memories of those concerned can be regarded as trustworthy.
CASE 11.--X., thirty-one years of age, is a foot-fetichist. He believes
that his preference for feet dates from the age of six years, when he
began to regard with extraordinary interest the feet of a servant girl
in his father's house when she was engaged in washing the floor. From
the age of six to the age of eleven years, X.'s memories are somewhat
confused. Thenceforward, however, in the matter of his fondness for
feet, his memories are distinct enough. When he was twelve years old he
saw in his parents' house a young girl standing bare-footed before the
kitchen fire; he seized the opportunity of crouching down on the ground
quite close to the girl's feet, giving as his excuse that he wanted to
bask in the heat of the fire. While doing this, he yearned to touch or
to kiss the girl's feet. Between the ages of thirteen and sixteen he was
crazy about the naked feet of girls and women. He took every opportunity
of seeing the servants' feet when they were scrubbing the floors, and
this sight sufficed to induce in him erection of the penis. This foot
fetichism has persisted, directed sometimes towards the feet of women,
sometimes towards the feet of men. Since he grew up, X. has from time to
time had normal heterosexual intercourse.
CASE 12.--Y., twenty-five years of age, homosexual, with a special
preference for soldiers. In early childhood he noticed in himself a
great fondness for handsome men. When walking in the streets of the town
as a small boy, it was the soldiers, in especial, from among the men he
met, who made a strong impression upon him. He remembers that when he
was seven years of age, he allowed a soldier to take him on his knees,
and that it gave him great pleasure to stroke the man's cheeks. The
roughness of the cheeks gave him an extremely agreeable sensation, and
he sought every opportunity of renewing this sensation. He found cavalry
soldiers especially stimulating. From the age of eleven dates his
peculiar delight in the well-rounded nates of a cavalry soldier. As he
himself puts it, with the lapse of time, this has become to him a
genuine fetich. Subsequently, young men-servants also aroused his
interest, but never to the same degree as cavalry soldiers. The
homosexual tendency has persisted into adult life.
CASE 13.--Z., twenty-seven years of age, has several times been
prosecuted, on account of his attempts to spy upon women in public
lavatories. It is his custom, when in such a place he can observe the
genital organs of a woman in the act of defæcation, to masturbate. He
states that this tendency was well marked in him at the age of thirteen
years. He believes, indeed, that at this time he was inspired mainly by
curiosity--by a desire to see what the genital organs of a female were
like. But he recalls that when a child, at about the age of eight or
nine years, he experienced sexual stimulation when a girl cousin of six
sat on his face; and he thinks that when only five or six years old he
crawled under the petticoats of a servant girl, in order to lay his face
against her nates. Even as early as this he experienced great pleasure
in the act.
CASE 14.--X., is now twenty years of age. He always experiences sexual
excitement when he thinks of the act of whipping. It is unnecessary for
him to play any active part in this himself; and it is a matter of
indifference to him whether a man beats a woman, a woman beats a man, or
an adult of either sex beats a child. In all cases alike the sight
induces sexual excitement; and the imaginative reproduction of such a
scene is his customary stimulus during masturbation--this being a fairly
frequent occurrence. He traces back to childhood the stimulus exercised
on him by a whipping seen or imagined. When from seven to nine years of
age, he began to find such experiences sexually stimulating; by the age
of ten, he was quite clear as to the existence of this peculiarity in
himself. At this early age he struck himself with a stick, under the
influence of an obscure impulse to arouse voluptuous sensations by means
of the blows; he did this fairly frequently.
As regards his sexual sensibilities in general, he is by no means
indifferent to members of the opposite sex. He gladly seeks social
intercourse with females, and likes to kiss them; but he does not
experience any definite sexual impulse towards them, such as might
culminate in sexual intercourse. Three times he has had actual
intercourse, but on each occasion he has been able to effect erection
and ejaculation only by means of all kinds of artificial stimulation. It
is a noteworthy fact that when he was fifteen or sixteen years of age he
became intimate with the members of a homosexual circle, and only by
considerable effort was he able to free himself from these associations.
In autobiographical literature we from time to time come across accounts
of such perverse modes of sexual sensibility. Ulrich von Lichtenstein,
in whom masochistic inclinations were unmistakably present, relates that
when he was barely twelve years of age he became the devoted slave of a
grown woman; and he describes his sentiments, at this early age and
subsequently, towards this woman, who was well born, good and beautiful,
chaste in mind and body, and in every respect virtuous. Well known, too,
is the case of Rousseau, of which I shall have to speak again later;
this writer traces his masochistic perversion back to the seventh year
of his life. I may allude also to Rétif de la Bretonne, who was born in
1734, and certainly experienced sexual sentiments in very early
childhood. In his _Monsieur Nicolas_,[58] which must be regarded as an
autobiographical work, Rétif relates the beginnings, in the years
1743-44, of his fetichistic fondness (which endured throughout his life)
for women's feet and women's shoes. In purely fictional works, analogous
cases are also described. Thus, in his _Pour une Nuit d'Amour_, Zola
depicts a sadistic-masochistic relationship between two children:--
"From earliest childhood Thérèse von Morsanne used Colombel as the
scapegoat and the sport of her caprices. He was about six months older
than she. Thérèse was a dreadful child. Not that she was wild and
uncontrolled, like the ordinary unruly child; on the contrary, she was
extraordinarily serious, with the outward aspect of a well-brought-up
young lady. But she had most remarkable whims and caprices, When she was
alone, she would from time to time utter inarticulate cries or angry
howls.
"From the age of six she began to torment little Colombel. He was small
and weakly. She would lead him to the back of the park, to a place where
the chestnut-trees formed an arbour; here she would spring on his back
and make him carry her about, riding sometimes round and round for
hours. She compressed his neck, and thrust her heels into his sides, so
that he could hardly breathe. He was the horse, she was the lady on
horseback. When he was tired out, and ready to drop from exhaustion, she
would bite him till the blood flowed, and would cling to her seat so
tightly that her nails sank into his flesh. And the ride would thus
start once more. The cruel queen of six years old, borne on the back of
the little boy who served her as beast of burden, hunted thus on
horseback with her hair streaming in the wind. Afterwards, when they
were with their parents, she would pinch him secretly, and by repeated
threats would prevent him from crying or complaining. Thus in secret
they led a life of their own, very different from that which was
apparent to the eyes of others. When they were alone, she treated him as
a toy, to be broken to fragments at her pleasure, simply to see what
might be inside. Was she not the Marquise? Were not people on their
knees before her? And when she was tired of tyrannising over Colombel in
private, she would take a peculiar pleasure, when a number of others
were present, in tripping him up, or in running a pin into his arm or
leg, whilst at the same time she forbade him with a fierce glance of her
black eyes to show even by the movement of an eyelid that she was to
blame.
"Colombel bore his martyrdom with a dull resentment. Trembling, he kept
his eyes on the ground, to escape the temptation to strangle his young
mistress. And yet he did not dislike being beaten; it gave him a bitter
delight. Sometimes, even, he actually sought for a blow, awaiting the
pain with a peculiar thrill, and feeling a certain satisfaction in the
smart when she pricked him with a pin."
I have now recounted a number of cases in which the perversions observed
in adults can be traced back to early childhood. I have shown that it
remains doubtful, when the specific perversion first makes its
appearance, whether it results from a congenital predisposition which is
merely aroused to activity by an outward stimulus, or whether the
outward stimulus is also the true determinant. A further point has now
to be considered, and it is one which, as far as I know, has hitherto
been completely ignored in the literature of the subject. The majority
of sexual perverts trace back the origin of their perversion to a time
at which the detumescence impulse had not yet been awakened. Thus, the
homosexual tells us of a peculiar impulse he felt in childhood to kiss
his tutor; we learn from the hair-fetichist that when still a child he
loved to play with girls' hair; and so on. And we are told that these
impulses, voluptuously tinged, occurred at a time when erection and
ejaculation had not yet taken place, and that there was not as yet any
of that peripheral voluptuous sensation which can be clearly
differentiated from the purely psychical voluptuous sensation. The
question then arises, was this voluptuous sensation excited during
childhood of a truly sexual nature at this early age? Was the boy's
impulsive desire to kiss his tutor a sexual impulse? From the fact that
later in life such an impulse is unmistakably sexual, the conclusion is
often drawn that the earlier inclinations, and the pleasurable
sensations associated with the corresponding mental processes, were also
sexual. The inference is an obvious one, and is doubtless justified in
many instances. But the following point must be taken into
consideration. It is a fact that the psychosexual processes of the child
are less sharply differentiated from other psychical processes than is
the case in the adult; and it is therefore possible that the specific
sexual perversions, and the specific sexual sensibility, develop out of
a corresponding sensibility in the child which is not yet of a sexual
character. The observation of Stanley Hall[59] that children display a
peculiar interest, not only in their own feet, but also in the feet of
other persons, would appear to confirm this view. He writes: "Quite
small children often display a marked fondness for stroking the feet of
others, especially when these feet are well formed; and many adults
testify to the persistence of such an impulse, whose gratification gives
them a peculiar pleasure." It may readily be supposed, in many cases of
foot-fetichism, that this unmistakably sexual phenomenon has originally
developed out of such a non-sexual fondness for feet.
Unquestionably, many of the processes of childhood are not to be
regarded as sexual, although they are closely related to the sexual
life. This statement applies to many of the friendships between boys or
between girls, such as are formed during the period in which the sexual
impulse is still undifferentiated, or after its differentiation has
occurred--and such friendships must not be identified with sexual
feelings. At this period of life, we occasionally observe a desire in
boys to form romantic friendships with others of their own sex; and the
same is true also of girls. In many cases of this kind, there is no
question of the presence of any sexual element, and we have no right,
therefore, to regard as manifestations of the sexual impulse such
instances of enthusiastic friendship during the period of
undifferentiated sexual impulse. Each case must be separately analysed,
in order to determine its nature. On the other hand, the sexual
character of an inclination may sometimes be recognised in the early
years of childhood, even in cases in which the boy's own genital organs
are in no way involved. It may happen that a boy of eight will display a
marked interest in the genital organs of youths or of men, and will
seize every opportunity of peeping at them; and in such a case we are as
a rule justified in assuming the existence of a homosexual tendency,
even when there is no reflection of sexual disturbance to the boys own
genital organs. But we must guard against the mistake of seeing a sexual
element in every friendship between boys.
As with human beings, so also with the lower animals, it is not always
possible to differentiate friendship from the sexual impulse. Robert
Müller has collected a number of interesting observations bearing on
this matter.[60] He states that the so-called animal friendships,
friendships between animals of different species, are in many cases
determined by sexual feelings. He mentions the case of a dog ten months
old, which made sexual attacks on hens, and thereby killed them; in
another instance, a thorough-bred dog, two years old, exhibited a
similar perversion, and had a lasting sexual relationship with a hen. He
also quotes a case of which a man named P. Momsen was the witness, in
which a gander attempted to pair with a bitch. These examples show that
in the cases of animal friendship so often reported in the newspapers,
the existence of an element of perverse sexuality is at least possible.
But it does not, of course, follow that every strange animal friendship
is of a sexual nature.
This is true, also, of other perversions--of sadism, for instance. The
tendency to cruelty appears in early childhood, and it is only
subsequently that this tendency becomes definitely associated with the
sexual life. But even though this association (of cruelty with the
sexual life) is demonstrable in so many instances, we are not for this
reason justified in regarding every brutal act, all deliberate cruelty,
as manifestations of sadism; and this reservation applies no less to
adults than to children. Thus, delight in the sufferings of others,
though it may be regarded as analogous with sadism, has no necessary
connexion with the sexual impulse. Just as little can we assume that the
deliberate ill-treatment of animals, whether on the part of children or
on that of adults, is necessarily the outcome of sadism.
Felix Platter relates in his autobiography that when as a boy verging on
maturity he had already chosen his future profession as a medical man,
he came to the conclusion that he ought to accustom himself to the sight
of disagreeable things; with this end in view, to habituate himself to
see without emotion the heart and other viscera, he frequented the
slaughter-house. Subsequently he experimented on a little bird, to
ascertain if it had blood-vessels, and if it could be "bled"; he opened
a vein with a penknife, and the little bird died. He did the same thing
with various insects--stag-beetles, cock-chafers, and the like. Actions
of this kind performed by children have, of course, no connexion with
the sexual life. When a child tears off the feet of an insect, or
mutilates any other animal, the motive is often simply that with which
the same child will pull a watch to pieces. The same act may result from
various motives; and for this reason we must guard against the
misconception which might lead us, from every cruel act performed by a
child, to diagnose the existence of sadism, or the certainty of a
subsequent sadistic development.
In a case of rose-fetichism, which I have published elsewhere, the
subject was a philologist, thirty years of age, who had never
masturbated during his school days, and until he was nineteen or twenty
had remained sexually neutral, experiencing sexual inclination neither
towards females nor towards members of his own sex. But he had from an
early age exhibited a very great interest in flowers, and while still a
child used to kiss them. He is unable, however, to recall the existence
in this connexion of any sexual excitement. When about twenty-one years
old he was introduced to a young lady who at the time was wearing a
large rose fastened into the front of her jacket. Henceforward, in his
sexual sensibility, the rose assumed extraordinary importance. Whenever
he was able, he bought roses, kissed them, and took them to bed with
him. The act of kissing a rose induced an erection of the penis. In his
seminal dreams, the image of the rose always played a leading part.
This case is extremely instructive. A great love for flowers, leading to
the act of kissing, occurs in many children without any subsequent
association, when these children have grown up, of sexual sentiments
with flowers. Such persons will lay little stress on their memories of
such occurrences in childhood--indeed, in adult life these incidents are
for the most part forgotten. But to X., who when grown-up became
affected with rose-fetichism as a sequel of a specific experience, it
seems that his sexual fetichism is causally dependent upon his childish
love of flowers--and probably he is right in so thinking. But we must
not for this reason assume that his childish preference had any sexual
character. It is more likely that the abnormally great fondness for
flowers, beginning in childhood, was a favouring factor of the
subsequent development of the rose-fetichism. What applies here to a
pathological instance, may also be assumed to be true of the normal
sexual life. _That is to say, the experiences of childhood, which have
not as yet any relationship with sexual life, are nevertheless of great
significance in relation to the subsequent upbuilding of the sexual
life, and above all in relation to the development of the psychosexual
sentiments._
For the sake of completeness I must allude here to two additional
processes which are also related to the sexual life of the child, viz.,
exhibitionism and skatophilia. As regards exhibitionism, Lasègue[61]
describes as exhibitionists those persons who display their genital
organs to others from a certain distance, without attempting any other
improper manipulations, and above all without making any endeavour to
effect sexual intercourse. Kovalevsky[62] contends that the tendency to
exhibitionism is observed in the male sex especially during childhood at
the approach of puberty, and in old age. He records the following case:
"The headmistress of a boarding-school one day brought to see me a boy
fourteen years of age, very well behaved and intelligent, who
experienced from time to time an irresistible impulse, when he met one
of the little girls of the school, to expose his penis. As a rule he was
able to withstand this terrible impulse, but occasionally he yielded to
it. He then experienced a sense of confusion in his head and his vision,
and his whole body seemed to become tense, whilst at the same time he
experienced a voluptuous sensation in the penis and in the body
generally. This state lasted for one or two minutes, and was succeeded
by a moderate sense of weakness and a very distressing sense of shame.
The acts of exhibition were never accompanied with seminal emission,
although he sometimes had such emissions during the night." I have
myself hardly ever observed this form of exhibitionism in children.
Somewhat commoner, however, is the mutual and perfectly voluntary
exhibition of their genital organs by children, generally boys and girls
together; in these cases, as previously explained (p. 71), the acts are
determined rather by curiosity than by the sexual impulse. It is
necessary to insist upon this fact, as distinguishing exhibitionism in
children from exhibitionism in adults. A like question arises regarding
the skatological inclinations and interests of children, which are
assumed by Havelock Ellis[63] to be intimately connected with the sexual
life. It is an undoubted fact that many children before puberty are
greatly interested in the excretions from the bladder and the intestine.
Stanley Hall,[64] to whom Havelock Ellis refers, is of opinion that
"micturitional obscenities, which our returns show to be so common
before adolescence, culminate at ten or twelve, and seem to retreat into
the background as sex-phenomena appear." He distinguishes between two
classes of cases: "fouling persons or things, secretly from adults, but
openly with each other," and, less often, "ceremonial acts, connected
with the act or the product, that almost suggest the skatological rites
of savages." I can myself, as a result of numerous inquiries, confirm
the existence of skatophilia in children. But I have not yet been able
to satisfy myself that these processes always, or even usually, have any
connexion with the sexual life. Such a connexion unquestionably exists
in some cases, but no less certainly it is not an invariable one.
Skatological acts--those, that is to say, in which the more disgusting
excreta play a part--arise in some instances out of a masochistic mode
of sensibility. In cases in which adult masochists have such
inclinations, it is often impossible to trace their existence back into
childhood. It rather appears, in most of the instances of skatological
inclinations which have come under my own observation, that these
inclinations have been superimposed upon other masochistic tendencies,
and these latter may sometimes be traced back to the days of childhood.
But in a few cases I have found skatological perversions to have
originated very early in life. A man with a university education, with
an inclination to the practice of cunnilinctus, assured me that this
inclination began in childhood. Another man, whose interest in the
female nates and anus was unquestionably not the result of any excesses,
stated positively that he was able to refer the origin of this
inclination to a definite experience of his childhood. When only seven
years of age, he experienced the impulse to look at the nates of a
servant-maid; and he believes that this inclination, which in his case
was certainly generalised at a very early age, arose from a still
earlier experience, viz., the chance sight of his mother's nates, when
she urinated in his presence. His whole account of the matter suggests
the existence of a fetichism directed to the nates, impelling him to the
most disgusting acts, which he has several times performed. A similar
case, but on a homosexual basis, will be found recorded as Case 20 in my
work on Sexual Inversion.[65]
No detailed account of other pathological manifestations of the sexual
life will now be attempted, since this work professes to deal only with
subjects of a wide and general significance. We cannot consider those
cases, for instance, in which there is developmental defect of the
reproductive organs; those, for example, in which there is no
discoverable development of the reproductive glands. But some reference
may be made to hermaphroditism. In the human species true
hermaphroditism is a very rare occurrence, whereas apparent
hermaphroditism, the so-called pseudo-hermaphroditism, is comparatively
frequent. The sexual life of pseudo-hermaphrodites has in some instances
been very carefully studied, more especially with reference to the
relationship of pseudo-hermaphroditism to the direction of the sexual
impulse. It appears that in a number of cases of pseudo-hermaphroditism,
not only did the secondary sexual characters exhibit an inverted or
contrary sexual development, but the sexual impulse was also
inverted--was directed, that is to say, towards individuals of the same
sex as that to which the pseudo-hermaphrodite really belonged. Beyond
question, cases have been observed in which pseudo-hermaphrodites with
testicles have had sexual inclination towards males; and
pseudo-hermaphrodites with ovaries, sexual inclination towards females.
In many of these cases, such contrary sexual tendencies could be traced
back into childhood. We have, of course, to reckon with the fact that in
the case of pseudo-hermaphrodites the diagnosis of the sex is usually
based upon the formation of the external genital organs, and without any
expert examination of the reproductive glands; thus they are often
brought up as members of a sex to which they do not really belong, and
in consequence of this their education is sexually inverted. In such
cases it may reasonably be suggested that the homosexuality is the
result, not so much of a congenital inversion of the sexual impulse, as
of the contrary sexual education.
For a detailed treatment of the subject of hermaphroditism, reference
should be made to the special literature of the subject, and above all
to the exhaustive and laborious work of Neugebauer.[66]