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Full text of "Psychopathia Sexualis, with especial reference to the antipathic sexual instinct, a medico-forensic study;"






( The abort portrait was given by the author to the translator.) 



Psychopathia Sexualis 

WITH ESPECIAL BKTEUNCI TO TH 

Antipathic Sexual Instinct 

A MEDICO-FOREN6LC STUDY 



BY 

DR. R. v. KRAFFT-EBING 

P. O. PROr. rtJB PSYCIIIATKIE UND NERVENKIIANKHEITEN AN DB* K. K. ONITRRSITAT 

WIBN 



ONLY AUTHORISED ENGLISH ADAPTATION OF THE TWELFTH 
GERMAN EDITION 

BY F. J. REBMAN 



With Author's Portrait as Frontispiece 




NEW YORK 

REBMAN COMPANY 

141 WEST 36rH STREET 






All Elhta Reserved, Especially the Right 0* TranslatloB 



Printed in America 



PSYCHOPATHIA SEXUALIS 



PREFACE TO THE FIRST EDITION. 

FEW people are conscious of the deep influence exerted by 
sexual life upon the sentiment, thought and action of 
man in his social relations to others. Schiller, in his 
essay "Die Weltweisen," touches upon this subject in these 
memorable words: "So long as philosophy keeps ^together 
the structure of the Universe so long does it maintain 
the world's machinery by hunger and love". 

From the standpoint of the philosopher sexual life 
takes a subordinate position. 

Schopenhauer ("Die Welt als Wille und Vorstellung," 
third edition, vol. ii., p. 586, etc.) considers it peculiar 
that love has hitherto offered material to the poet only 
and not also to the philosopher, the scant researches by 
Plato, Rousseau and Kant always excepted. 

Whatever Schopenhauer, and after him E. von Hart- 
mann, the philosopher of the unknown, discuss about 
sexual relationship, is so thoroughly incorrect and illogical 
that, so far as science is concerned, empirical psychology 
and the metaphysics of man's sexual existence are simply 
virgin soil. Michelet's "L'amour" and Mantegazza's 
"Physiology of Love" are merely clever causeries, and 
cannot be considered in the light of scientific research. 

The poet is the better psychologist, for he is swayed 
rather by sentiment than by reason, and always treats his 
subject in a partial fashion. He cannot discern deep 
shadows, because he is dazed by the blazing light and 
overcome by the benign heat of the subject Although 



VI PBEFACE TO THE FIRST EDITION. 

the "Physiology of Love" provides inexhaustible material 
for the poetry of all ages and of all peoples, nevertheless 
the poet will not discharge his arduous task adequately 
without the active co-operation of natural philosophy and, 
above all, that of medicine, a science which ever seeks to 
trace all psychological manifestations t6 their anatomical 
and physiological sources. 

In these efforts medicine succeeds, perhaps, in forming 
a connection between the pessimistic reflections of the 
philosopher of the stamp of Schopenhauer and Hartmann, 1 
and the gay and naive creations of the pget. 

It is not intended to build up in this book a system of 
the psychology of sexual life, still from the close study of 
psychopathology there arise most important psychological 
facts which it behoves the scientist to notice. 

The object of this treatise is merely to record the 
various psychopathological manifestations of sexual life in 
man and to reduce them to their lawful conditions. This 
task is bj no means an easy one, and the author is well 
aware of the fact that, despite his (varied) far-reaching 
experience in psychiatry and criminal medicine, he is yet 
unable to offer anything but an imperfected system. 

The importance of the subject, however, demands 
scientific research on account of its forensic bearing and 
its deep influence upon the common weal. The medical 
barrister only then finds out how sad the lack of our 
knowledge is in the domain of sexuality when he is called 
upon to express an opinion as to the responsibility of the 
accused whose life, liberty and honour are at stake. He 
then begins to appreciate the efforts that have been made 
to bring light into darkness. 

1 llartmann's philosophical conception of love ("Philosophy of 
the Unknown," Berlin, 18(59, p. 583) is: " Love causes more pain than 
pleasure. Pleasure is only an illusion. Reason would demand the 
avoidance of love were it not for that fatal sexual instinct. Hence it 
would be better to be castrated." Schopenhauer expresses the same 
vi-w in his work: "Die Welt als Wille und Vorstellung," third 
edition, vol. ii. p. 586, etc. 



PUEFACE TO TllK MUST EDITION. Til 

Certain it is that so fur as sexual crimes are concerned 
( -IT- -iieuus ideas prevail, unjust decisions arc given, ;in<l 
the luw as well as public opinion are prima facie prejudiced 
againM the <llen<ler. 

The scientific study of the psychopathology of sexual 
life necessarily deals with the miseries of man and the 
dark sides of his existence, the shadow of which contorts 
the sublime image of the deity into horrid caricatures, and 
leads astray a?stheticism and morality. 

It is the sad privilege of medicine, and especially that 
of psychiatry, to ever witness the weaknesses of human 
nature and the reverse side of life. 

The physician finds, perhaps, a (satisfaction) solace in 
the fact that he may at times refer those manifestations 
which offend against our ethical or aesthetical principles 
to a diseased condition of the mind or the body. He can 
save the honour of humanity in the forum of morality, 
and the honour of the individual before the judge and his 
fellow-men. It is from the search of truth that the exalted 
duties and rights of medical science emanate. 

The author adopts the saying of Tardieu ("Dcs at- 
tentats aux moeurs") : "Aucune misere physique oil 
morale, aucune plaie, quelque corrompue qu'clle soit, ne 
doit effrayer celui qui s'est voue a la science de Thomme, et 
le ministere sacre du medecin, en 1'obligeant a tout voir, 
lui ]>ermet aussi de tout dire". 

lie appeals to men engaged in serious study in the 
domains of natural philosophy and medical jurisprudence. 

A scientific title has been chosen, and technical terms 
are used throughout the book in order to exclude the lay 
reader. For the same reason certain portions are written 
in Latin. 



VIU 



PREFACE TO THE TWELFTH EDITION. 

THIS edition is entirely rewritten and considerably 
enlarged. The (exceptionally) favourable criticisms which 
have been accorded in professional circles to former edi- 
tions are a guarantee that the book* exercises a beneficent 
influence upon legislation and jurisprudence, and will as- 
sist in removing erroneous ideas and superannuated laws. 

Its commercial success is the best proof that large 
numbers of unfortunate people find in its pages instruction 
and relief in the frequently enigmatical manifestations of 
sexual life. The hosts of letters that have reached the 
author from all parts of the world substantiate this as- 
sumption. Compassion and sympathy are strongly elicited 
by the perusal of these letters, which are written chiefly 
by men of refined thought and of high social and scientific 
standing. They reveal sufferings of the soul in compari- 
son to which all the other afflictions dealt out by Fate 
appear as trifles. 

May it continue to convey solace and social elevation 
to its readers. 

The number of technical terms has been increased, 
and the Latin language is more frequently made use of 
than in former editions. 

May the same kind reception be accorded to this 
edition which was enjoyed by its predecessors. That it 
may prove of utility in the service of science, justice and 
humanity is the wish of the 

AUTHOR 
GSAZ. 



PUBLISHERS' PREFACE. 

THE publishers sincerely trust that this translation from 
the Twelfth German Edition of Psychopathia Sexualis 
by Dr. R. v. Krafft-Ebing will be received with 
favour by those for whom the book is written, and that ita 
readers will derive that benefit which the author had in 
view. 

Preparing and sifting the material for the Twelfth 
Edition of this work was the final task of the late author. 
When he was attacked by the fatal illness which carried 
him off, the manuscript was all ready for the printer. 

Dr. Gugl and Dr. Stichl, pupils and for many years 
collaborators of the author, were entrusted by the family 
of the deceased with the revision of the proofs. 

The sale of the book is rigidly restricted to the mem- 
bers of the medical and legal professions. 

Any communications intended for the translator should 
be addressed to "Translator" (Krafft-Ebing), care of 
Rebman Company, 1123 Broadway, New York. 

THE PUBLISHERS. 



CONTENTS 

PAD* 

L FRAGMENTS OF A SYSTEM OF PSYCHOLOGY Of 

SEXUAL LIFE I 

Force of sexual instinct, 1 Sexual instinct the basis of 
ethical sentiments, 2 Love as a passion, 2 Historical 
development of sexual life, 3 Chastity, 3 Christianity, 
3 Monogamy, 4 Position of woman in Islam, 5 Sen- 
suality and morality, 5 Cultural demoralisation of 
sexual life, 5 Episodes of the moral decay of nations, 6 
Development of sexual desire; puberty, 7 Sensuality 
and religious fanaticism, 7 Relation between religious 
and sexual domains, 8 Sensuality and art, 11 Ideal- 
isation of first love, 12 True love, 12 Sentimentality, 
12 Platonic love, 13 Love and Friendship, 13 Differ- 
ence between the love of the mnn and that of the woman, 
14 Celibacy, 15 Adultery, 16 Matrimony, 16 Fond- 
ness of dress, 16 Facts of physiological fetichism, 17 
Religious and erotic fetich ism, 18 Hair, hand, foot of 
the female as fetiches, 21 Eye, smell, voice, psychical 
qualities as fetich, 22. 

H. PHYSIOLOGICAL FACTS a6 

Puberty, 25 Time limit of sexual life, 26 Sexual instinct, 
26 Localisation, 27 Physiological development of 
sexual life, 28 Erections : Centre of erection, 28 Sphere 
of sexuality and olfaction, 32 Flagellation as a stimu- 
lant for sexual life, 34 Sect of flagellants, 35 " Flagel- 
lum Salutis" of Paulini, 36 " Erogenous " (hypersss- 
thctic) zones, 38 Control of sexual instinct, 40 
Coitus, 40 Ejaculation, 41. 



ffl. ANTHROPOLOGICAL FACTS 



Primary and secondary sexual characteristics, 42 Psychical 
characterintics, 42 Differentiation of sexes, 42 rOyne- 
comasty, 43 Development of sexual type, 44 Eunuchs, 
46. 

XI 



XII CONTENTS 

PACK 

IV. GENEBAL PATHOLOGY (KEUBOLOGICAL AND 

PSYCHOLOGICAL) 48 

Frequency and importance of pathological manifestations, 48 
iScliedule ot Literature, 48 Sexual neuroses, 49 In- 
fluences stimulating the erectile tissues, 49 Paralysis of 
the erectile tissues, 50 Temporary impotence, 50 
Neurosis of the nerve centres of ejaculation, 51 
. Neuroses produced by cerebral causes, 62 I'aradoxia, 
i.e., sexual instinct outside the period of anatomical- 
phyaiological processes, 65 Sexual instinct in early 
childhood, 55 Sexual instinct reappearing in old age, 
57 Sexual perversions in seniles due to impotence or 
dementia, 57 Ana's thtivw acxualis, i.e., absence of sexual 
instinct, 61 congenital, 61 acquired, 68 Hyper- 
assthesia, i.e., pathologically exaggerated sexual instinct, 
69 Conditions and manifestations of this anomaly, 70 
Partfsthesia or perversion of the sexual instinct, 79 
Perversion and perversity, 79 Madism, an attempted ex- 
planation of sadism, 80 Sadistic lust murder, 88 An- 
thropophagy, 95 Mutilation of corpses, 99 Maltreat- 
ment of women by cutting or flogging, etc., 105 Defile- 
ment of female persons, 113 Symbolic sadism, i.e., 
brutal force employed against female persons, 118 
Ideal sadism, 118 Sadism practised on any other object, 
121--Flogging of boys, 121 Sadistic acts on animals, 125 
Sadism in woman, 129 Kleist's " Penthesilea/' 130 
Masochism, 131 Essence and clinical manifestations of 
masochism, 132 Maltreatment and humiliation invited 
for the purpose of sexual gratification, 134 Passive 
flagellation and its relations to masochism, 140 Fre- 
quency and practices of masochism, 149 Symbolic maso- 
chism, 159 Ideal masochism, 161 Jean Jacques Rous- 
seau, 166 Masochism in scientific and belletristical 
literature, 169 Latent masochism, 171 Shoe and foot 
fetichism, 171 Koprolagnia, ISO-Masochism in woman, 
195 An attempted explanation of masochism, 200 
Sexual bondage, 202 Masochism and sadism, 213 
Fetichism, definition of, 218 Cases in which the fetich 
is a part of the female body, 224 Hand fetichism, 226 
Bodily defects as fetiches, 234 Hair fetichism, 239 
Hair despoilers. 241 The fetich is a part of female 
attire, 247 Mania for (theft of) female handkerchiefs, 
255 Shoe fetichism, 260 The fetich consists of some 
special fabric, 268 Fur, silk, velvet, gloves, roses, 274 
/Beast fetichism, 281 Antipathic sexual instinct, 282 
Acquired sexual inversion in either sex, 286 Neurotic 
taint a condition of antipathic sexual instinct, 289 
Grades of acquired perversion, 289 Simple inversion of 
sexual instinct, 289 Eviration and dcfemination, 297 
Insanity among the Scythians, 302 Mujerados, 303 
Transition to metamorphosis sevualis, 304 Metamor- 
phosis sexualis paranoica, 328 Congenital antipathic 
sexuality, 335 Various clinical forms thcroof, 336 -Gen- 
eral symptoms, 339 Attempted explanation of this 
anomaly, 340 Congenital antipathic sexuality in the 
male, 350 Psychical hernnnhroditism, 352 Homo- 
sexuality. 304 Urmngs, ZMEffeminatirm, 382 



CONTENTS - XIII 



Androgyny, 389 Congenital antipathic c*ual\ty in tke 
female. 395 Complications of antipathic sexual instinct, 
439 Diagnosis, prognosis and therapy of sexual inver- 
sion, 443. 

IV. SPECIAL PATHOLOGY 445 

The manifestations of pathological sexual life in the various 
forms and conditions of mental disturbance, 462 In- 
hibition of psychical development, 462 Acquired mental 
debility, 466 Dementia following psychosis or apoplexy, 
466 Or injuries to the head, 466 Or lues cerebralit, 
467 Dementia paralytica, 468 Epilepsy, 469 Periodi- 
cal dementia, 478 Ptychopathia seantali* prriodica, 479 
Mania, 481 Symptoms of sexual excitement in 
maniacs, 481 -Satyriasis and nymphomania, 482 
Chronic satyriaaia and nymphomania, 486 Melancholia, 
492 Hysteria, 492 Paranoia, 494. 

V. PATHOLOGICAL SEXUAL LIFE BEFORE THE 

CRIMINAL FOEUM 498 

Sexual crimes endanger the common weal, 498 On the in- 
crease, 499 Probable causes, 500 Clinical researches, 
501 Sexual crimes not properly understood by the law 
profession, 502 Points for the proper judgment of sexual 
crimes, 502 Conditions for the cessation of responsi- 
bility, 502 Points for the paychopathological importance 
of sexual crimes, 503 tiexual crime* classified, 503 
Exhibitionists, 604 Frotteurt, 522 Defilers of statues, 
525 Rape and lust-murder, 526 Bodily injury, viola- 
tion of things, cruelty to animals caused by sadism, 
633 Masochism and sexual bondage, 539 Bodily injury, 
robbery, theft emanating from fetichism, 543 Notes on 
the question of responsibility in sexual offences caused 
by delusions, 549 Immorality with persons under the 
age of fourteen, 552 Non-psychopathological cases, 552 
Psychopathological cases, 554 Unnatural abuse, 561 
Violation of animals, sodomy, bestiality, 561 Zooerasty, 
663 Unnatural sexual relations with persons of the 
same sex, pederasty, 571 In relation to sexual inversion, 
672 Necessity to distinguish between pathological and 
normal conditions of pederasty, 572 Forensic opinion 
on congenital sexual inversion nnd when pathologically 
acquired, 573 Letter from an timing, 574 Reasons why 
legal proceedings against homosexual acts should be 
topped, 578 Cultivated pederasty (not pathological), 
685 Causes of the vice, 585 Social life of pederasts, 
687 A woman-hater's ball in Berlin, 590 Various cate- 
gories of unle loving men, 593 Pcrdicatio mulierum, 
S94 Amor Irtbini*. 007 Necrophilia, 611 Incest, 612 
Violation of wards, C14. 

INDEX 615 






I. FRAGMENTS OF A SYSTEM OF PSYCHOLOGY 
OF SEXUAL LIFE. 

THE propagation of the human race is not left to mere 
accident or the caprices of the individual, but is guaran- 
teed by the hidden laws of nature which are enforced by 
a mighty, irresistible impulse. Sensual enjoyment and 
physical fitness are not the only conditions for the en- 
forcement of these laws, but higher motives and aims, 
such as the desire to continue the species or Ihe individu- 
ality of mental and physical qualities beyond time and 
space, exert a considerable influence. Man puts himself 
at once on a level with the beast if he seeks to gratify 
lust alone, but he elevates his superior position when by 
curbing the animal desire he combines with the sexual 
functions ideas of morality, of the sublime, and the beau- 
tiful. 

Placed upon this lofty pedestal he stands far above 
nature and draws from inexhaustible sources material for 
nobler enjoyments, for serious work and for the realisation 
of ideal aims. Maudsley ("Deutsche Klinik," 1873, 2, 3) 
justly claims that sexual feeling is the basis upon which 
social advancement is developed. 

Tf man were deprived of sexual distinction and the 
nobler enjoyments arising therefrom, all poetry and prob- 
ably all moral tendency would be eliminated from his life. 

Sexual life no doubt is the one mighty factor in the 
individual and social relations of man which disclose his 
powers of activity, of acquiring property, of establishing a 
homo, of awakening altruistic sentiments towards a person 
of the opposite sex, and towards his own issue as well as 
towards the whole human race. 

1 



2 PSYCIIOPATHIA 8EXDALIS. 

Sexual feeling is really the root of all ethics, and no 
doubt of cestheticism and religion. 

The sublimest virtues, even the sacrifice of self, may 
spring from sexual life, which, however, on account of its 
sensual power, may easily degenerate into the lowest 
passion and basest vice. 

Love unbridled is a volcano that burns down and lays 
waste all around it; it is an abyss that devours all 
honour, substance and health. 

It is of great psychological interest to follow up the 
gradual development of civilisation and the influence 
exerted by sexual life upon habits and morality. 1 The 
gratification of the sexual instinct seems to be the primary 
motive in man as well as in beast. Sexual intercourse is 
done openly, and man and woman are not ashamed of 
their nakedness. The savage races, e.g., Australasians, 
Polynesians, Malays of the Philippines are still in this stage 
(vide Ploss}. Woman is the common property of man, 
the spoil of the strongest and mightiest, who chooses the 
most winsome for his own, a sort of instinctive sexual 
selection of the fittest. 

Woman is a "chattel," an article of commerce, exchange 
or gift, a vessel for sensual gratification, an implement for 
toil. The presence of shame in the manifestations and 
exercise of the sexual functions, and of modesty in the 
mutual relations between the sexes are the foundations of 
morality. Thence arises the desire to cover the nakedness 
("and they saw that they were naked") and to perform 
the act in private. 

The development of this grade of civilisation is fur- 
thered by the conditions of frigid climes which necessitate 
the protection of the whole body against the cold. It is an 

*Cf. Lombroso, " The Criminal " ; Westermarck, " The History of 
Marriage "; Ploss, " Das Weib in der Natur- und VOlkerkunde," third 
edition, vol. ii., p. 413-90. Joseph Miiller, " Das sexuelle Leben der 
NaturvSlkur," 2 Aufl. 1902; derselbe, "Das sexuelle Leben der alten 
Kulturvolker, 1902 (Leipzig, Grieben). 



A SYSTEM OF PSYCHOLOGY OF SEXUAL LIFE. 

anthropological fact that modesty can be traced to much 
earlier periods among northern races. 1 

Another element which tends to promote the refined 
development of sexual life is the fact that woman ceases 
to be a "chattel". She becomes an individual being, and, 
although socially still far below man, she gradually ac- 
quires rights, independence of action, and the privilege to 
bestow her favours where she inclines. She is wooed by 
man. Traces of ethical sentiments pervade the rude sen- 
sual appetite, idealisation begins and community of woman 
ceases. The sexes are drawn to each other by mental and 
physical merits and exchange favours of preference. In 
this stage woman is conscious of the fact that her charms 
belong only to the man of her choice. She seeks to hide 
them from others. This forms the foundation of modesty, 
chastity and sexual fidelity so long as love endures. 

This development is hastened wherever nomadic habits 
yield to the spirit of colonisation, where man establishes 
a household. He feels the necessity for a companion in 
life, a housewife in a settled home. 

The Egyptians, the Israelites, and the Greeks reached 
this level at early periods, so did the Teutonic races. Its 
principal characteristics are high appreciation of virginity, 
chastity, modesty and sexual fidelity in strong contrast 
to the habits of other peoples where the host places the 
personal charms of the wife at the disposal of the guest 

The history of Japan furnishes a striking proof that 
this high grade of civilisation is often the last stage of 
moral development, for in that country to within twenty 
years ago prostitution was not considered to impair in any 
way the social status of the future wife. 

Christianity raised the union of the sexes to a sublime 
position by making woman socially the equal of man and 
by elevating the bond of love to a moral and religious 

'According to Wctermarck, op. cit., it wag "not the feHinp of 
shame which sn^ested the garment, but the garment engendered 
shame. The desiro to make themselves more attractive originated 
the habit among men and women to cover their nakedness." 



4 PSYCIIOPATHIA SEXUAU8. 

institution. 1 Thence emanates the fact that the love of 
man, if considered from the standpoint of advanced civili- 
sation, can only be of a monogamic nature and must rest 
upon a staple basis. Even though nature should claim 

This assertion may be modified in so far that the symbolical and 
sacramental character of matrimony was clearly defined only by the 
Council of Trent, although the spirit of Christianity always tended 
to raise woman from the inferior position which she occupied in pre- 
vious centuries and in the Old Testament. 

The tradition that woman was created from the rib of the sleep- 
ing man (see Genesis) is one of the causes of delay in this direction, 
for after the fall she is told " thy will shall be subject to man." Ac- 
cording to the Old Testament, woman in responsible for the fall of 
man, and this became the corner-stone of Christian teaching. Thus 
the social position of woman had to be neglected, as it were, until 
the spirit of Christianity had conquered tradition and scholastic 
tenets. 

It is a remarkable fact that the gospels (barring divorce, Matt, 
xix. 9) contain not a word in favour of woman. The clemency shown 
towards the adulteress and the penitent Magdalen do not affect the 
position of woman in general. The epistles of St. Paul definitely in- 
sist that no change can be permitted in the position of woman (2 Cor. 
xi. 3-12; Eph. v. 22, "woman shall be subject to man," and 23, 
" woman shall fear man "). 

How much the fathers of the Church are prejudiced against 
woman on account of Eve's part in the temptation may be easily 
learned from Tertulllan, " Woman, thou shouldst ever go in mount- 
ing and sackcloth, thy eyes filled with tears. Thou has brought 
about the ruin of mankind." St. Jerome has aught but good to say 
about woman. " Woman is the gate of the devil, the road of evil, th 
sting of the scorpion" ("De Cultu Fcminarum," i. 1). 

Canon law declares: "Man only is created to the image of God, 
not woman ; therefore woman shall serve him and be his handmaid ". 

The Provincial Council of Macon (sixth century) seriously dis- 
cussed the question whether woman had a soul at all. 

These opinions of the Church had a sympathetic influence upon 
the peoples who embraced Christianity. Among the converted Ger- 
manic races the doicer value of woman fell considerably (J. FaU-~e, 
" Die rittcrliche Gesellschaft," Berlin, 18G2, p. 49. Re the valuation 
of the two sexes among the Jews, cf. 3 Moses, xxvii. 3-4). 

Even polygamy, which is distinctly recognised in the Old Testa- 
ment, (Dcut. xxi. l."j) is nowhere in the New Testament definitely 
prohibited. In fact many Christian princes (e.g. the Merovingian 
kings: Chlotar I., Charihort I., Pippin I. and other Prankish nobles) 
indulged in polygamy without a protest being raised by the Church 
at the time (Weinhold, "Die deutschen Fraucn itn Mittelalter," ii., 
p. 15 ; cf. Unger, " Marriage," etc., and Louis Bridel, " La Femme et 
le Droit," Paris, 1884). 



A SYSTEM OF PSYCHOLOGY OF SEXUAL LIFE. 5 

merely the law of propagation, a community (family or 
state) cannot subsist without the guarantee that the off- 
spring thrive physically, morally and intellectually. From 
the moment when woman was recognised the peer of man, 
nli. -a monogamy became a law and was consolidated by 
legal, religious and moral conditions, the Christian nations 
obtained a mental and material superiority over the poly- 

.;c races, and especially over Islam. 

Mohammed strove to raise woman from the position of 
the slave and mere handmaid of enjoyment, to a higher 
x.cial and matrimonial grade; yet she remained still far 
below man, who alone could obtain divorce, and that on 
the easiest terms. 

Above all things Islamism excludes woman from public 
life and enterprise, and stifles her intellectual and moral 
advancement. The Mohammedan woman is simply a 
moans for sensual gratification and the propagation of 
the species ; whilst in the sunny balm of Christian doctrine, 
blossom forth her divine virtues and her qualities of house- 
\\ifi-, companion and mother. What a contrast! 

Compare the two religions and their standard of future 
happiness. The Christian expects a heaven of spiritual 
bliss absolutely free from carnal pleasure; the Mohamme- 
<l.in an eternal harem, a paradise among lovely houris. 
in spite of the aid which religion, law, education and 
tlio moral code offer him, the Christian (to subdue- his 
sensual inclination) often drags pure and chaste love from 
its sublime pedestal and wallows in the quagmire of sen- 
sual enjoyment and lust. 

Life is a never-ceasing duel between the animal instinct 
and morality. Only will-power and a strong character 
can emancipate man from the meanness of his corrupt 
nature, and teach him how to enjoy the pure pleasures of , 
love and pluck the noble fruits of earthly existence. 

1 It is an open question whether the moral status of 
mankind has undergone an improvement in our times. 
No doubt society at large shows a greater veneer of 



6 PSYOHOPATHIA SEXUALIS. 

modesty and virtue, and vice is not as flagrantly practised 
as of yore. 

The reader of Scherr ("Deutsche Culturgeschichte") 
will gain the impression that our moral code is not so 
gross as was that of the middle ages, even if only more re- 
fined manners have taken the place of former coarseness. 

In comparing the various stages of civilisation it be- 
comes evident that, despite periodical relapses, public 
morality has made steady progress, and that Christianity 
is the chief factor in this advance. 

We arc certainly far beyond sodomitic idolatry, the 
public life, legislation and religious exercises of ancient 
Greece, not to speak of the worship of Phallus and Priapus 
in vogue among the Athenians and Babylonians, or the 
Bacchanalian feasts of the Romans and the privileged posi- 
tion held by the cburtesans of those days. 

There are stagnant and fluctuating periods in this slow 
progress, but they are only like the ebb- and flood-tide of 
sexual life in the individual. 

The episodes of moral decay always coincide with the 
progression of effeminacy, lewdness and luxuriance of the 
nations. These phenomena can only be ascribed to the 
higher and more stringent demands which circumstances 
make upon the nervous system. Exaggerated tension of 
the nervous system stimulates sensuality, leads the indi- 
vidual as well as the masses to excesses, and undermines 
the very foundations of society, and the morality and pur- 
ity of family life. The material and moral ruin of the com- 
munity is readily brought about by debauchery, adultery 
and luxury. Greece, the Roman Empire, and France 
under Louis XIV. and XV., are striking examples of this 
assertion. In such periods of civic and moral decline the 
most monstrous excesses of sexual life may be observed, 
which, however, can always be traced to psycho-patho- 
logical or neuro-pathological conditions of the nation in- 
volved. 1 

*Cf. Friedlander, " Sittengeschichte Rom8 " ; Wiedemeister, " Der 
Casarenwahnsinn " ; Suetonius, MoreOAi, " Des aberrations du sens 
gn6sique ". 



A SYSTEM OF PSYCHOLOGY OF SEXUAL LIFE. 7 

Largo cities are hotbeds in which neuroses and low 
morality are bred, vide the history of Babylon, Nineveh, 
Rome and the mysteries of modern metropolitan life. It 
is a remarkable fact that among savages and half-civi 
races sexual intemperance is not observed (except among 
the Aleutians and the Oriental and Nama-IIottentot 
women who practise masturbation). 1 

The study of sexual life in the individual naturally 
deals with its various phases, beginning with the stage of 
puberty to the extinction of sexual feeling. 

Mantegazza ("Physiology of Love") draws a beautiful 
picture of the bodings and yearnings of awakening love, of 
the mysterious sensations, foretastes and impulses that iill 
the heart, long before the period of puberty has arrived. 
Psychologically speaking, this is, perhaps, the most mo- 
mentous epoch of life, for the wealth of ideas and senti- 
ments engendered through it, forms the standard by which 
psychic activity may be measured. 

The advance of puberty develops the impulses of youth, 
hftherto vague and undefined, into conscious realisation of 
the sexual power. The psychological reactions of animal 
passion manifest themselves in the irresistible desires of 
intimacy, and the longing to bestow the strange affections 
of nature upon others. 

Religion and poetry frequently become the temporary 
haven of rest, even after the period of storm and stress is 
passed. Religious enthusiasm is more commonly met 
with in the young than the old. The lives of the saints* 

1 Friedreich (" Hdb. dei gerichtlichilrztlich, Praxis," 1843, i. p. 
271) is of a different opinion, for according to him the Red Indians 
of America are addicted to the practice of pederasty. Cf. also Lorn- 
broso, p. 42, and Block, Beitriige zur Etiologie der Psychopathia 
Sexualis, 2. Theil, 1903. 

'Cf. Fncdreich (" Gerichtl. Psychologic," p. 389) who quotes nu- 
merous examples. For instance, lilankebin, the nun, was constantly 
tormented by the thought of what could have become of that part of 
Christ which was removed in circumcision. 

Veronica Jiiliani, beatified by Pope Pius II., in memory of the 
divino lamb, took a real lamb to bed with her, kissed it and suckled 
it on her breasts. 



8 P8YCHOPATHIA SEXUALIS. 

are replete with remarkable records of temptations. The 
religious feasts of the ancients often degenerated into 
orgies, or into mystic cults of a voluptuous character. 
Even the meetings of certain modern sects dissolve them- 
selves simply into obscene practices. 

On the contrary we find that the sexual instinct, when 
disappointed and unappeased, frequently seeks and finds 
a substitute in religion. 

Even where psycho-pathological conditions are diag- 
nosed beyond dispute, this relation between religious and 
sexual feelings can easily be established. The cause of re- 
ligious insanity is often to be found in sexual aberration. 
In psychosis a motley mixture of religious and sexual delu- 
sions is observable, viz., in female lunatics who imagine 
that they are or will be the mother of God, and especially 
in persons slaves to masturbation. The cruel, sensual acts 
of chastisement, violation, emasculation and even crucifix- 
ion perpetrated upon self by religious maniacs, bear out 
this assertion. 1 



Any attempt to explain the psychological relations be- 
tween religion and love must needs meet with difficulties, 
for analogous instances are met with in great numbers. 

Sexual inclinations and religious leanings (if consid- 
ered as psychological factors), are composed of two ele- 
ments. 

Schleier mocker recognised the primary feeling of de- 

St. Catharine of Genoa often burned with such intense inward 
fire that in order to cool herself she would throw herself upon the 
ground crying, " Love, love, I can endure it no longer ". At the same 
time she felt a peculiar inclination to her confessor. One day lifting 
his hand to her nose she noticed a peculiar odour which penetrated 
to her heart " a heavenly perfume that would awaken the dead ". 

St. Armelle and St. Elizabeth were troubled with a similar long- 
ing for the Infant Jesus. The temptations of St. Anthony, of Padua, 
nre known to the world. Of significance is an old Protestant prayer: 
" Oh ! that I had found thee, bless'd Emanuel ; that thou wert with 
me in my bed, to bring delight to body and soul. Come and be mine. 
My heart shall be thy resting place." 

1 Cf. Friedreich, " Diagnostik der psych. Krankheiten," p. 247 
etc. ; Neumann, Lehrb. d. " Psychiatric," p. 80. 



A SYSTEM OF PSYCHOLOGY OF SEXUAL LIFE. 



* the paramount clfini-nt in religion, long before 
modern anthropological and ethnographic research in the 
domain of primitive causes, arrived at the same conclu- 
sions. 

The secondary and truly ethical element, i.e., the love 
of God, enters the religious sentiment only when a higher 
stage of culture is attained. At first, the double-faced, 
now benevolent, now angry, chimeras of complicated 
mythologies, take the place of the evil spirits, until they 
in turn are dislodged by the benign form of the deity, the 
giver of perpetual happiness, whether it be in the shape 
of Jehovah as the author of all earthly blessings, or Allah 
who bestows physical delight in Paradise, or Christ who 
is gone before to prepare mansions of eternal light and 
bliss, or Nirvana who reigns in the heaven of the Buddhist 

The primary element of sexual preference is love, i.e. f 
the expectation of unsurpassed pleasure. The secondary 
element is the feeling of dependence, although it is in 
reality the root from which spring alike, as the former 
may be entirely absent. It certainly exists in a stronger 
measure in woman, on account of her social position, and 
the passive part which she takes in the act of procreation ; 
but at times it is also found in men who are of a feminine 
type. 

Religion as well as sexual love is mystical and trans- 
cendental. In sexual love the real object of the instinct, 
i.e., propagation of the species, is not always present to 
the mind during the act, and the impulse is much 
stronger than could be justified by the gratification that 
can possibly be derived from it. Religious love strives 
for the possession of an object that is absolutely ideal, 
and cannot be defined by experimental knowledge. Both/ 
are metaphysical processes which give unlimited scope to| 
imagination. 

They converge, however, in a similar indefinite focus ; 
for the gratification of the sensual appetite promises a 
boon which far surpasses all other conceivable pleasures, 
and faith has in store a bliss that endures for ever. 



10 PSYCHOPATHIA SEXUALIS. 

In either condition the mind is conscious of the enor- 
mous importance of the object to be obtained; thus im- 
pulses often become irresistible and overcome all opposing 
motives. But because neither of them can at times grasp 
the real object of their existence they easily degenerate 
into fanaticism, in which intensity of emotion overbalances 
clearness and stability of reason. Expectation of un- 
fathomed bliss is now coupled with reckless resignation 
and unconditional submission. 

Owing to this conformity it happens that under high 
tension one dislodges the other, or that both make their 
appearance together; for every violent upheaval in the 
soul must necessarily sweep along its surroundings. 
Nature, always the same, draws alike upon these two 
spheres of conception, now forcing one then the other 
into stronger activity, which degenerates even into acts of 
cruelty either actively exercised, or passively endured. 

In religious life this may assume the shape of self- 
sacrifice or self-destruction, prompted by the idea that 
the victim is necessary for the material sustenance of the 
deity. The sacrifice is brought as a sign of reverence or 
submission, as a tribute, as an atonement for sins com- 
mitted, or as a price wherewith to purchase happiness. 

If, however, the offering consists in self-punishment 
and that occurs in all religions! it serves not only as a 
symbol of submission, or an equivalent in the exchange 
of present pain for future bliss, but everything that is 
thought to come from the deity, all that is done in 
obedience to divine mandates or to the honour of the 
Godhead, is felt directly as pleasure. Thus religious 
exuberance leads to ecstasy, a condition in which con- 
sciousness is so preoccupied with feelings of mental 
pleasure, that distress is stripped of its painful quality. 

Exaggerated religious enthusiasm also finds pleasure 
in the sacrifice of another person, when rapture combines 
with sympathy. 

Similar manifestations may be observed in sexual life, 



A SYSTEM OF PSYCHOLOGY OF SSXUAL LIFE. 11 

as will be shown later on under the headings of Sadism 
and Masochism. 

Thus the relations existing between religion, lust, and 
cruelty, 1 may be condensed into the formula: Religious ' 
and sexual hyperaesthesia at the acme of development 
show the same volume of intensity and the same quality 
of excitement, and may therefore under given circum- 
stances interchange. Both will in certain pathological * 
states degenerate into cruelty. 

Sexual influence is just as potent in the awakening of 
a3sthetic sentiments. What other foundation is there for 
the plastic art or poetry? From (sensual) love arises 
that warmth of fancy which alone can inspire the creative 
mind, and the fire of sensual feeling kindles and preserves 
the glow and fervour of art. 

This explains the sensual natures of great poets and 
artists. 

The world of fancy keeps pace with the development 

* of sexual power. Whoever during that period cannot be 

animated by the ideals of all that is great, noble and 

beautiful remains a "Philistine" all his life. Even the 

dolt tries his hand at poetry when in love. 

On the borders of physiological reaction may be 
observed those mysterious processes of maturing puberty, 
which give origin to obscure yearnings and moods of 
despondency and Weltschmerz, rendering life tedious, and 
coupled with the impulse to inflict pain and sorrow upon 
others (weak analogies of a psychological connection be- 
tween lust and minify). 

First love for ever trends in a romantic idealising 
direct ion. Tt wraps the beloved object in the halo of 
perfection. In its incipient stages it is of a platonic 
character, and turns rather to forms of poetry and history. 

'This may be observed in the actual life as well as in the fiction 
and the plastic arts of degenerate eras. For instance, Bernini't carv- 
ing, which represents St. Teresa " sinking in an hysterical faint upon 
a marble cloud, whilst an amorous angel plunges the arrow (of divine 
love) into her heart." Liibke. 



12 PSYCHOPATHIA SEXUALIS. 

With the approach of puberty it runs the risk of trans- 
ferring the idealising powers upon persons of the opposite 
sex, even though mentally, physically and socially they be 
of an inferior station. To this may easily be traced many 
cases of misalliance, abduction, elopement and errors of 
early youth, and those sad tragedies of passionate love that 
are in conflict with the principles of morality or social 
standing, and often terminate in murder, self-destruction, 
and double suicide. 

Purely sensual loye_is_never true and lasting, for which 
reason first love is, as a rule, 6ut a passing infatuation L a 
iting passion. 

rue love is rooted in the recognition of the moral 
/and mental qualities of the beloved person, and is equally 
ready to share pleasures and sorrows and even to make 
sacrifices. True love shrinks from no dangers or obstacles 
in the struggle for the undisputed possession of the beloved. 

Deeds of daring and heroism lie in its wake. But un- 
less the moral foundation be solid it will lead to crime, 
and jealousy often mars its beauty. 

The love of the feeble-minded is based upon sentimen- 
tality, and when unrequited results in suicide. 

Sentimental love is likely to degenerate into a bur- 
lesque, especially when the sensual element lacks force 
(e.g. the Knight of Joggenburg, Don Quixote, and many 
of the minstrels and troubadours of the middle ages). 

This kind of love is nauseating and has a repulsive or 
ludicrous effect on others, whilst true love and its mani- 
festations command sympathy, respect, and even fear. 

Love when weak is frequently turned away from its 
real object into different channels, such as voluptuous 
poetry, bizarre aesthetics, or religion. In the latter case 
it readily falls a prey to mysticism, fanaticism, sectarian- 
ism or religious mania. A smattering of all this can al- 
ways be found in the immature love of early puberty. The 
poetical effusions of that period of life are only then 
worthy of perusal when emanating from the pen of the 
truly endowed genius. 



A SYSTEM OF PSYCHOLOGY OP SEXUAL LIFE. 

Ethical surroundings are necessary in order to clevato 
love to its true and pure form, hut, notwithstanding. 
sensuality will ever remain its principal basis. 

Platonic love is a platitude, a misnomer for "kindred 
spirits". 

Since love implies the presence of sexual desire it can 
only exist between persons of different sex capable of 
sexual intercourse. When these conditions are wanting 
or destroyed it is replaced by friendship. 

The sexual functions of man exercise a very marked 
influence upon the development and preservation of char- 
acter. Manliness and self-reliance are not the qualities 
which adorn the impotent onanist 

GyurkoveMy ("Mannl. Impotenz," Wien, 1889) is 
correct in his observation that virility establishes the ratio 
of difference between old men and young, and that im- 
potence impairs health, mental freshness, activity, self- 
confidence and imagination. The damage stands in 
proportion to the age of the subject and the extent of his 
debauchery. 

The sudden loss of the virile powers often produces 
melancholia, or is the cause of suicide when life without 
love is a mere blank. 

In cases where the reaction is less pronounced, the 
victim is morose, peevish, egotistical, jealous, narrow- 1 
minded, cowardly, devoid of energy, self-respect and 
honour. 

The Skopzes for instance after castration rapidly de- 
generate. 

This matter will be further elucidated under the head- 
ing of "Effeminatio" (v. .). 

In the sedate matron this condition is of minor psy- 
chological importance, though it is noticeable. The 
biological change affects her but little if her sexual career 
has been successful, and loving children gladden the ma- 
ternal heart The situation is different, however, where 



14 PSYCHOPATHIA SEXUALIS. 

sterility has denied that happiness, or where enforced 
celibacy prevented the performance of the natural func- 
tions. 

These facts characterise strongly the differences that 
prevail in the psychology of sexual life in man and 
woman, and the dissimilarity of sexual feeling and desire 
in both. 

Man has beyond doubt the stronger sexual appetite of 
the two. From the period of pubescence he is instinc- 
tively drawn towards woman. His love is sensual, and 
his choice is strongly prejudiced in favour of physical 
attractions. A mighty impulse of nature makes him 
aggressive and impetuous in his courtship. Yet the law 
of nature does not wholly fill his psychic being. Having 
won the prize, his love is temporarily eclipsed by other 
vital and social interests. 

Woman, however, if physically and mentally normal, 
and properly educated, has but little sensual desire. If 
it were otherwise, marriage and family life would be 
empty words. As* yet the man who avoids women, and 
the woman who seeks men are sheer anomalies. 

Woman is wooed for her favour. She remains passive. 
Her sexual organisation demands it, and the dictates of 
good breeding come to her aid. 

Nevertheless, sexual consciousness is stronger in 
woman than in man. Her need of love is greater, it 
is continual not periodical, but her love is more spiritual 
than sensual. Man primarily loves woman as his wife, 
and then as the mother of his children; the first place in 
woman's heart belongs to the father of her child, the 
second to him as husband. Woman is influenced in 
her choice more by mental than by physical qualities. 
As mother she divides her love between offspring and 
husband. Sensuality is merged in the mother's love. 
Thereafter the wife accepts marital intercourse not so 
much as a sensual gratification than as a proof of her hus- 
band's affection. 

Woman loves with her whole soul. To woman love 



A SYSTEM OF PSYCHOLOGY OF SEXUAL LIFE. 15 

is life, to man it is the joy of lift-. Misfortune in love 
bruises the heart of man; but it ruins the life of woman 
and wrecks her happiness. It is really a psychological J 
question worthy of consideration whether woman can truly/ 
love twice in her life. Woman's mind certainly inclines j 
more to monogamy than that of man. 

In t lie sexual demands of man's nature will be found 
the motives of his weakness towards woman. He is 
enslaved by her, and becomes more and more dependent 
upon her as he grows weaker, and the more he yields to 
sensuality. This accounts for the fact that in the periods 
of decline and luxury sensuousness was the predominant 
factor. Whence arises the social danger when courtesans 
and their dependants rule the State and finally encompass 
its ruin. 

History shows that great (states) men have often been 
the slaves of women in consequence of the neuropathic 
conditions of their constitution. 

It shows a masterly psychological knowledge of human' 
nature that the Roman Catholic Church enjoins celibacy -. 
upon its priests in order to emancipate them from sensu- 
ality, and to concentrate their entire activity in the pursuit 
of their calling. Nevertheless it is a pity that the celibate 
state deprives the priest of the ennobling influence exer- 
cised by love and marital life upon the character. 

From the fact that by nature man plays the aggressive 
role in sexual life, he is exposed to the danger of over- 
stepping the limits set by law and morality. 

The unfaithfulness of the wife, as compared with 
that of the husband, is morally of much wider bearing, 
and should always meet with severer punishment at the 
hands of the law. The unfaithful wife not only dishon- 
ours herself, but also her husband and her family, not to 
speak of the possible uncertainty of paternity. 

Natural instincts and social position are frequent 
causes of disloyalty in man (the husband), whilst the 
wife is surrounded by many protecting influences. 

Sexual intercourse is of different import to the spinster 



16 PSYCHOPATHIA SEXUALI8. 

and to the bachelor. Society claims of the latter modesty, 
but exacts of the former chastity as well. Modern civil- 
isation concedes only to the wife that exalted position, in 
which woman sexually furthers the moral interests of 
society. 

The ultimate aim, the ideal, of woman, even when she 
is dragged in the mire of vice, ever is and will be marriage. 
Woman, as Mantegazza properly observes, seeks not only 
gratification of sensual desires, but also protection and 
-,support for herself and her offspring. No matter how 
sensual man may be, unless also thoroughly depraved, he 
seeks for a consort only that woman whose chastity he 
cannot doubt. 

The emblem and ornament of woman aspiring to this 
state, truly worthy of herself, is modesty, so beautifully 
defined by Mantegazza as "one of the forms of physical 
self-esteem." 

To discuss here the evolution of this, the most graceful 
of virtues in woman, is out of place, but most likely it is 
an outgrowth of the gradual rise of civilisation. 

A remarkable contrast may be found in the occasional 
exposure of physical charms, conventionally sanctioned by 
the world of fashion, in which even the most discreet 
maiden will indulge when robed for the ball-room, theatre, 
or similar social function. Although the reasons for such 
a display are obvious, the modest woman is fortunately 
no more conscious of them, than of the motives which 
underlie periodical fashions that bring certain forms of 
the body into undue prominence, to say nothing of corsets, 
etc. 

In all times, and among all races, the women are fond 
of toilet and finery. In the animal kingdom nature has 
distinguished the male with the greater beauty. Men 
designate women as the beautiful sex, a gallantry which 
clearly "arises from their sensual requirements. So long 
as woman seeks only self-gratification in personal adorn- 
ment, and so long as she remains unconscious of the psy- 
chological reasons for thus making herself attractive, no 



A SYSTEM OF PSYCHOLOGY OF SEXUAL LIFB 17 



can be raised against it, but, \\ljcn done with 
the fixed purpose to please men it degenerates into co- 
quetry. 

Under analogous circumstances man would make him- 
self ridiculous. 

Woman far surpasses man in the natural psychology 
of love, partly because evolution and training have made 
love her proper element, and partly because she is ani- 
mated by more refined feelings (Mantegazza). 

Even the best of breeding concedes to man that he 
looks upon woman mainly as a means by which to satisfy 
the cravings of his natural instinct, though it confines 
him only to the woman of his choice. Thus civilisation 
establishes a binding social contract which is called mar- 
riage, and grants by legal statutes protection and support 
to the wife and her issue. 

It is important, and on account of certain pathological 
manifestations (to be referred to later on) indispensable, to 
examine into those psychological events which draw man 
and woman into that close union which concentrates the 
fulness of affection upon the beloved one only to the ex- 
clusion of all other persons of the same sex. 

If one could demonstrate design in the processes of 
nature adaptation cannot be denied them then the fact 
of fascination by one person of the opposite sex with in- 
difference towards all others, as it occurs between true \ 
and happy lovers, would appear as a wonderful provision 
to ensure monogamy for the promotion of its object. 

The scientific observer finds in this loving bond of 
hearts by no means simply a mystery of souls, but he can 
refer it nearly always to certain physical or mental pecu- 
liarities by which the attracting power is qualified. 

Hence the words FETICH and FETICHISM. The word 
fetich signifies an object, or parts or attributes of objects, 
which by virtue of association to sentiment, personality, ori 
absorbing ideas, exert a charm (the Portuguese "fetisao") 
or at least produce a peculiar individual impression which 

2 



18 P8YCIIOPATIIIA 8EXUAX.IS. 

is in no wise connected with the external appearance of 
the sign, symbol or fetich. 1 ^ 

The individual valuation of the fetich extending even 
to unreasoning enthusiasm is dalled fetichism. This in- 
teresting psychological phenomenon may be explained by 
an empirical law of association, i.e., the relation existing 
/ between the notion itself and the parts thereof which are 
' essentially active in the production of pleasurable emotions. 
It is most commonly found in religious and erotic spheres. 
Religious fetichism finds its original motive in the delusion 
that its object, i.e., the idol, is hot a mere symbol, but 
possesses divine attributes, and ascribes to it peculiar 
wonder-working (relics) or protective (amulets) virtues. 

Erotic fetichism makes an idol of physical or mental 
qualities of a person or even merely of objects used by 
that person, etc., because they awaken mighty associations 
with the beloved person, thus originating strong emotions 
of sexual pleasure. Analogies with religious fetichism 
are always discernible; for, in the latter, the most in- 
significant objects (hair, nails, bones, etc.) become at 
times fetiches which produce feelings of delight and even 
ecstasy. 

The germ of sexual love is probably to be found in the 
individual charm (fetich) with which persons of opposite 
sex sway each other. 

The case is simple enough when the sight of a person 
of the opposite sex occurs simultaneously with sexual 
excitement, whereby the latter is intensified. 

Emotional and optical impressions combine and are 
so deeply embedded in the mind that a recurring sensation 
awakens the visual memory and causes renewed sexual 
excitement, even orgasm and pollution (often only in 
dreams), in which case the physical appearance acts as 
a fetich. 

Binet, inter alia, contends that mere peculiarities, 

l Cf. Maa M tiller who derives the word fetich etymologically from 
factitius, i. e., artificial, insignificant. 



A SYSTEM OF PSYCHOLOGY OF SEXUAL LIFE. 19 

whether physical or mental, may have the effect of the 
fetich, if their perception coincides with sexual emotion. 

Experience shows that chance controls in a large 
measure this mental association, that the nature of the 
fetich varies with the personality of the individual, thus 
arousing the oddest sympathies or antipathies. 

These physiological facts of fetichism often account 
for the affections that suddenly arise between man and 
woman, the preference of a certain person to all others 
of the same sex. Since, the fetich assumes the form of 
a distinctive mark it is clear that its effect can only be 
of an individual character. Being accentuated by the 
strongest feelings of pleasure, it follows, that existing 
faults in the beloved are overlooked ("Love is blind") and 
an infatuation is produced which appears incomprehensible 
or silly to others. Thus it happens that the devoted 
lover who worships and invests his lave with qualities 
which in reality do not exist, is looked upon by others 
simply as mad. Thus love exhibits itself now as a mere 
passion, now as a pronounced psychical anomaly which 
attains what seemed impossible, renders the ugly beautiful, 
the profane sublime, and obliterates all consciousness of 
existing duties towards others. 

Tarde ("Archives de 1'Anthropologie Criminelle," vol. 
v., No. 30) argues that the type of this fetich (ism) varies 
with persons as well as with nations, but that the ideal 
of beauty remains the same among civilised peoples of the 
same era. 

Binet has more thoroughly analysed and studied this 
fetichism of love. 

From it springs the particular choice for slender or 
plump forms, for blondes or brunettes, for particular form 
or colour of the eyes, tone of the voice, odour of the hair 
or body (even artificial perfume), shape of the hand, foot 
or ear, etc., which constitute the individual charm, the 
first link in a complicated chairt of mental processes, all 
f<>n verging in that one focus, love, i.e., the physical and 
mental possession of the beloved. 



20 PSYCHOPATHIA 8EXUALI8. 

This fact establishes the existence of physiological 
fetichism. 

Without showing a pathological condition the fetich 
may exercise its power so long as its leading qualities 
represent the integral parts, and so long as the love en- 
gendered by it comprises the entire mental and physical 
personality. 

"Normal love appears to us as a symphony of tones 
Max Dessoir (pseudonym Ludwig Brunn) 1 in an article 
"The Fetichism of Love," cleverly says : 

"Normal love appears to us as a symphony of tones 
of all kinds. It is roused by the most varied agencies. 
It is, so to speak, polytheistic. Fetichism recognises 
only the tone-colour of a single instrument; it issues 
forth from a single motive ; it is monotheistic." 

Even moderate thought will carry the conviction that 
the term real love (so often misused) can only apply 
where the entire person of the beloved becomes the phy- 
sical and mental object of veneration. 

Of course, there is always a sensual element in love, 
i.e., the desire to enjoy the full possession of the beloved 
object, and, in union with it, to fulfil the laws of nature. 

But where the body of the beloved person is made 
the sole object of love, or if sexual pleasure only is sought 
without regard to the communion of soul and mind, true 
love does not exist. Neither is it found among the disciples 
of Plato, who love the soul only and despise sexual en- 
joyment. In the one case the body is the fetich, in the 
other the soul, and love is fetichism. 

Instances such as these represent simply transitions 
to pathological fetichism. 

This assumption is enhanced by another criterion of 
true love, viz., the mental satisfaction derived from the 
sexual act. 2 

'"Deutsches Montagsblatt," Berlin, 20, 8, 80. 

* Magnan's " spinal ce"re"bral postgrieur " who finds gratification 

with any sort of woman, is only animated by lust. Meretricious love 

that is purchased cannot be genuine ( Mantegaaea). Whoever coined 

the adage : " Sublata lucerna nullum discrimen inter feminas," was 



A SYSTEM OF PSYCHOLOGY OF SEXUAL LIFE. 21 

A striking pin-it. -UK-MOM in fetiehism is that among 
(lie many thiM^s which may serve as fetiches there are 
some which gain that significance more commonly than I 
others; for instance, the HAIR, the HAND, the FOOT of 
\\onian, or the expression of the KYE. This is important 
in the pathology of fetichism. 

Woman certainly seems to be more or less conscious 
of these facts. For she devotes great attention to her 
hair and often spends an unreasonable amount of time 
and money upon its cultivation. How carefully the 
mother looks after her little daughter's hair! What an ( 
important part the hairdresser plays 1 The falling out of 
the hair causes despair to many a young lady. The 
author remembers the case of a vain woman who fell 
into melancholia on account of this trouble, and finally 
committed suicide. A favourite subject of conversation 
among ladies is coiffures. They are envious of each 
other's luxuriant tresses. 

Beautiful hair is a mighty fetich with many men. In 
the legend of the Lorelef, wno lured men to destruction, 
the "golden hair" which she combs with a golden comb 
appears as a fetich. Frequently the hand or the foot 
possesses an attractiveness no less powerful; but in these 
instances masochistic and sadistic feelings often though 

a cynic, indeed. The power to perform love's act is by no means a 
guarantee of the noblest enjoyment of love. 

There are urnings who are potent for women men who do not 
love their wives, but are nevertheless able to perform the marital 
" duty ". In the majority of these cases even lustful pleasure is ab- 
M-nt ; for it is simply an onanistic act rendered possible by the aid 
of imagination which substitutes another beloved being. This decep- 
tion may, indeed, superinduce sexual pleasure, but, rudimentary 
gratification as it is, it can only arise from a psychic trick, just as ' 
in solitary onaniam voluptuous satisfaction is obtained chiefly with 
the assistance of fancy. As a matter of fact that degree of orgasm 
which completes the lustful act is entirely dependent upon the inter- 
vention of fancy. 

Wlirre psychic impediments exist (such as indifference, disgust, 
ion, fear of contagion or impregnation, etc.) the feeling of sexual 
gratification seems to be wanting altogether. 



22 PSYCHOPATHIA SEXUALI8. 

not always assist in determining the peculiar kind of 
fetich. 

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

Max Dcssolr^op. c#.7~p6ints out that among the cus- 
toms of the middle ages drinking from the shoe of a 
beautiful woman (still to be found in Poland) played a 
remarkable part in gallantry and homage. The shoe also 
plays an important role in the legend of Aschenbrodel. 

The expression of the eye is particularly important 
as a means of kindling the spark of love. A neuropathic 
eye frequently affects persons of either sex as a fetich. 
"Madame, vos beaux yeux me font mourir d'amour." 
(Moliere). 

There are many examples showing that odours of the 
body become fetiches. 

This fact is taken advantage of in the "Ars amandi" 
by woman either consciously or unconsciously. Ruth 
sought to attract Boaz by perfuming herself. The demi- 
monde of ancient and modern times is noted for its lavish 
use of strong scents. Jager, in his "Discovery of the 
Soul," calls attention to many olfactory sympathies. 

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

Binet makes it probable that the voice also may act an 
a fetich. 

Belot in his novel "Les baigneuses de Trouville" 
makes the same assertion. Binet thinks that many 
marriages with singers are due to the fetich of their 
voices. He also observes that among the singing bird3 
the voice has the same sexual significance as odours 
among the quadrupeds. The birds allure by their song, 
and the male that sings most beautifully is joined at night 
by the charmed mate. 

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



A SYSTEM OP PS >,Y OF SEXUAL LIKE. 

Thus the fact of idiosyncrasies is explained, and the 
old proverb "De gustibus non est disputandum" retains its 
force. 

Witli regard to fetichism in woman, science must at 
least for the present time be content with mere con- 
jectures. This much seems to be certain, that being a 
physiological factor, its effects are analogous to those 
in men, i.e., producing sexual sympathies towards persons 
of the same sex. 

Details will come to our knowledge only when medical 
women enter into the study of this subject. 

We may take it for granted that the physical as well 
us the mental qualities of man assume the form of the 
female fetich. In most cases, no doubt, physical attributes 
in the male exercise this power without regard to the 
existence of conscious sensuality. On the other hand it 
will be found that the mental superiority of man con- 
stitutes the attractive power where physical beauty is 
wanting. In the upper "strata" of society this is more 
apparent, even if we disregard the enormous influence 
exercised by "blue blood" and high breeding. The 
possibility that superior intellectual development favours 
advancement in social position, and opens the way to a 
brilliant career, does not seem to weigh heavily in the 
balance of judgment. 

The fetichism of body and mind is of importance in 
progeneration ; it favours the selection of the fittest and 
the transmission of physical and mental virtues. 

Generally speaking the following masculine qualities 
impose on woman, viz., physical strength, courage, nubility 
of mind, chivalry, self-conrufence, even self-assertion, inso- 
Icncc, }>ravail<>, and a c.>n.-vi..us .-how .f ma- r the 

weaker sex. 

A "Don Juan" impresses many women and elicits 
admiration, for he establishes the proof of his virile powers, 
although the inexperienced maiden can in no wise suspect 
the many risks of lues and chronic urethritis she runs 
from a marital union with this otherwise interesting rake. 



24 PSYCHOPATHIA SEXUALIS. 

The successful actor, musician, or vocal artiste, the 
circus rider, the athlete, and even the criminal, often fasci- 
nate the bread and butter miss as well as the maturer 
woman. At any rate women rave over them, and inun- 
date them with love letters. 

It is a well-known fact that the female heart has pre- 
dominant weakness for military uniforms, that of the 
cavalry-man ever having the preference. 

The hair of man, especially the beard, the emblem of 
virility, the secondary symbol of generative power is g 
predominant feticli with woman. In the measure in 
which women bestow special care upon the cultivation 
of their hair, men who seek to attract and please women, 
cultivate the elegant growth of the beard, and especially 
that of the moustache. 

A The eye as well as the voice exert the same charm. 
Singers of renown easily touch woman's heart. They are 
overwhelmed with love letters and offers of marriage. 
Tenors have a decided advantage. 

Binet (op. cit.) refers to an observation of this charac- 
ter made by Dumas in his novel "La maison du vent". A 
woman who falls in love with a tenor-voice loses her 
virtue. 

The author has thus far not succeeded in obtaining 
facts with regard to pathological fetichism in woman. 



H. PHYSIOLOGICAL FACTS. 

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

Sexual desire during the years of sexual maturity is a 
physiological law. The duration of the physiological pro- 
cesses in the sexual organs, as well as the strength of the 
sexual desire manifested, vary, both in individuals and in 
races. Race, climate, heredity and social circumstances 
have a very decided influence upon it. The greater sensu- 
ality of southern races as compared with the sexual needs 
of those of the north is well known. Sexual development 
in the inhabitants of tropical climes takes place much 
earlier than in those of more northern regions. In women 
of northern countries oyulation, recognisable in the de- 
velopment of the body and the occurrence of a periodical 
flow of blood from the genitals (menstruation), usually 
begins about the thirteenth to the fifteenth year; in men 
puberty, recognisable in the deepening of the voice, the 
appearance of hair on the face and mons veneris, and the 
occasional occurrence of pollutions, etc., takes place about 
the fifteenth year. In the inhabitants of tropical countries, 

ver, sexual development obtains several years earlier 
in women sometimes as early as the eighth year. 

It is worthy of remark that girla who live in citiea 
develop about a year earlier than girls living in (lie country, 
anil that (he larger the town the earlier, ccteris paribus, 
the development takes place. 

Heredity, however, has no small influence on libido 
and sexual power. Thus there are families in which, 

(25) 



26 PSYCIIOPATIII.V SKXUALI8. 

with great physical strength and longevity, great libido 
and virility are preserved until a great age, while in other 
families the vita sexualis develops late and is early ex- 
tinguished. 

In woman the period of activity of the reproductive 
glands is shorter than in man, in whom sexual power 
may last until a great age; ovulation ceases about thirty 
years after puberty. The^geriodjof^waning activity of the 
ovaries is called the change of life (climacteriumj meno- 
pause ) . This biological phase does not represent merely 
a cessation of functional potency and final atrophy of the 
reproductive organs, but a transformation of the whole 
organism. 

In Middle Europe the sexual maturity of man begins 
about the eighteenth year, and virility reaches its acme 
at forty. After that age it slowly declines. The potentia 
generandi ceases usually at the age of sixty-two, but po- 
tentia cceundi may be present much longer. 

The existence of the sexual instinct is continuous 
during the time of sexual life, but it varies in intensity. 
Under physiological conditions it is never periodical in the 
human male, as it is in animals; it manifests an organic 
variation of intensity in consonance with the collection 
and expenditure of semen. In women the degree of sexual 
desire coincides with the process of ovulation in such a 
way that libido sexualis is intensified after the menstrual 
period. 

Sexual instinct as emotion, idea and impulse is a 
function of the cerebral cortex. Thus far no definite 
region of the cortex has been proved to be exclusively 
the seat of sexual sensations and impulses. This psycho- 
sexual centre is nothing more than a junction and crossing 
of principal paths which lead on the one hand to the sensi- 
tive motor apparatus of the sexual organs, and on the other 
hand to those nerve centres of the visual and olfactory 
organs which are the carriers of that consciousness which 
distinguishes between the "male" and the "female". 

Owing to the close relations which exist between thc> 



PHYSIOLOGICAL FACTS. 27 

sexual instinct and the olfactory sense, 1 it is to be i> re- 
sumed that the sexual and olfactory centres lie close 
together in the cerebral co: The development of 

M-xiial life has its lv 'ginning in the organic sensations 
which arise from the maturing reproductive glands. These 
excite the attention of the individual. Reading and the 
experiences of every-day life (which, unfortunately, are 
now-a-days too early and too frequently suggestive), con- 
vert these notions into clear ideas, which are accent' 
by organic sensations of a pleasurable character. With 
this accentuation of erotic ideas through lustful feelings, 
an impulse to induce them is developed (sexual desire). 

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

The cerebral cortex, by means of preconceived or re- 
produced sensual ideas, reacts on the reproductive organs, 
including hypersemia, production of semen, erection, ejacu- 
lation. This is effected by means of centres for vasomotor 
i nervation and ejaculation, which are situated in the 
lum'nar regions of the cord, and lie close together. Both 
are reflex centres. 

The centre .,f erection (Goliz, I'rh-hard} is an inter- 
mediate station placed between the brain and the genital 
apparatus. The nervous paths which connect it with the 
brain probably run through the pcdnnruli crrrhri and the 
ports. This centre may be excited by central (psychical 
and organic) stimuli, by direct irritation of the nerve-tract 
in the pedunculis cerebri, pons, or cervical portion of the 
cord, as well as by peripheral irritation of the sensory 

'The olfactory centre is presumed by Ferrier (" Function! of the 
Brain") to be in the n-jjion of the gyrus uncinntus. Zuckcrkandl 
(" UelT dm IJiorliciTilrnin," 1887), from researches in comparative 
:m:iti.iny, mnrludri that the olfactory centre haa ita seat in the Hip- 
I>ocaiiipu8 nmjor. 



28 PSYCIIOPATHIA 8EXUALIS. 

nerves (penis, clitoris and annexa). It ia not directly sub- 
ordinated to the will. 

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

The action of the nervi erigentes, which renders erec- 
tion possible, is inhibitory in so far as it inhibits the 
ganglionic nervous mechanism in the corpora cavernosa, 
upon the action of which the smooth muscle-fibres of the 
corpora cavernosa are dependent (Kolliker and Kohl- 
rausch). Under the influence of the action of the nervi 
erigentes, these fibres of the corpora cavernosa become re- 
laxed, and their spaces fill with blood. Simultaneously, as 
a result of the dilatation of the capillary net-work of the 
corpora cavernosa, pressure is exerted upon the veins of the 
penis and the return of blood is impeded. This effect is 
aided by the contraction of the bulbo cavemosus and erector 
penis muscles, which extend by means of an aponeurosis 
over the dorsal surface of the penis. 

The erection-centre is under the influence of both 
\ exciting and inhibitory innervation arising from the cere- 
brum. Ideas and sense-perceptions of sexual content 
, have an exciting effect. According to observations made 
on men that have been hung, it is evident that the 
erection-centre may also be aroused by excitation of the 1 
tract of the spinal cord. Observations on the insane and 
those suffering with cerebral disease show that this is 
also possible as a result of organic irritation in the 
cerebral cortex (psycho-sexual centre'?). Spinal diseases 
(tain's, especially myelitis) affecting the lumbar portion 1 
of the cord, in their earlier stages, may directly excite 
the erection-centre. 

Reflex excitation of the centre is possible and frequent 
in the following ways: by irritation of the (peripheral) 

1 Later researches by MUller (Klin. u. experiment. Studien, etc., 
Deutsche Zeitschr. f. N. heilkunde xxi.) seem to render it more prob- 
able that the centre of erection does not lie in the conus medullrxns 
of the spinal cord,, but rather in the sacral ganglia, thus constituting 
a sympathetic reflex. 



1MIY8IOLOOI 29 

sensory nerves of the genitals and surrounding parta by 
fricti.n ; by irritation of the un-tlia ( g< niOTrtHHO , of the 
rectum (hemorrhoids, oxyuris), of the bladder (distension 
with urine, especially in the morning; irritation of cal- 
culi) ; by distension of the vesieulffi seminales with semen; 
by hypersemia of the genitals, occasioned by lying on the 
back and thus inducing pressure of the intestines upon 
the blood-vessels of the pelvis. 

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

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

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

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

The central point of the sexual mechanism is the cere- 
bral cortex. It is justifiable to presume that there is a 
definite region of the cortex (cerebral centre), which gives 
rise to sexual feelings, ideas and impulses, and is the place 
of origin of the psycho-somatic processes which we <1 
nate as sexual life, sexual instinct, and sexual desire. This 
centre is susceptible to both central and peripheral stimuli. 

Central stimuli, in the form of organic excitation, may 
be due to diseases of the cerebral cortex. Physiologically 
they are dominated by psychical impressions (memory and 
sensory perceptions, lascivious stories, touch, pressure of 
the hand, kiss, etc.). Auditory and olfactory perceptions 
certainly play but a very subordinate role. Under patho- 



30 PSYCHOPATHIA SEXUALIS. 

logical conditions (v. infra}, the latter have a very decided 
influence in inducing sexual excitement. 1 

In beasts the influence of olfactory perception on the 
sexual sense is unmistakable. Al/lmus ("Beitrage zur 
Physiol. und Pathol. des Olfactorius," "Archiv fiir Psych." 
xii., II. 1) declares that the sensa of smell is important 
with reference to the reproduction of the species. He 
shows that animals of opposite sexes are drawn to each 
other by means of olfactory perception, and that almost 
all animals, at the time of rutting, emit a specially distinct 
odour from their genitals. An experiment by Schiff is 
confirmatory of this. He extirpated the olfactory nerves 
in puppies, and found that, as the animals grew up. the 
male was unable to distinguish the female. Again, an 
experiment by Mantegazza ("Hygiene of Love"), who re- 
moved the eyes of rabbits and found that the defect con- 
stituted no obstacle to procreation, shows how important 
in animals the olfactory sense is for the vita sexualis. 

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

Althaus also shows that in man there are certain re- 
lations existing between the olfactory and sexual senses. 
He mentions Cloquct ("Osphresiologie," Paris, 1826), who 
calls attention to the sensual pleasure excited by the odour 
of flowers, and tells how Eichelieu lived in an atmosphere 
laden with the heaviest perfumes, in order to excite his 
sexual functions. 

Zippe ("Wien. Med. Wochenschrift," 1879, No. 24), 
in connection with a case of kleptomania in an onanist, 
likewise establishes such relations, and cites Hildebrand as 
authority, who in his popular physiology says: ''It can- 
not be doubted that the olfactory sense stands in remote 

l Cf. Albert Hagen, "Die sexuelle Osphresiologie," Charlotten- 
burg, 1901 (Verlag H. Basdorf), a most interesting monograph on 
the relations between the olfactory senses and odours and the sexual 
acts in man. Albert Moll, " Untersuchungen liber libido sexualis," 
p. 377. (Literature and studies on the olfactory sense as a stimu- 
lating cause of the sexual instinct.) 



1'IIYM' FACTS. 31 

with the sexual apparatus. Odours of flov. 
often occasion pleasurable sensual feelings, and when 

infers the passage in the 'Song of Solomon,' 'And my 
hands dropped with myrrh, and my lingers with R\\ 
smelling myrrh, upon the handles of the lock,' one finds 
that it did not escape Solomon tti<>n. In the Orient 

the pleasant perfume* an- esteemed for their relatioi 
the sexual organ-, and the women's apartments of the Sul- 
tan are redolent with the fragrance of flo\\ 

Most, professor in Rostock (cf. ///>/*), relates: "I 
learned from a sensual young peasant that ho had excited 
many a chaste girl sexually, and easily gained his end, by 
carrying his handkerchief in his axilla for a time, while 
dancing, and then wiping his partner's perspiring face 
with it." 

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

Professor Jdger, the "discoverer of the soul," refers to 
the same thing in his well-known book (2nd. ed., 1880, 
chap, xv., p. 173) ; for he regards the sweat as important 
in the production of sexual effects, and as being especially 
seductive. 1 

One learns from reading the work of Ploss ("Da 
Weih"), that attempts to attract a person of the opposite 
ex by means of the perspiration, may be discerned in 
many forms in popular psychology. 

'See also further interesting observations on the aphrodiaic ef- 
fect* of sweat on both sexes. Ftrt, 1'instinct sexuel, p. 127. (Paris, 
1899). 



32 PSYCHOPATH'IA SEXUALIS. 

In reference to this, a custom which holds among the 
natives of the Philippine Islands when they become en- 
gaged, as reported by Jagor, is remarkable. When it be- 
comes necessary for an engaged pair to separate, they ex- 
change articles of wearing-apparel, by means of which each 
becomes assured of faithfulness. These objects are care- 
fully preserved, covered with kisses, and smelled. 

The love of certain libertines and sensual women for 
perfumes 1 indicates a relation between the olfactory and 
the sexual senses. 

A case mentioned by Heschl ("Wiener Zeitschrift f. 
pract. Heilkunde," 22d March, 1861) is remarkable, 
where the absence of both olfactory lobes was accompanied 
by imperfectly developed genitals. It was the case of a 
man aged forty-five, in all respects well developed, with 
the exception of the testicles, which were not larger than 
beans and contained no seminal canals, and the larynx, 
which seemed to be of feminine dimensions. Every trace 
of olfactory nerves was wanting, and the trigona olfactoria 
and the furrow on the under surface of the anterior lobes 
were absent. The perforations of the ethmoid plate were 
sparingly present, and occupied by nerveless processes of 
the dura instead of by nerves. In the mucous membrane 
of the nose there was also an absence of nerves. 

Finally, the clearly defined relation of the olfactory 
and sexual senses in mental diseases is worthy of notice, 
for in the psychoses of both sexes superinduced by mas- 
turbation, as well as in insanity due to disease of the 
female organs, or during the climacterium, olfactory hal- 
lucinations are especially frequent, while in cases where 
a sexual cause is wanting they are very infrequent. 

II am inclined to doubt 2 that, under normal conditions, 
olfactory impressions in man, as in animals, p? an im- 
portant role in the excitation of the sexual centre. On 

*Cf. Laycock, who ("Nervous Diseases of Women," 1840) found 
that in women the love for musk and similar perfumes was related 
to sexual excitement. 

The following case, reported by Binet, seems to be in opposition 
to this idea. Unfortunately nothing is said concerning the mental 



PHY8IOLOOICAI. PACTS. 33 

account of the importance of this consensus for the under- 
rtamling of pathological cases, it is necessary here to thor- 
oughly consioVr tin- relations existing between the olfactory 
and srxtial senses. 

With n (" rence to these physiological relations it may 
he mentioned as an interesting fact that there exists a cer- 
tain histologieal conformity Intwctn the nose and the 
genitals, f<r both have KJJKCTILE tissue (likewise the 
nipple,). 

Interesting physiological and clinical obeervatiens by 
J. N. Mackenzie may be found in the "Journal of Medical 
Science," April, 1884. He finds: (1) that in certain 
women with normal olfactory organs regularly with men- 
struation a swelling of the erectile tissue of the nose oc- 
curs which disappears again with the flooding; (2) that 
menstruation is at times replaced by epistaxis, which dis- 
appears when the uterine flow begins, but in some cases 
always recurs with the menstrual functions; (3) irrita- 
tions of the nasal organs such as violent sneezing, etc., oc- 
cur at the_time of sexual excitement; (4) Stimulation of 
the genital' tracts is occasioned by affections of the nasal 
organs 

He, also observe.- that nasal affections in women grovr 
worse during tho time of menstruation; that venereal ex- 
cesses produce inflammation of the Schneiderian mem- 
brane, or intensify it where it already exists. 

He also points out that masturbators very frequently 
suffer from nasal disease, are troubled with abnormal sen- 
sations of olfaction, and are subject to epistaxis. Accord- 
ing to his experience there are affections of the nose which 
stubbornly resist all treatment until the concomitant (and 
causal) genital disease is removed. 

ehara. <>f the person. In any event, it is certainly confirma- 

tory of tne relations existing between the olfactory and sexual 
MOMS: 

D., a medical student, was seated on a bench in a public park, 
rending a book (on pathology). Suddenly a violent erection dis- 
turbed him. He looked up and noticed that a lady, redolent with 
perfume, had taken a seat upon the other end of the bench. D. could 
attribute the erection to nothing but the unconscious olfactory im- 
pression made upon him. 3 



34 PSYCHOPATHIA SEXUALIS. 

Other interesting observations and elucidations about 
the consensus narium et gcnitalium may be found in a book 
by Fliess recently published r "Die Beziehungen zwisoiim 
N&se und weiblichen Geschlechtsorganen," Vienna (Deut- 
icke), 1897. Cerviset, contribut. a 1'etude du tisses erec- 
tile des fosses nasales. These de Lyon 1887. Joal, rcvuc 
mensuelle de laryngologie 1888 Fevr. Peyer, Miinch. 
med. Wochenschr, 1889. 4; Eudriss, Dissertat, Wurz- 
burg 1892. 

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

Libido sexualis may also be induced by stimulation of 
the gluteal region (castigation, whipping). 1 

This fact is important for the proper understanding of 
certain pathological manifestations. It sometimes happens 
that in boys the first excitation of the sexual instinct is 
caused by a spanking, and they are thus incited to mas- 
turbation. This should be remembered by those who have, 
the care of children. 

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

Passive -flagellation may excite sensuality, as is shown 

Mfeibowutw, " De flagiorum usu in re medica," London, 1765: 
Boileau, "The History of the Flagellants," London, 1783; Doppct, 
" Aphrodisiaque externe," Paris, 1788; Cooper, " Der Flagellantismus 
u. d. Flagellanten; Hunscn, Stock u. Peitache in xix. Jahrhundert 
(Dohrn, Dresden), 2 vola. 



1MIY8IOLOGICAL FACTS. ,V 

by the sects of flagellants, 1 so widespread in the thirteenth 
and fifteenth centuries. They were accustomed to whip 
themselves, partly as an atonement and partly to mortify 
the flesh (in accordance with the principle of chastity pro- 
mulgated by the Church i. e., the emancipation of the 
soul from sensuality). 

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

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

It was the same with Elizabeth of Genton. As a result 
<>f whipping she actually passed into a state of bacchanalian 
madness. As a rule, she raved when, excited by unusual 

l Corvin, Hist. Denkmale des ohrist lichen Fanatismus, II., L?ip- 
tig, 1847; Fofrittmann, Die chriatlicheo Geiaalergoaellachaften, Halle, 
1828. 



36 PSYCIIOPATIIIA SEXUALI8. 

flagellation, she believed herself united with her "ideal". 
This condition was so exquisitely pleasant to her that sho 
would frequently cry out, "O love, O eternal love, O love, 
you creatures! cry out with me: 'Love, Love!' ' 

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

These facts find an interesting confirmation in the 
following experiences, taken from Paullini's "Flagellum 
Salutis" (1st ed., 1698; reprint, Stuttgart, 1847) : 

"There are some nations, viz., the Persians and Rus- 
sians, where the women regard blows as a peculiar sign of 
love and favour. Strangely enough, the Russian women 
are never more pleased and delimited iliaii when they re- 
ceive hard Mows from their husbands, as John Barclarus 
relates in a remarkable narrative. A German, named 
Jordan, went to Russia, and, pleased with the country, 
settled there and took a Russian wife, whom he loved 
dearly, and to whom he was always kind in everything. 
But she always wore an expression of dissatisfaction, and 
went about with sighs and downcast eyes. The husband 
asked the reason, for he could not understand what was 
wrong. 'Aye/ she said, 'though you love me, you do not 
show me any sign of it.' He embraced her, and begged 
to be told what he had carelessly and unconsciously done 
to hurt her feelings, and to be forgiven, for he would never 
do it again. 'I want nothing/ was the answer, 'but what is 
customary in our country the whip, the real sign of love.' 
When Jordan adopted the custom his wife began to love 
him dearly. 

Similar stories are told by Peter Pcireus, of Erlesund, 
who adds that husbands, immediately after the wedding, 
among other indispensable household articles, provide 
themselves with a whip." 

On page 73 of this remarkable book, the author says 
further: "The celebrated Count of Mirandula, John Picus, 
relates of one of his intimate acquaintances that he was 



PHYSIOLOGICAL FACTS. 37 

an insatiable fellow, but so lazy and incapable of love 
that he was practically impotent until he had been roughly I 
handled. The more he tried to satisfy his desire, the 
heavier the blows he needed, and he could not attain his 
', unless he had boon whipped till the blood came. 
For this purpose ho had a suitable whip made, which was 
placed in vinegar the day before using it. He would give 
this to his companion, and on bended knees beg her not to 
spare him, but to strike blows with it, the heavier the 
better. The good count thought this singular man found 
the pleasure of love in this punishment. Not being a bad 
man in other respects he understood and hated his weak- 
ness." 

Coelius Rhodigin relates a similar story, as does also 
the celebrated jurist, Andreas Tiraquell. In the time of 
the skilful physician, Otten Brunfelsen, there lived in 
Munich, then the capital of the Bavarian electorate, a de- 
bauchee who could never perform his (sexual) duties with- 
out a severe preparatory beating. Thomas Barthelin knew 
a Venetian, who had to be beaten and driven before he 
could have intercourse, just as reluctant Cupid was driven 
by his followers with sprays of hyacinths. & few years 
ago there was in Liibeck a cheesemonger, living on Mill 
Street, who, on a complaint to the authorities of unfaith- 
fulness, was ordered to leave the city. The prostitute with 
whom he had been, went to the judges and begged on his 
behalf, telling how difficult all intercourse had become for 
him. He could do nothing until he had been mercilessly 
beaten. At first the fellow, from shame and to avoid dis- 
grace, would not confess, but after earnest questioning he 
could not deny it There is said to have been a man in 
the Netherlands who was similarly incapable, and could 
do nothing without blows. On the decree of the authori- 
ties, however, he was not only removed from his position, 
but also severely punished. A reliable friend, a physician 
in an important city of the kingdom, related to me how a 
woman of bad character had told a companion, who had 
been in the hospital a short time before, that she, with 



38 PSYCHOPATIIIA SEXUALI8. 

another woman of like character, had been sent to tho 
woods by a man who followed them there, cut rods for 
them, and then exposed his naked buttocks, commanded 
them to belabour him well. They obeyed, and it is easy 
to conjecture what he then did with them. Not only men 
have thus been excited and inflamed to lasciviousness, but 

(also women, that they too might experience greater in- 
tensity of pleasure. 1 For this reason the Roman woman 
had herself whipped and beaten by the lupercis. Thus 

Juvenal writes: 

."" Steriles moriuntur, et illis 
Turgida non prodest condita psycido Lyde: 
Nee prodest agili palinas prtebere Luperco." 

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

In woman the nipple particularly seems to possess this 
quality. Titillatio hujus regionis plays an important part 
in the ars erotica. In his "Typographical : Anatomy," 
1865, Bd. i., p. 552, Hyrtl cites Val. Hildenbrandt, who 
observed a peculiar anomaly of the sexual instinct in a 
girl, which he called suctusstupratio. She had her mammae 
sucked by her lover, and after a while, by constantly pull- 
ing her nipples, she was enabled to suck them herself, an 
act that gave her most intense pleasure. Hyrtl also calls 
attention to the fact that cows sometimes suck the milk 
from their own udders. L. Brunn ("Zeitg. f. Literatur." 
etc., d. Hamburg, Correspondent, 1889, No. 21), in an in- 
teresting article on "Sensuality and Love of Kin," points 
mt how zealously the nursing mother gives herself to the 
cursing of the babe, "for love of the weak, undeveloped, 
helpless being". 

'It is a common proceeding for biased and impotents to have 
themselves whipped. A few years ago mucli noise was made about 
one such amateur who died whilst being whipped by several women 
in a house of prostitution at Moscow. (Ibankoic. Archives d' An- 
tnropol. criminelle. xiv. p. 697). 



PHYSIOLOGICAL FACTS. 'I'.) 

It is easy to assume tliat, l.y the side of the ethical 
motives, tin- fact tliut the sucking may be attend. -d by 
feelings of physical ili-asurr phtys a part The remark of 
I'.ninn. although correct in it>elf, Lut one-sided, that, ac- 
cording to HouZ' iierienee, among the majority of 
animals the relations between mother ami offspring are 
close only during the time of nursim:. ami thereafter in- 
different, also speaks in favour of this assumption. 

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

Under pathological conditions, as is shown by Cham- 
bard, among others, in his thesis for the doctorate, other 
portions of the body (in hysterical persons) about the 
mammae and genitals may attain the significance of "hy- 
peraesthetic" zones. 

In man, physiologically, the only "hyperaesthetic" zone 
is the glans penis and perhaps the skin of the external 
genitals. 

Under pathological conditions the anus may become 
a "hyperaesthetic" area. Thus anal automasturbation, 
which seems to be only too frequent, and passive pederasty 
would be explained. (Cf. Gamier, "Anomalies sexuelles,*' 
Paris, p. 514; A. Moll, "Contrare Sexualempfindung," 3rd 
ed., p. 369; Frigerio, "Archivio di Psichiatria," 1893; 
Cristiani, "Archivio delle Psicopatie sessuali," p. 182, "au- 
topederastia in un alienato, affetto da follia periodica".) 

The psycho-physiological process comprehended in the 
idea of sexual instinct is composed of 

(1) concepts awakened centrally or peripherally; 

(2) the pleasurable feelings associated with them. 
The longing for sexual satisfaction (libido sexualis) 

arises from them. This desire grows stronger constantly 
in proportion as the excitation of the cerebral sphere ac- 
centuates the feeling of pleasure, by appropriate concep- 
tions and activity of the imagination ; and the pleasurable 
sensations are increased to lustful feeling by excitation of 
the erection centre and the consequent hypersemia of the 



40 PSYCHOPATHIA SEXUALIS. 

genitals (entrance of liquor prostaticus into the urethra, 
etc.). 

If circumstances favour the satisfactory performance 
of the sexual act, the ever-increasing desire is gratified ; if, 
however, conditions are unfavourable, inhibition occurs, 
checks the central erectile power, and prevents the sexual 
act. 

To civilised man the ready presence of ideas which 
inhibit sexual desire is of distinct import. The moral 
freedom of the individual, and the decision whether, under 
certain circumstances, excess, and even crime, be committed 
or not, depend, on the one hand, upon the strength of the 
instinctive impulses and the accompanying organic sen- 
sations; on the other, upon the power of the inhibitory 
ideas. Constitution, and especially organic influences, 
have a marked effect upon the instinctive impulses ; educa- 
tion and cultivation of self-control counteract the opposing 
influences. 

The exciting and inhibitory powers are variable quanti- 
ties. For instance, over-indulgence in alcohol is very fatal 
in this respect, since it awakens and increases libido sexu- 
alis, while at the same time it weakens moral resistance. 

THE ACT OF COHABITATION/ 

The essential condition for the man is sufficient erec- 
tion. Anjel ("Arch, fur Psych., viii., H. 2) calls atten- 
tion to the fact that in sexual excitement not alone the erec- 
tion centre is influenced but the nervous excitement is dis- 
tributed over the entire vasomotor system of nerves. The 
proof of this is the turgescence of the organs in the sexual 
act, injection of the conjunctiva, prominence of the eye- 
balls, dilation of the pupils, cardiac palpitation (resulting 
from paralysis of the vasomotor nerves of the heart, which 
arise from the cervical sympathetic, and the resulting dila- 
tion of the cardiac arteries, and the increased stimulation 
of the cardiac ganglia induced by the consequent hype- 

*Cf. Roubavd, " TraiW do Pimpuissance et de la eWrilittf," Paria 
1878. 



Till 41 

r:i mia of the canliae walls). The sexual act is accom- 
panied by a pleasurable feeling, which, in the male, is 
evoked by the passage of semen through the ductus ejacur 
II to tho urethra, in consequence of the sensory stimula- 
tion of the genitals. This pleasurable sensation occurs 
earlier in the male than in the female, grows rapidly in 

iisity up to the moment of commencing ejaculation, 
reaches its acme in the instant of free emission, and disap- 
pears quickly post ejaculationem. 

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

The distinctive event in coitus is ejaculation. This 
function is dependent on a centre (geni to-spinal), which 
Budge has shown to be situated at the level of the fourth 
lumbar vertebra. It is a reflex centre. The stimulus that 
excites it, is the ejection of semen from the vesicula* semi' 
nales into the pars membranacea urethras, a reflex effect 
of stimulation of the glans penis. As soon as the collec- 
tion of semen, with ever-increasing pleasurable sensation, 
has reached a sufficient amount to be effectual as a stimu- 
lus of the ejaculation-centre, this centre acts. The reflex 
motor path lies in the fourth and fifth lumbar nerves. The 
action consists of a convulsive excitation of the bulbo- 
cavernosus muscle (innervated by the third and fourth 
sacral nerves), which forces the semen out. 

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

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



III. ANTHROPOLOGICAL FACTS. 1 

EVERY individual whose sexual development has been 
in accordance with the normal process, represents physical 
and metaphysical attributes which, as experience shows, 
are typical of the sex to which the individual belongs. 
These sexual characteristics are either primary (sexual 
glands and organs of propagation) or secondary. The latter 
are bodily and psychical and are developed only during the 
period of puberty. Now and then cases of precocious as 
well as retarded sexual development are reported. As a 
rule they may be found to be due to abnormal evolutionary 
conditions in them, chiefly in individuals with a heavy neu- 
rotic taint. 

The secondary sexual characteristics differentiate the 
two sexes ; they present the specific male and female types. 
The higher the anthropological development of the race, 
the stronger these contrasts between man and woman, and 
vice versa. 

Important somatic secondary sexual characteristics are, 
the skull, skeleton, pelvis (particularly), facial types, hair, 
larynx (voice), mammae, thighs, etc. 

Important psychical characteristics are sexual con- 
sciousness (i.e., the knowledge of a special sexual indi- 
viduality as man or woman) and a congruous sexual in- 
stinct, from both of which a long series of special features 
and individual peculiarities are evolved, such as psychical 
dispositions, inclinations, etc. 

This differentiation of the sexes and the development 
of sexual types is evidently the result of an infinite suc- 

'Bardach, Die Physiologic als Erfahrungswissenschaft, 1826-40; 
Ploss, Das Weib, 1891, 3d edition; A. Moll, Die contrare Sexualem- 
pfindung, 3d ed. p. 3; Idem, Untersuchungen fiber die Libido sexualis, 
1897-98. 

(42) 



ANTHROPOLOGICAL FACTS. 43 

cession of intermediary stages of evolution. The primary 
stage undoubtedly was bi-sexuality, such as still exists in 
the lowest classes of animal life and also during the first 
months of foetal existence in man. The type of the present 
stage of evolution is mono-sexuality, that is to say, a 
gruous development of the secondary bodily ami psychical 
sexual characteristics belonging to the respective sexual 
glands. 

Observation teaches that the pure type of the man or 
the woman is often enough missed by nature, that is to say 
that certain secondary male characteristics are found in 
woman and vice versa, to wit, men with an inclination for 
female occupations (embroidery, toilet, etc.), and women 
with a decided predilection for manly sports (without the 
inlluencing elements of early education). In both in- 
stances particular cleverness in the inverted and pro- 
nounced awkwardness in the originally proper occupation 
will be noticed. In this class belong castrates, women with 
a bass voice (abnormal development of the larynx), a 
narrow pelvis, a beard, undevelopment of the mammae, 
etc. 

Of special scientific interest are the cases of GyncB- 
comasty, i.e., the development of mammae in the male in- 
dividual, with concomitant inhibited development of the 
testicles during the period of puberty. Galen described and 
named this anomaly. Laurent's monograph 1 on this sub- 
ject is worthy of mention. 

As a rule the gynccomast is slender in build, has a 
smooth face and stunted testicles, Is devoid of the secondary 
sexual characteristics of the man, has but little sexual de- 
sire for the opposite sex, is in short a sort of a man- woman 
of moral and metaphysical inferiority. 

It is a remarkable fact that Gynecomasty only occurs 
in neurotically degenerated families, and must be looked 
upon as the manifestation of an anatomical and functional 

; i oration. 

'Laurent, lea bisexual, Paris. 1894; Idem, de l'here\litfi dec 
gyn&omaates. Annales d. 'hygiene, publ. 1990. 



44 PSTCHOPATHIA 8EXUALIS. 

Castration never produces Gynecomasiy , in which the 
glandular tissue but rarely develops, whilst the nipple bo- 
comes erogenous and capable of erection as in woman. Lac- 
tation has but seldom been observed. With involution even 
the mammae disappear. The true Gynecomast betrays 
signs of effemination the voice is soft and has a high 
pitch, the hair on the mons veneris is that of a woman, the 
skin is soft, the pelvis wide, potency though weak is yet 
heterosexual and libido is wanting. It cannot be denied 
that in these cases through the interruption of evolutionary 
processes the sexual characteristics of the man have been 
replaced by those of the woman and that by this substitu- 
tion the development also of other physical and psychical 
sexual characteristics has been influenced in the sense of 
inversion. The possible combinations, of course, vary 
greatly. 

An interesting and important question now arises, viz. : 
"What determines the development of an individual of 
that definite sexual type which possesses all the character- 
istics of a man, or a woman ?" 

One is tempted to look upon the development of the 
genital glands as the determining factor which may be 
recognized even in the apparently bisexual foetus. For 
the primary sexual characteristics in the form of the sexual 
organs are present and may be with puberty developed into 
the secondary sexual characteristics. 

That the sexual glands are important so far as the sex 
itself is concerned is hardly open to controversy, but they 
are not necessarily the determining factor. For we shall 
see later on that the secondary characteristics (sexual sen- 
sations, attraction by the physical and psychical properties 
of the opposite sex, and the instinct to have sexual inter- 
course with persons of the opposite sex) may be inverted 
even at the very beginning of sexual development. 

Again the experience of gynecologists allows of the fol- 
lowing deductions: Hegar (Nothnagel's Pathologic, xx. 
Part L, p. 371) points out: 

(1) that despite of congenital defects and rudimentary 



ANTHROPOLOGICAL FACTS. 45 

development of the ovaries the feminine type may be thor- 
oughly preserved ; 

(2) that the female sexual characteristics are relatively 
independent of the ovaries as is proved by transverse 
lit rmaphroditism. The old axiom "Propter solum ovari- 
uin raulier est quod est," therefore falls. 

The sex-determining moment tun is unknown. ( 

The form of the sexual glands is therefore not the quali- 
fying element of sex-determination, but we must look 
rather to sexual sensations and the sexual instinct. 

All this directs our attention to the central domains of 
that nervous plexus which dominates the sexual functions 
and which renders intermediary sexual gradations between 
the pure type of man and woman possible, <juite in accord- 
ance with the original bisexual predisposition of the foetus. 
These grades may be due to some interference in the evolu- 
tion of our present mono-sexuality (corresponding physical 
and psychical sexual characteristics) based upon degener- 
ative, especially hereditary degeneration conditions. 

The science of to-day can boast of but little positive 
knowledge about the evolutionary influence which the va- 
rious departments of the sexual apparatus exercise upon 
each other. It is natural that we should study the influ- 
ence exercised by the removal or total loss of the sexual 
glands upon the development or course of the vita sexualis. 
That such an influence exists cannot be doubted; but the 

Mt of the controlling power of ]>oripheral factors might 
largely depend on whether the elimination of the sexual 
glands took place before or after the development of pu- 
berty ; and again due regard must be given to the fact that 
the rise of psychical sexual characteristics may have con- 
siderably preceded physical development. Facts seem to 
prove that with the loss of the genital glands previous to 
puberty the development of somatic and psychical sexual 
characteristics is stunted even unto Asexuality. This is 
true as to the male and female of the human kind as well as 
of domestic animals. 

Matters are different if the injury occurs after this bio- 



46 PBYCIIOPATHIA 8EXUALIS. 

logical phase. Here we are bound to find physical as well 
as psychical characteristics already existing, but their 
further development becomes stunted. The manner in 
which these organs succumb (through illness or surgical 
interference) is of no import, neither is the sex itself. The 
only condition needed is that the development of the sec- 
ondary sexual characteristics had already begun as this is 
plainly dependent upon central spheres. How far then 
sexual development will go, depends chiefly upon the con- 
dition and the developing powers of these central factors; 
whilst its direction is governed by the biological energy of 
these bisexually predisposed centres. 

If the development ran hitherto in heterosexual chan- 
nels, but was lacking in force, the sex experiences simply 
a check ; but if the original bisexual predisposition had not 
yet received a definite sexual direction, and possessed 
strength, sexual characteristics of the opposite sex and 
under circumstances even of an inverted nature may un- 
fold. In most cases there is but a partial development of 
the characteristics of the opposite sex. 

Analogous experiences are made in cases in which the 
sexual glands were lost long after matured puberty. For 
instance, bearded women are frequently found in the post 
mortem, minus ovaries (Diet, de med. et de chirurg. prat, 
art. "ovario"). In a similar manner pheasant hens are 
found with degenerated ovaries, but with the plumage and 
voice of the male. 1 (Discuss, de la societe zoologique de 
Londres). 

It is a well-known fact that many women grow a beard 
after the climacterium and that the voice drops to a lower 
register. If the climax be reached very early and vitality 
remains very strong even another (opposite) sex may be 
developed. See page 247 and cases 128 and 129. 

A smart difference may also be found in eunuchs, ac- 
cording to whether castration took place before or after 

l Cf. Moll, Libido sexualis, p. 335-350, where he gives a large 
number of cases of perverted sexual characteristics, of a physical as 
well as psychical nature, even of sexual inversion. 



ANTIIBOP01 FACT8. 47 

hical pulM-rty. In tin- 1; tlie vita scxualis is 

Ity no menus a Malik ]>:iL r - f->r M-xnal fVrling, and sexual 
in-tinct for the opposite sex are present, although physical 
and psychical sexual characteristics of the male are stunted 
and femininism may take its place. 

In rare cases apparently in strongly developed bi- 
sexuality signs of inverted sexuality may appear (Bedor's 
case in Cadiz of a eunuch with developed mammae). 

These facts are not in favour of the exclusive effects 
exercised by the sexual glands upon the development of the 
vita sexualis, especially of the psychical sexual character- 
istics, which no doubt belong to those central spheres which 
normally come into functional force with arriving puberty 
a^pd thus determine the essential criterion of the sex (sex- 
ual instinct). 



IV. GENERAL PATHOLOGY. 1 

(NEUROLOGICAL AND PSYCHOLOGICAL.) 

ANOMALIES of the sexual functions are met with especially 
in civilised races. This fact is explained in part by the 
frequent abuse of the sexual organs, and in part by the 
circumstance that such functional anomalies are chiefly 
the signs of an inherited diseased condition of the central 
nervous system ("functional signs of degeneration"). 

'Literature: Parent-Duchatelet, " Prostitution dans la ville de 
Paris," 1837. Rosenbautn, " Entstehung der Syphilis," Halle, 1839 
also, " Die Lustseuche im Alterthuin," Halle, 1839. Descuret, " La 
medecine des Passions," Paris, 1800. Caspar, " Klin. Novellen," 
1860. Bastion, " Der Mensch in der Geschichte ". Friedlander, " Sit- 
tengeschichte Roms ". Wiedemeister, " Casarenwahnsinn ". Scherr, 
" Deutsche Kultur und Sittengeschichte," Bd. i., cap. ix. Jeannel, 
" Die Prostitution," dcutsch von Miillcr, Erlangen, 1809. ; v. Krafft, 
" Neue Forschungen auf dcm Gebiete der Psychopathia sexualis," 
2 Aufl., Stuttgart, 1891. Taxil, " La Prostitution conteraporaine," 
Paris, 1884. Frank Lydston, " Philadelph. Med. and Surg. Reports, 
1889. Urquhardt, Journal of Mental Science, Jan. 1891. Antonini, 
" Archiv. di Psichiatria," xxi., 1, 2. Cantat ano, Zcitschr. " La Psi- 
chiatria," v., 2, 3. Krauss, " Psychologic des Verbrechens," 1884. 
Kiernan, "Medic. Standard," Nov., 1889. Delcourt, " Le Vice ft 
Paris," 1889. Lombroso, " L'uomo Delinquente," 2 Aufl., 1878. Toul- 
mouche, " Annal. d'hygiene," 1868. Giraldds et Horteloup, ibidem, 
1876, p. 419. Eulenburg, " Klin. Handb. d. Harn- und Sexualorgane," 
1894, 4 Abthl., p. 36. Moll, " Untersuchungen tiber die Libido sex- 
ualis," 1897; "Archivio delle psicopatie scssuali," Naples (1896) 
volume unico. Tardicu, " Des attentats aux mceurs," 7 e"dit., 1878. 
Emminghaus, " Psychopatliol.," pp. 98, 225, 230, 232. Schiile, "Hand- 
buch der Geisteskrankheiten," p. 114. Marc, "Die Geisteskrankheiten," 
ii., p. 128. v. Krafft, " Lehrb. d. Psychiatric, 6 Aufl. i., p. 77; 
" Lehrb. d. ger. Psychopathol.," 3 Aufl., p. 279 ; " Archiv f. Psychi- 
atric," vii., 2. Morcau, " Des aberrations du sens genesique," Paris, 
1880. Kirn, " Allg. Zeitschr. f. Psychiatric," 39, Heft 2 u. 3. Lom- 
broso, " Geschlechtstrieb und Verbrechen in ihren gcgenseitigen Bozie- 
hungen". (Goltdammer's "Archiv." Bd. 30). Tamotcsky, "Die krank- 
haften Erscheinungcn des Geschlechtsainnes," Berlin, 1886. Ball, " La 

(48) 



SPINAL NEUROSES. 40 

Since the general ivo organs stand in Important func- 
tional relation to the entire nervous system, and especially 
to its psychical and somatic functions, the frequency of 
general neuroses and psychoses arising in sexual (func- 
tional or organic) disturbances, is easy to understand. 

SCHEDULE OF THE SEXUAL NEUROSES. 

I. PERIPHERAL. 

1. Sensory. 
(a) Anaesthesia; (6) Hyperaesthesia ; (c) Neuralgia. 

2. Secretory. 
(a) Aspermia; (6) Polyspennia. 

3. Motor. 
(a) Pollutions (spasm) ; (6) Spermatorrhoea (paralysis) 

II. SPINAL NEUROSES. 
1. Affections of the Erection Centre. 

(a) Irritation (priapism) arises from reflex action of 
peripheral sensory irritants (e.g., gonorrhoea) ; directly, 
from organic irritation of the nerve-tracts leading from 
the brain to the erection centre (spinal disease in the lower 
cervical and upper dorsal regions), or of the centre itself 
(certain poisons) ; or from psychical irritation. 

In the latter case satyriasis exists, t. e. t abnormal dura- 

folie trotique," Paris, 1888. Rtrieux, " Recherches cliniques sur le* 
anomalies de 1'instinct sexuel," Paris, 1888. Hammond, " Sexual 
Impotence," 1889. v. Krafft, " Qber sexuale Penrersionen." Leyden'i 
deutache Klinik, l!01, vi. v. 8chrenk-\otzing, Die Suggestionathera- 
I i- 1S92; also, Zeitach. fUr Hypnotism us, vii., H. 1 & 2, viii., H. 1. 
( I.iti-ntnr.) Moll, die contrftre Sexualempfindung, 3 Aufl. 1889; also. 
Intorsurhunt.'.-n ab. d. Libido sexualis, 1897-98. Hirachfeld, Jahrb. 
f. sexucllc Xwi^-licnstufon, Jahrg. i.-iv. Block, Beitrfige z. Aetiologie 
>lor Paychopathia sexualis, ii., Tlieil, 1903. 

Among mo<lern novelists who dal with the subject of sexual per- 
version tin- French arc most pre-eminent, tn*.; Catullc Mendto, Pffa- 
dan, Lcmonnier, Dubut de la Forett (" L'homme de joie"), Huyt- 
man* ("La baa"), Zola. 



50 PSYCHOPATHIA SEXUALIS. 

tion of erection, with libido sexualis. In reflex or direct 
organic irritation, libido sexualis may be wanting, and the 
priapism may even give rise to disgust. 

(6) Paraylsis arises from the destruction of the centre, 
or of the nerve-tracts (nervi erigentes), in diseases of the 
spinal cord (paralytic impotence). 

A milder form is that of lessened excitability of the 
centre, resulting from over-stimulation (sexual excess, 
especially onanism), or from alcoholic intoxication, abuse 
of bromides, etc. It may also originate from cerebral 
anaesthesia, or that of the external genitals. Cerebral 
hyperaesthesia is more frequent in such cases (increased 
libido sexualis, lust). 

A peculiar form of diminished excitability is shown in 
those cases where the centre responds only to certain stimu- 
li. Thus there are men to whom sexual contact with their 
virtuous wives does not supply the necessary stimulus for 
an erection, but in whom it occurs when the act is at- 
tempted with a prostitute, or in the form of some unnatural 
sexual act. So far as psychical stimuli are concerned, they 
may be inadequate (v. infra, parsesthesia and perversion of 
sexual instinct). 

(c) Inhibition. The erection centre may become in- 
capable of function through cerebral influence. This in- 
hibitory influence is an emotional process (disgust, fear 
of contagion), or fear 1 of impotence. There are men who 
have an unconquerable antipathy to woman, or fear of 
infection, or are suffering with perverse sexual instinct. 
In the latter condition are those neuropathic individuals 
(neurasthenics, hypochondriacs), frequently weakened sex- 
ually (masturbators), who have reason, or think they have, 
to mistrust their sexual power. This idea acts as an in- 

*An interesting instacce of how an imperative conception of 
non-sexual content can exert an influence is related by Magnan 
("Ann. Me"d. Psych.," 1885) : Student, aged twenty-one, strongly pre 
disposed hereditarily, previously a masturbator, constantly struggles 
with the number thirteen as an imperative conception. A oon as 
he attempts coitus the imperative idea inhibits erection and renders 
the act impossible. 



SPINAL NEUROSES. 51 

hibitory impulse, and makes the act with the person of the 
opposite sex temporarily or absolutely impossible. 

(d) Irridihli' H Kikncss. In this condition there is 
abnormal impressionability of the centre, but accompanied 
by rapid diminution of its energy. There may be func- 
lional disturbance of the centre itself, or weakness of the 
innervation through the nervi erigentes; or there may be 
\\cakness of the erector penis muscle. Cases in which erec- 
tion is abortive on account of abnormally early ejaculation, 
form a transition to the following anomalies : 

2. Affections of the Ejaculation Centre. 

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

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

The accompanying pleasurable feeling may be patho- 
logically absent. This occurs in defective men and women 
(anaesthesia, aspermia?), and, further, as a result of dis- 
ease (neurasthenia, hysteria) ; or (in prostitutes) it fol- 
lows over-stimulation and the blunting this induced. The 
intensity of the pleasurable feeling accompanying the 



52 PSYCHOPATH I A 8EXUALIS. 

sexual act depends on the degree of psychical and motor 
excitement. Under pathological conditions this may 
become so pronounced, that the movements of coitus 
assume the character of involuntary convulsive actions, 
and even pass into general convulsions. 

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

III. CEBEBBAI, NEUBOSES. 

(1) Paradoxia, i.e., sexual excitement occurring inde- 
pendently of the period of the physiological processes in 
the generative organs. 

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

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

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

Sub-divisions of parcesthcsia are : 
(a) Sadism,. It consists in this that the association 
of lust and cruelty, which is indicated in the physiological 



CEREBRAL NKURO8ES. .1., 

consciousness, lxcomes strongly market! on a psychically 
aerated basis, ami that this lustful impulse coupled 
with presentations of cruelty rises to the height of power- 
ful affects. This generates a force that seeks to mate- 
rialise these presentations of fancy, and which is ac- 
complished when hvpenesthesia supervenes as a compli- 
cation, or inhibitory moral counter-presentations fail to 
act. 

The quality of sadistic acts is defined by the relative 
potency of the tainted individual. If potent, the impulse 
of the sadist is directed to coitus, coupled with prepar- 
atory, concomitant or consecutive maltreatment, even 
murder, of the consort ("Lust murder"), the latter oc- 
curring chiefly because sensual lust has not been satisfied 
with the consummated coitus. 

If the sadist is psychically or spinally impotent, as an 
equivalent of coitus, there will be noticed strangling, stab- 
bing, flagellating (of women), or under circumstances 
ridiculously silly and mean, acts of violence on the other 
person (symbolical sadism), or also faute de mieux 
on any living and feeling object (whipping of school 
children, recruits, apprentices, cruel acts on animals, 
etc.). 

(6) Masochism is the counterpart of sadism in so far 
as it derives the acme of pleasure from reckless acts of 
violence at the hands of the consort. It springs from the 
impulse to create a situation by means of external phy- 
sical force, which is in accordance with the individual 
psychical and spinal stage of potency, as a preparatory 
and concomitant means to experience the voluptuous sen- 
sation of coitus, to increase it or to make it a substitute 
for cohabitation. In direct ratio of the intensity of the 
perverse instinct and the remaining power of moral and 
aesthetic counter motives, it forms a gradation of the most 
abhorrent and monstrous to the most ludicrous and absurd 
acts (the request for personal castigation, humiliations of 
all sorts, passive flagellation, etc.). 

(c) Fetichism invests imaginary presentations of sep- 



54 PSYCIIOPATHIA BEXUALIS. 

arate parts of the body or portions of raiment of the op- 
posite sex, or even simply pieces of clothing-material, with 
voluptuous sensations. The pathological aspect of this 
manifestation may be deduced from the fact that fetichism 
of parts of the body never stands in direct relation to sex, 
that it concentrates the whole sexual interest in the one 
part abstracted from the entire body. 

As a rule, when the individual fetish is absent coitus 
becomes impossible or can only be managed under the in- 
fluence of the respective imaginary presentation, and even 
then grants no gratification. Its pathological condition is 
strongly accentuated by the circumstance that the fetichist 
does not find gratification in coitus itself, but rather in 
the manipulation of that portion of the body or that object 
which forms the interesting and effective fetich. 

The fetich varies individually and is, no doubt, occa- 
sioned by some incident which determines the relation be- 
tween a single impression and the voluptuous feeling. 

(rf) Antipathic Sexuality is the total absence of sex- 
ual feeling toward the opposite sex. It concentrates all 
sexuality in its own sex. The physical and psychical 
properties of persons of the same sex alone exercise an 
aphrodisic effect and awaken a desire for sexual union. 
It is purely a psychical anomaly, for the sexual instinct 
does in no wise correspond with the primary and second- 
ary physical sexual characteristics. In spite of the fully 
differentiated sexual type, in spite of the normally devel- 
oped and active sexual glands, man is drawn sexually to 
the man, because he has, consciously or otherwise, the in- 
stinct of the female toward him, or vice versa. 

From the clinical and anthropological standpoint this 
abnormal manifestation offers various grades of develop- 
ment. 

(a) In predominant homosexual instinct traces of 
heterosexual (psychical) hermaphrodisia are to be found. 

(6) If there is only inclination to the own sex (ho- 
mosexuality) the secondary physical sexual characteristics 



CEREBRAL NEUROSES. 05 

are normal, but the psychical ones may point to incipient 
inversion. 

(c) The psychical sexual characteristics are inverted, 
i.e., they are shaped in accordance with the existing ab- 
normal sexuality (effeminatio-viraginity). 

(d) Also the secondary physical sexual characteristics 
approach that sex to which the individual, according to his 
instinct, belongs (androgyny-gynandry). 

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

A. Paradoxia. Sexual Instinct Manifesting Itself Inde- 
pendently of Physiological Processes. 

1. Sexual Instinct Manifested in Childhood. 

Every physician conversant with nervous affections and 
diseases incident to childhood is aware of the fact that 
manifestations of sexual instinct may occur in very young 
children. The observations of Ultzmann concerning 
masturbation in childhood 1 are worthy of attention in 
relation to it. It is necessary here to differentiate between 
tlu* numerous cases, in which, as a result of phimosis, 
balanitis, or oxyriris in the rectum or the vagina, young 

l Louycr-Villermay speaks of masturbation in a girl of three 
or four years, and Moreau ("aberrations du sens ge'ne'sique," 2 etlit., 
p. 209) of the same in one of two years. See further Maudtlry, 
' Physiology and Pathology of Mind": flirscluprung ( Kopenhagen ) , 
Berlin, klin. Wochenschr.," 1886, Nr. 38; Lombroto. " The Criminal," 
case* 10, 10, and 21. 



56 PSYCHOPATIIIA SEXUALIS. 

children have itching of the genitals, and experience a 
kind of pleasurable sensation from manipulations occar 
sioned thereby, and thus come to practise masturbation; 
and those cases in which sexual ideas and impulses occur 
in the child as a result of cerebral processes without 
peripheral causes. It is only in this latter class of cases 
that we have to do with premature manifestations of sexual 
instinct In such cases it may always be regarded as an 
accompanying symptom of a neuropsychopathic consti- 
tutional condition. 

A case of Marc's ("Die Geisteskrankheiten," etc., von 
Ideler, i., p. 66) illustrates very well these conditions. The 
subject was a girl of eight years of age, of respectable fam- 
ily, who was devoid of all child-like and moral feelings, and 
had masturbated from her fourth year; at the same time 
she consorted with boys of the age of ten or twelve. She 
had thought of killing her parents, that she might become 
her own mistress and give herself up to pleasure with 
men. 

In these cases of premature manifestation of libido the 
children begin early to masturbate; and, since they are 
greatly predisposed constitutionally, they often sink into 
dementia, or become subjects of severe degenerative neu- 
roses or psychoses. 

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

Zamlaco ("L'Encephale," 1882, Tr. 1, 2) tells the 
disgusting story of two sisters affected with premature 
and perverse sexual desire. The elder R masturbated 



ICE DEAL NEUROSES - PABADOXIA. 57 

at the age of si .'-li.-r.l lewdaess with boys, stole 

wherever she could, , her l'mir-v car-old si.ster into 

masturbation, and at the age of ten was given up to the 
practice of the most revolting vires. Even ferrum candens 
ad clitoridcm had no effect in overcoming the practice, and 
she masturbated with the cassock of a priest while he was 
exhorting her to reformation. 

Cf. also Magnan, "Lectures on Psychiatry," (in Ger- 
man by Mobius, vols. ii. and iii., p. 27), giving the case of 
premature and preverse vita sexualis in a girl of twelve 
with hereditary taint. Other cases, ibidem p. 120-121. 

2. Re-awakening of Sexual Instinct in Old Age.* 

Cases in which the sexual instinct prevails until a 
great age are rare. "Senectus non quidem annis sed 
viribus magis tcstimatur" (Zittmann). Oestcrlen (Masch- 
Tca, Handb.," iii., p. 18) mentions the case of a man aged 
eighty-three, who was sentenced to three years' imprison- 
ment by a court in Wiirtemberg on account of sexual mis- 
demeanours. Unfortunately nothing is said of the nature 
of the crime or of the mental condition of the criminal. 

The manifestation of sexual instinct in old age is not 
in itself pathological. 

Presumption of pathological conditions must neces- 
sarily be entertained when the individual is decrepit and 
his sexual life has already long become extinct ; and when 
the impulse, in a man whose sexual needs were in his early 
life, perhaps, not very marked, manifests itself with 
greater strength, and strives for even perverse satisfaction 
in a shameless and impulsive manner. 

In such cases a presumption of pathological condi- 
tions suggests itself at once. Medical science recognises 
the fact that such an impulse depends upon the morbid 
alterations of the brain which lead to senile dementia. 
This abnormal manifestation of sexual life may be the 



't'f. Kirn, " Zeitachr. f. Psych.," Bd. T^JT Lcgrand du Baulle. 
"Annal. d'hyg.," Oct., 1868. 



58 PSYCHOPATH I A SKXUALIS. 

precursor of senile dementia, and make its appearance 
even long before there are any well-defined manifesta- 
tions of intellectual weakness. The attentive and expe- 
rienced observer will always be able to detect in this 
prodromal stage an alteration of character in pejus, and 
a deterioration of the moral sense accompanying the 
peculiar sexual manifestation. 

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

The annals of legal medicine distinguish as such, ex- 
hibition of the genitals, 1 lustful handling of the genitals 
of children, 2 inducing them to perform manustupration on 
the seducer, and performing masturbation 8 or flagellation 
on the victim. 

In this stage the intellect may still be sufficiently in- 
tact to allow avoidance of publicity and discovery, while 
the moral sense is too far gone to allow consideration of 
the moral significance of the act, and resistance to the 
impulse. With the progress of dementia, these acts are 
more and more shamelessly committed. Then care on 
account of defective sexual power disappears, and adults 
also become the objects of the senile passion; but the 
defective sexual power necessitates equivalents for coitus. 
Not infrequently sodomy results, and, as Tarnowsky (op. 
cit., p. 77) points out, in the sexual act performed with 

'Cases, vide Lastgue; " Les exhibitionistes," Union m&licale, 
1871: 1st May. 

'Legrand du Saulle, " La folie devant les tribunaux," p. 530. 

Kirn, Maschka's " Handb. d. ger. Med." pp. 373, 374; " Allg. 
Zeitschrift f. Psychiatric," Bd. xxxix., p. 220. 



CEREBRAL NEUROSES PABADOZIA. 59 

geese, chickens, etc., the sight of the dying animal and 
its death-struggles at the time of coitus afford complete 
gratification. The perverse sexual acts with adults are 
piite as horrible, and may be explained psychologically 
in the same way. 

Case 49, in the author's "Text-Book of Legal Psycho- 
pathology," second edition, p. 161, demonstrates how 
enormously increased sexual lust may be during the 
course of senile dementia. Quum scnex libidinosus ger- 
manam suam /ilium cemulatione motus necaret et adspeetu 
pectoris scissi puellcB moribundce delectareiur. 

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

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

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

It may be seen from a reading of Schopenhauer? that, 
as a result of senile dementia, the abnormally excited and 
perverse instinct may be directed exclusively to persons 
of the same sex (v. infra). Gratification is obtained by 

1 "Die Welt als Wille und Vorstellung," 1859, Bd. ii., p. 41 et teq. 



60 PSYCIIOPATUIA 8EXUALIS. 

passive pederasty, or, as I ascertained in the following 
case, by mutual masturbation : 

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

The patient's temper, always peculiar and quick, had 
for years been growing more violent. He had become 
exceedingly suspicious, and slight opposition to his wishes 
induced attacks of anger which turned at times into actual 
raving, when he would raise his hand even against his wife. 
For a year there had been unmistakable signs of incipient 
senile dementia. The patient had become forgetful, local- 
ised past events incorrectly, and had false ideas of time. 
For fourteen months it was noticed that he manifested af- 
fection for certain male servants, especially for a garden- 
er's boy. Otherwise rude and overbearing to servants, he 
surfeited his favourite with favours and presents, and com- 
manded his family and his house officials to treat the boy 
with the greatest respect. The aged patient awaited the 
hour of rendezvous in true sexual excitement. He sent his 
family away, that he might be with his favourite undis- 
turbed, and remained shut up with him for hours; and 
when the doors were opened again, he was found lying on 
the bed exhausted. Besides this object of his passion, the 
patient had intercourse episodically with other servants. 
It is certain that he enticed them, asked them for kisses, 
exhibited himself, allowed manipulation ad gcnilulia, and 
practised mutual masturbation. By these practices abso- 



CEREBRAL NEUROSES PARADOX!*. 61 

lute demoralisation was brought about in the household. 
The family was powerless; for any opposition caused 
violent outbreaks of anger and even threats against his 
relatives. The patient was completely without apprecia- 
tion of his perverse sexual acts; and therefore the only 
course left to the afflicted family was to remove all author- 
ity from his hands and place him in an asylum. No erotic 
inclination towards the opposite sex was observed, though 
tin- patient occupied a sleeping-apartment with his wife. 
With reference to the perverse sexuality and the defective 
moral sense of this unfortunate man, it is worthy of note 
that he questioned the servants of his daughter-in-law as 
to whether she had lovers. 

B. Anaesthesia Sexualis (Absence of Sexual Feeling). 

1. As a Congenital Anomaly. 

Only those cases can be regarded as unquestionable 
examples of absence of sexual instinct dependent on cere- 
bral causes, in which, in spite of generative organs nor- 
mally developed and the performance of their functions 
(secretion of semen, menstruation), the corresponding 
emotions of sexual life are absolutely wanting. These func- 
tionally sexless individuals are rare cases, and, indeed, 
always persons having degenerative defects, in whom other 
functional cerebral disturbances, states of psychical degen- 
eration, and even anatomical signs of degeneration, may be 
observed. 

Case 3. K., age 29, civil servant, consulted me on 
account of his abnormal sexual condition. Being without 
relatives he wanted to marry, but only on rational grounds. 
Iff elaime.i to have never experienced a sensual emotion, 
.al life was known to him only from what he had 
heard other men say about it or from what he had read in 
erotic novels, which, however, had never made any im- 
pression upon him. He had no dislike for the 



62 PSYCHOPATIIIA 8EXUALI8. 

opposite sex, or special inclination towards his own BOX, 
and had never masturbated. Since his seventeenth year 
he had at intervals nocturnal pollutions, but without con- 
comitant lascivious dreams. Erections occurred in the 
morning when waking which, however, disappeared at once 
after emptying the bladder. Excepting this want of sexual 
instinct K. considered himself quite normal. No psychical 
defects could be detected. He was fond of solitude, but 
of a frigid nature, without interest in the arts or the beau- 
tiful, but a highly efficient and esteemed official. 

Case 4. W., age 25, merchant, claimed to be un- 
tainted, never had a severe illness, never had masturbated, 
siuce his nineteenth year had but rarely pollutions, mostly 
without sensual dreams. Since his twenty-first year coitus 
rarissimus, actus quasi masturbatorius, in corpore feminae, 
sine ulla voluptate. W. declared to have made these at- 
tempts solely through curiosity, and soon gave them up 
altogether as desire, gratification, and ultimately even 
erection were wanting. He never had any leaning towards 
his own sex. His deficiency did not seem to cause him any 
worry. In the ethical and sesthetical field there were no ab- 
normal manifestations. 

Case 5. P., aged thirty-six, common labourer, was 
received at my clinic in the beginning of November on 
account of spastic spinal paralysis. He declared he came 
of a healthy family. A stutterer from his youth. Cranium 
microcephalic (cf. 53 cm.). Patient somewhat imbecile. 
He was never sociable, never had a sexual emotion. The 
sight of a woman never had anything enticing for him. 
He never had a desire to masturbate. Erections frequent 
but only on awakening in the morning with a full bladder, 
and without a trace of sexual feeling. Pollutions very 
infrequent about once a year, in sleep and usually 
while dreaming that he was concerned with a female. 
These dreams, however, as his dreams in general, were not 
markedly erotic. He said the act of pollution was not ac- 



CEBEBRA1 M I IC08E8 - AN.ESTIIIMA SKXUAU8. 63 



lv any pleasurable sensation. Patient did 
!< < 1 tliis absence of sexual sensation. He gave tin; 

assurance that his brother, aged thirty-four, was in exactly 

the same sexual condition as himself, and made it seem 
able that a sister, aged twenty-one, was in a similar 
. A younger In-other, he said, was sexually normal. 

The examination <>f his genitals revealed nothing abnormal 
vd phimosis. 
Further cases see V. Krafil, "Arbeiten," iv., p. 178, 

179. 

Hammond ("Sexual Impotence"), even with his wide 
experience, reports only the following three cases of anaes- 
thesia sexualis : 

Case 6. Mr. W., aged thirty-three; strong, healthy, 
with normal genitals. He had never experienced libido, 
and had vainly sought to awaken his defective sexual in* 
stinct by means of obscene stories and intercourse with 
prostitutes. On the occasion of such attempts he experi- 
enced only disgust, with even a feeling of nausea, and 
became nervously and mentally exhausted. Only once, 
when he forced the situation, did he have a transitory erec- 
tion. W. had never masturbated, and had had pollutions 
about once every two months from his seventeenth year. 
Important interests demanded that he should marry. He 
had no horror femince, and longed for a home and a wife, 
but felt that he was incapable of the sexual act He 
died unmarried in the American Civil War. 

Case 7. X., aged twenty-seven, genitals normal; 
never felt libido. Mechanical or thermic stimuli easily in- 
duced erection, but libido sexualis was regularly replaced 
by a desire for alcoholic indulgence. Such excesses also 
induced erections, and he then sometimes masturbated. 
He had a disinclination for women and a loathing of 
e"it us. If, with an erection, he made an attempt at 
enitus, it disappeared at once. Death in coma during an 
attack of cerebral hypersemia. 



64 PBYCIIOPATHIA 8EXUALJS. 

Case 8. Mrs. O., normally developed, healthy, men- 
struated regularly; aged thirty-five; fifteen years marri' <1. 
She never experienced libido, and never had any erotic 
excitement in sexual intercourse with her husband. She 
was not averse to coitus, and sometimes seemed to experi- 
ence pleasure in it, but she never had a wish for repetition 
of cohabitation. 

In connection with such genuine cases of anaesthesia, 1 
there should be considered other cases in which the mental 
side of the vita sexualis is a blank leaf in the life of 
the individual, but where elementary sexual sensations 
manifest themselves at least in masturbation (cf. the tran- 
sitional case 7). According to Magnan's ingenious classi- 
fication which, however, is not strictly correct and 
somewhat too dogmatic in such cases the sexual life is 
so limited as to be designated spinal. Possibly in some 
such cases there exists virtually a mental side of the vita 
sexualis, but it is very weak, and undermined by mastur- 
bation before it attains development. These represent 
the transitional cases from the congenital to the acquired 
(psychical) anaesthesia sexualis. This danger threatens 
many masturbators of vitiated constitution. It is psycho- 
logically interesting that when the sexual element is early 
vitiated, then an ethical defect is manifested. 

The two following cases, previously published by me 
in the "Archiv fur Psychiatric," vii., are given here as 
illustrations worthy of consideration: 

"No doubt Swift's, the great satirist, was a case of anaesthesia 
sexualis. Adolf Stern says in his biography of Swift (" Aus dem 18. 
Jahrhundert; Biographische Bilder und Skizzen," Leipzig, 1874) : 
" It seems that he was totally devoid of the sensual elements of love ; 
hia candid cynicism, found in many of his letters, is almost definite 
proof of this. Whoever properly grasps certain passages in ' Gulli- 
ver's Travels,' and especially the account which Swift gives of the 
marriage and progeny of the Houyhnhorses, the noble steeds of the 
last chapters, can scarcely doubt that this great satirist abhorred 
marriage, and never felt the impulse which draws the sexes together.'' 
Practically speaking, the enigmatical side of Swift's character, and 
several of his works, viz., "Diary to Stella" and "Gulliver's Travels." 
can only be understood if Swift is considered sexually anaesthetic. 



CEKEB&AL NEUROSES ANESTHESIA SKXUAJJ8. 65 

Case 9. F. J., aged nineteen, student; mother waa 
nervous, sister epileptic. At the age of four, acute braiu 
affection, lasting two weeks. As a child he was not 
affectionate, and was cold towards his parents ; as a student 
he was peculiar, retiring, preoccupied with self, and given 
to much reading. Well endowed mentally. Masturbation 
from fifteenth year. Eccentric after puberty, with con- 
tinual vacillation between religious enthusiasm and ma- 
terialism now studying theology, now natural sciences. 
At the university his fellow-students took him for a fool. 
He read Jean Paul almost exclusively, and wasted his 
time. Absolute absence of sexual feeling toward the op- 
posite sex. Once he indulged in intercourse, experienced 
no sexual feeling in the act, found coitus absurd, and did 
not repeat it. Without any emotional cause whatever, he 
often had a thought of suicide. He made it the subject of 
a philosophical dissertation, in which he contended that it 
was, like masturbation, a justifiable act. After repeated 
experiments which he made on himself with various poi- 
sons, he attempted suicide with fifty-seven grains of opium, 
but he was saved and sent to an asylum. 

Patient was destitute of moral and social feelings. Hia 
writings disclosed incredible frivolity and vulgarity. His 
knowledge was of a wide range, but his logic peculiarly 
distorted. There was no trace of emotionality. He treated 
everything (even the sublime) with incomparable cynicism 
and irony. He pleaded for the justification of suicide with 
false philosophical premises and conclusions, and, as one 
would speak of the most indifferent affair, he declared that 
he intended to accomplish it. He regretted that his pen- 
knife had been taken from him. If he had it, he would 
open his veins as Seneca did in the bath. At one time 
a friend had given him instead of a poison as he sup- 
posed, a cathartic. Instead of sending him to the other 
world, it sent him to the water-closet Only the Great 
Operator could eradicate his foolish and fatal idea with the 
scythe of death, etc. 

The patient had a large, rhombic, distorted skull, the 

5 



66 PSYCHOPATHIA SEXUALI8. 

left half of the forehead being flatter than the right. The 
occiput was very straight. Ears far back, widely project- 
ing, and the external meatus formed a narrow slit. Genitals 
very lax ; testicles unusually soft and small. 

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

Case 10. E., aged thirty, journeyman painter, was 
arrested while trying to cut off the scrotum of a boy he 
had caught in the woods. He gave as a motive for this 
act that he wished to cut it off in order that the world 
should not multiply. Often in his youth, with like 
purpose, he had cut into his own genitals. 

It is impossible to learn anything of his ancestry. 
From his childhood he was mentally abnormal, violent, 
never lively, very irritable, irascible, selfish and weak 
minded. He hated women, loved solitude, and read much. 
He sometimes laughed to himself and did silly things. 
Of late years his hatred of women had increased, especi "y 
of those that were pregnant, they being responsible for 
the misery of the world. He also hated children, and 



CEREBRAL NEUROSES ANAESTHESIA 8EXUALIS. 67 

cursed his father. Ho entertained communistic ideas, 
and berated the rich aiid the ministry and God, who 
had allowed him to come into the world so poor, lie 
declared that it would be better to castrate all children 
than to allow others to come into the world fated only to 
endure poverty and misery. He had always had the in- 
tention, from his fifteenth year, of castrating himself, in 
order that he might have no part in increasing unhappiness 
and adding to the number of men. lie hated the female 
sex because it was a means of procreation. Only twice in 
his life had he allowed women to practise manustupration 
on him, and, with the exception of this he had never had 
anything to do with them. Occasionally he had sexual 
desire, but never for a natural gratification of it When 
nature did not help him, he occasionally helped himself 
by means of masturbation. 

He was a powerful, muscular man. The formation of 
the genitals presented no abnormality. On the scrotum 
and penis were numerous scars, the results of his attempts 
at self-emasculation, which, he asserted, were not carried 
out on account of pain. Genu valgum of right leg. No 
evidence of onanism could be discovered. He was moody, 
defiant, irritable. Social feelings were absolutely foreign 
to him. With the exception of imperfect sleep and fre- 
quent headaches, there were no functional disturbances. 

From cases of this kind, depending on cerebral causes, 
there must be distinguished others in which the absence 
of function arises from an absence of malformation of the 
generative organs, as in certain hermaphrodites, idiots and 
cretins. 

Ultzmann's 1 observations show that anaesthesia sexualis 
is not caused simply by axpcrmia. He shows that even in 
congenital aspermia the vita sexualis and sexual power 
may be entirely satisfying; an additional proof that de- 

'" Ueber mannliche Sterilitlt," Wiener med. Presse, 1878, Nr. 1. 
' Ueber Potentia generandi et coSundi," Wiener Klinik, 1885, Heft 1, 
S. 5. 



68 PSYCIIOPATHIA SEXUALIS. 

fective libido db origine is to be sought for iii cerebral con- 
ditions. 

The naturae frigidae of Zacchias are examples of a 
milder form of anaesthesia. They are met with more fre- 
quently in women than in men. The characteristic signs of 
this anomaly are : slight inclination to sexual intercourse, or 
pronounced disinclination to coitus without sexual equiva- 
lent, and failure of corresponding psychical, pleasurable 
excitation during coitus, which is indulged in simply from 
sense of duty. I have often had occasion to hear com- 
plaints from husbands about this. In such cases the wivoa 
have always proved to be neuropathic ab origine. Some 
were at the same time hysterical. 

2. Acquired Anasthesia. 

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



CEKEHRAL NEUROSES HTPK&S8THE8IA. 69 

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

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

C. Hyperatsthesia (Abnormally Increased Sexual Desire). 

One of the most important anomalies of sexual life is 
an abnormal presence of sexual sensations and presenta- 
tions from which necessarily arise frequent and violent 
impulses for sexual gratification. No doubt it is the out- 
come of the education, or rather the breeding of many 
centuries that the sexual instinct which is indispensable 
for the preservation of the race and therefore congenital 
in every normal individual, is not the predominant key 
in the chord of human sentiments, but rather forms epi- 
sodes in the physical and psychical life of cultured man 
with periods of ebb and flood tide; is the generating ele- 
ment of higher and nobler social and moral sentiments, 
and leaves room for other spheres of activity, the object 
of which is the furtherance of interests affecting the indi- 
vidual as well as society at large. 



70 PSYCHOPATHIA SEXUALIS. 

It is, moreover, a statute of the moral code and of 
the common law that civilised man satisfy his sexual in- 
stinct only within the barriers (established in the interests 
of the community) of modesty and morality, and that 
man should, under all circumstances, control this instinct 
so soon as it comes in conflict with the altruistic demands 
of society. 

If the normally constituted civilised individual were 
unable to comply with this rule, family and state would 
cease to exist as the foundations of a moral, lawful com- 
munity. 

Practically speaking the sexual instinct never develops 
in the normal, sane individual that has not been deprived 
by intoxication (alcohol, etc.) of his reason or good senses, 
to such an extent that it permeates all this thoughts and 
feelings, allowing of no other aims in life, tumultuously, 
and in rut-like fashion demanding gratification without 
granting the possibility of moral and righteous counter-pre- 
sentations, and resolving itself into an impulsive, insatiable 
succession of sexual enjoyments. 

For the latter would at once betray a pathological con- 
dition, which episodically might produce such a high 
degree of sexual affection, that self-consciousness becomes 
clouded, sanity impaired, and a true psychical calamity 
established which would lead to an irresistible impulse to 
commit sexual acts of violence. 

Such psycho-sexual extravagances have been but little 
probed scientifically, though they are of great importance 
for the criminal forum since the individual so affected 
can scarcely be held mentally responsible. It is fortunate 
for society and for the criminal doctor, who is called upon 
to make the diagnosis, that these cases, in which irresistible 
hypersensuality leads to the gravest and indisputably path- 
ological sexual aberrations, are only encountered in that 
category of human beings whom we class among the de- 
generates infected with hereditary taint. 

Alas, their number is by no means small in modern so- 
ciety, which shows many marks of physical and psychical 



CEREBRAL NEUROSES H YPER.E8THKBIA. 7l 



degeneration, especially in the centres of culture and re- 
finement. 

Coupled with perversions of sexual life and sexual im- 
becility springing from the same degenerated soil, often 
with the aiding influence of alcohol, the most monstrous and 
horrible sexual excesses (cf. Sadism) are perpetrated 
which would disgrace humanity at large, could they be 
committed by normal man. 

The commission of these atrocious acts by degenerated 
and partially defective individuals is the outcome of an ir- 
resistible impulse or delirium. The mechanism of these 
actions is indeed the property of psychical degeneration. 

The special act follows the direction given by the her- 
editary or acquired impulse and in many instances is de- 
termined by the relative potency or impotence of the agent. 
This pathological sexuality is a dreadful scourge for ita 
victim, for he is in constant danger of violating the laws of 
the state and of morality, of losing his honor, his freedom 
and even his life. Alcohol and prolonged sexual abstinence 
are apt to produce in such degenerated persons at any time 
powerful sexual affections. 

Besides these graver manifestations of pathological sex- 
uality we find also milder and more numerous gradations 
of hypersexuality, to the lowest of which, perhaps, belong 
those individuals who, impecunious though they be whilst 
sexually potent, move in the better classes of society and 
have no other aim in life than to gratify their sexual de- 
sires. These are not afflicted with a pathological sexual 
condition, know to control themselves in a measure, observe 
the acknowledged rules of decency, do not compromise 
themselves, but allow no opportunity to pass by without 
utilizing it to the utmost. Another grade are the apron-} 
hunters, the Don Juans, whose whole existence is an end- 
less chain of sensual enjoyment and whose blunted moral I 
sense does not keep them from seduction, adultery and 
even incest. 

Case 11. P., Caretaker, age 53; married; no evi- 



72 PSTCHOPATHIA SEXUALIS. 

dence of hereditary taint; no epileptic antecedents; mod- 
erate drinker ; no sign of senium precox ; appeared, accord- 
ing to the statement of his wife during the whole time of 
their married life covering a period of 28 years, hypersex- 
ual, extremely libidinous, ever potent, in fact insatiable in 
his marital relations. During coitus he became quite bestial 
and wild, trembled all over with excitement and panted 
heavily. This nauseated the wife who by nature was rather 
frigid and rendered the discharge of her conjugal duty a 
heavy burden. He worried her with his jealous behaviour, 
but he himself soon after the marriage seduced his wife's 
sister, an innocent girl, and had a child by her. In 1873 he 
took mother and child to his home. He now had two 
women, but gave preference to the sister-in-law, which the 
wife tolerated as a lesser evil. As years went by his libido 
increased, though his potency decreased. He often resorted 
to masturbation even immediately after coitus, and with- 
out in the least minding the presence of the women. Since 
1892 he committed immoral acts with a girl of 16 years, 
who was his ward, i.e., puellam coagere solebat, ut eum 
masturbaret. He even tried to force her at the point of a 
revolver to have coitus with him. The same attempts he 
made on his own illegitimate child, so that both often had 
to be protected from him. At the clinic he was quiet and 
well-behaved. His excuse was hypersexuality. He ac- 
knowledged the wrongfulness of his actions, but said ho 
could not help himself. The frigidity of the wife had 
forced him to commit adultery. There was no disturbance 
of his mental faculties, but the ethical elements were ut- 
terly wanting. He had several epileptic fits but no signs 
of degeneration. 

We must concede that the degree of libido sexualis is 
subject to rise and fall in the untainted individual, accord- 
ing to age, constitutional conditions, mode of life and the 
various influences of health and illness of the body, etc. 
Sexual desire rapidly increases after puberty, until it 
reaches a marked degree ; it is strongest from the twentieth 
to the fortieth year, and then slowly decreases. Married 



CEREBRAL NEUBO8E8 HYPEBJE8THK8IA. 

life seems to preserve and control the instinct v Sexual in- 
tercourse with many persons increases the desire. 

Since woman has less sexual need than man, a pre- 
dominating sexual desire in her arouses a suspicion of its 
pathological significance. Those living in large cities, who 
are constantly reminded of sexual things and incited to 
sexual enjoyment, certainly have more sexual desire than 
those living in the country. A dissipated, luxurious, se- 
dentary manner of life, preponderance of animal food, and 
the consumption of spirits, spices, etc., have a stimulating 
influence on the sexual life. In woman the sexual inclina- 
tion is post-menstrually increased. At this period, in neu- 
ropathic women, the excitement may reach a pathological 
degree. 

The great libido of consumptives is remarkable, even 
during the very latest stages of the disease. Sexual hyper- 
testhesia is in my opinion a functional manifestation of de- 
generation. Whether it may occur as an acquired, acci- 
dental, episodical condition in the untainted is worthy of 
scientific research. Excessive libido may be peripherally 
or centrally induced. The former manner of origin is the 
more infrequent. Pruritus and eczema of the genitals may 
cause it, and likewise certain substances, like cantharides, 
which powerfully stimulate sexual desire. 

Not infrequently in women at the climacteric period 
sexual excitement occurs, occasioned by pruritus, and also 
in cases where there is neuropathic taint. Magnan ("An- 
nales medico-psychol.," 1885, p. 157) reports the case of 
a lady who was afflicted in the mornings with attacks of 
frightful erethismus genitalis, and the case of a man aged 
fifty-five who was tormented at night by unbearable pri- 
apism. In each case there was a neurosis. 

The central origin of sexual excitement can often be 
traced 1 in persons having neurotic taint or hysteria and in 

'In individuals in whom intense sexual hyperwstheaia is asso- 
ciated with acquired irritable weakness of the sexual apparatus, it 
happens that simply at the sight of a pleasing female figure, without 
peripheral irritation of the genitals, the psycho-sexual centre may 
excite into action not only the mechanism of the erection, but alM 



74 PSYCIIOPATHIA SEXUALIS. 

conditions of psychical exaltation. When the cortex and 
the psycho-sexual centre are in a condition of hypenesthesui 
(abnormal excitability of the imagination, increased ease 
of association), not only visual and tactile impressions, but 
also auditory and olfactory sensations, may be sufficient 
to call up lascivious conceptions. 

Magnan (op. cit.) reports the case of a young woman 
who hud an increasing sexual desire from puberty, and 
satisfied it by masturbation. Gradually she grew to l>e- 
come sexually excited at the sight of any man pleasing to 
her ; and, since she was unable to control herself, she would 
sometimes shut herself up in a room until the storm had 
passed. At last she gave herself up to men of her 
choice, that she might get rest from her tormenting desire, 
but neither coitus nor masturbation brought relief, and she 
went to an asylum. 

The case of a mother of five children is added, who, in 
despair about her inordinate sexual impulse, attempted 
suicide, and then sought an asylum. There her condition 
improved, but she never trusted herself to leave it. 

There are several illustrative cases in men and women 
in the author's article, "On Certain Anomalies of Sexual 
Instinct," cases 6 and 7 ("Archiv fur Psychiatrie," vii., 

2). 

The two following cases show how powerful, dangerous 
and painful sexual hypencsthesia may become in those af- 
flicted with this anomaly : 

Case 12. Hypercesthesia sexualis. Masturbatio 
coram discipulis in schola. 

Z., 36 years of age, father of seven children, president 

that of ejaculation. For such individuals, all that is necessary to 
induce orgasm or even ejaculation, is to imagine themselves in a 
sexual situation with a female that sits opposite them in a railway 
carriage or a drtiwincr-room. Hammond (op. cit., p. 40) describee 
several cases of this kind that came to him for treatment or subse- 
quent impotence, and he mentions that these individuals used the 
tc-rm " ideal coitus " for the act. Dr. Moll, of Berlin, told me of a 
similar case, and in this instance the same designation was chosen 
for the act. 



CEREBRAL NEUROSES H YPKR.E8THE8IA. 75 

of school, confessed that he committed masturbation in 
school whilst sitting at his desk which, however, pn -venn ! 
the act being seen hy tin- pupils as it was encased all 
arouii(i. Ho drank more than usual on the preceding 
ini:, had been provoked to an^i-r before going to school, 
and had ln-en excited by the sight of some very pretty girls 
attending his lecture. This produced a violent erection 
and led to masturbation. At'u r the act he became conscious 
at once of his compromising position, but the thought that 
the pupils had not noticed his excitement had helped him to 
regain self-possession. 

1 1 is previous conduct being without a blemish, the au- 
thorities suspected a pathological condition and insisted 
upon a medical examination by the author. 

The facts elicited were the following: Z. came from 
healthy parents. Two close relations were epiletics. At 
the age of 13 Z. suffered from a severe concussion of tlio 
brain, which produced an acute dementia lasting three 
weeks. Since that time frequent spells of irritability and 
intolerance of alcohol. 

At the age of 16 awakening of vita sexualis with ab- 
normal vigor and pronounced sexual emotions. Lascivious 
literature and pictures of women produced satisfying ejacu- 
lation. From the age of 18 onward he indulged now and 
then in coitus. But as a rule the touching of a woman's 
arm sufficed to produce orgasm and ejaculation. He mar- 
ried at the age of 24 and indulged in coitus three or four 
times daily, and besides practised masturbation, coupled 
with ideal coitus. 

(See footnote on page 73). 

With the birth of his fourth child (three years ago) Z. 
was forced, for economical reasons, to restrain himself from 
sexual intercourse as he despised anticonceptional means. 
Tactus feminarum, which produced pollutio diurna, proved 
unsatisfactory as did also automasturbation. He suffered 
much from incessant sexual excitement, which at the end 
of periods of six weeks became so strong that it affected 
his mind and will power sensibly. Only masturbation 



76 PSYCHOPATHIA 8EXITALI8. 

kept him from committing sexual violence on women. Ho 
became very irritable and easily flew into passion, yelled 
and raged about the house and even beat wife and children. 

It often happened now that at the height of such a spell 
he would fall over and become unconscious, rattling from 
the throat in a peculiar manner. After a few minutes he 
would recover again with complete amnesia of what had 
happened. An attack of this kind had, however, not pre- 
ceded the act with which he now stood charged, but had 
occurred three days afterward. 

Z. was an intelligent, decent man, most penitent and 
filled with shame. 

He understood quite well that he could no longer teach 
at a girl's school and bewailed his unnatural, unbridled 
sensuality. 

He made no attempt to in any way excuse his action, 
but pointed out that his nervous system had been thor- 
oughly shaken of late by libido insatiata and overwork (les- 
sons up to twelve hours daily). 

Vegetative functions normal ; parietal protuberance of 
cranium ; genitals large, lax, but normal. 

Patellar reflexes much exaggerated. 

In my report I pointed out that Z. suffered from a 
pathologically exaggerated vita sexualis and most probably 
from epilepsy, and had committed the act whilst subject to 
a sexual affection which depressed the power of self-con- 
trol to a minimum. 

Further legal proceedings were withdrawn. Z. was 
pensioned off. 

Case 13. On llth July, 1884, R., aged thirty-three, 
servant, was admitted suffering with paranoia persecutoria 
and neurasthenia sexualis. Mother was neuropathic ; father 
died of spinal disease. From childhood he had an intense 
sexual desire, of which he became conscious as early as his 
sixth year. From this age, masturbation; from fifteenth 
year, faute de mieux, pederasty ; occasionally, sodomitic in- 
dulgences. Later, dbusus coitus in matrimonio cum uxore. 



CEBEBRAL NEUROSES - HYPEILK8THE8IA. 77 



Now and then even perverse impulse to commit 
and t<> administer cantharides to his wife, because her 
do did not equal his own. His wife died after a short 
period of married life. Patient's circumstances became 
straitened, and he had no means to indulge himself sexu- 
ally. Then masturbation again ; employment of lingua 
canis to induce ejaculation. At times, priapism and con- 
ditions approaching satyriasis. He was then driven to 
masturbate in order to avoid rape. With gradually pre- 
dominating sexual neurasthenia and hypochondria came 
beneficial diminution of libido nimia. 

A particular species of hypercesthesia sexualis may be 
found in females in whom a most impulsive desire for sexu- 
al intercourse with certain men imperatively demands 
gratification. No doubt "unrequited love" for another man 
may often affect the married woman who does not either 
psychically or physically (impotentia mariti) experience 
connubial satisfaction; but the normal, untainted wife 
guided by ethical reasons knows how to conquer herself. 

Of course, pathological conditions change the situation. 

Fetichism must here be considered. Sexual impulse is 
overpowering, at times periodically recurrent. The very 
attempt to overcome it produces most painful attacks of 
worry and anxiety. This pathological want becomes so 
powerful that all considerations of shame, conventionality 
and womanly honour simply disappear, and it reveals itself 
in the most shameless manner even to the husband, whilst 
the normal woman, endowed with full moral consciousness, 
knows how to conceal the terrible secret 

Magnan ("Psychiatr. Vorlesungen") quotes two strik- 
ing instances from his own experience. One is specially 
instructive. A young woman, mother of three children, 
with a blameless past, but daughter of a lunatic, tells her 
husband one day openly that she is in love with a certain 
young man and that she would kill herself if her intimate 
relations with him were interfered with. She begs per- 
mission to live with him for six months in order to quench 



78 PSTCHOPATHIA SEXUALIS. 

the fire of her passion, when she would return to her 
family again. Husband and children have no place in her 
heart with her present love. The husband took her to a 
foreign country and placed her there under medical treat- 
ment. 

This pathological love of married women for other men 
is a phenomenon in the domain of psychopathia sexualis 
which sadly stands in need of scientific explanation. The 
author has had the opportunity of observing five cases be- 
longing to this category. The pathological conditions were 
paroxysmal, in one case repeatedly recurrent; but always 
sharply distinct from the unaffected, healthy period, during 
which deep sorrow and contrition over the occurrence were 
manifested. But it was the sorrow over an unavoidable 
fatality caused by psychically abnormal conditions. 

Whilst the pathological conditions lasted, absolute in- 
difference, even hatred, prevailed towards husband and 
children, and an utter want of understanding the bearings 
and consequences of the scandalous behaviour, jeopardising 
the honour and dignity of wife and family, were noticeable. 
It .is remarkable that in all these cases the husband and 
relatives had come to the conclusion that the condition was 
caused by psychopathia, even before they had obtained ex- 
pert opinion. 

As against the "non-psycliopathical" but otherwise ab- 
normally libidinous Messalinas, it is well worthy of note 
that this sexual aberration is only an episode in the life of 
the otherwise honourable woman, and that the illicit inter- 
course was of a strictly monogamic character. This, and 
particularly the circumstance that the unfortunate woman 
was not omnium virorum mulier, but only the mistress of 
one man, establishes a distinct difference from nympho- 
mania. In three of the cases mentioned above, the grossly 
sensual momentum was missing, the real motive for marital 
infidelity was to be found in a fetich-like charm, in mental 
superior qualities, in one case the voice of the charmer. 

In two cases unmistakable proofs of hypercssthesia 
sexualis and of absolute impotence towards the husband 



CKRXBRAL NEUROSES PAR.E8TIIEHIA OF FEELING. 79 

were found, whilst the merest touch of the other man pro- 
duced orgasm, and the sexual act the acme of pleasure. Of 
course, in these latter cases absolute sexual abandonment 
followed. 

D. Par&sthesia of Sexual Feeling (Perversion of the Sex- 
ual Instinct). 

In this condition there is perverse emotional colouring 
of the sexual ideas. Ideas physiologically and psycho- 
logically accompanied by feelings of disgust, give rise to 
pleasurable sexual feelings; and the abnormal association 
finds expression in passionate, uncontrollable emotion. The 
practical results are perverse acts (perversion of the sexual 
instinct). This is more easily the case if the pleasurable 
feelings, increased to passionate intensity, inhibit any op- 
posing ideas with corresponding feelings of disgust ; or the 
influence of such opposing conceptions may be rendered 
impossible on account of the absence or loss of all ideas of 
morality, aesthetics and law. This loss, however, is only too 
frequently found where the spring well of ethical ideas and 
feeling* (a normal sexual instinct) has been poisoned from 
the beginning. 

With opportunity for the natural satisfaction of the 
sexual instinct, every expression of it that does not corre- 
spond with the purpose of nature i.e., propagation must 
be regarded as perverse. The perverse sexual acts resulting 
from parsesthesia are of the greatest importance clinically, 
socially, and forensically ; and, therefore, they must here 
receive careful consideration; all aesthetic and moral dis- 
gust must be overcome. 

Perversion of the sexual instinct, as will be seen farther 
on, is not to be confounded with perversity in the sexual 
act; since the latter may be induced by conditions other 
than psycho-pathological. The concrete perverse act, mon- 
strous as it may be, is clinically ndt decisive. In order 
to differentiate between disease (perversion) and vice (per- 
versity), one must investigate the whole personality of the 



80 PSYCHOPATHIA SEXUALIS. 

individual and the original motive leading to the perverse 
act Therein will be found the key to the diagnosis (v. in- 
fra}. 

Partsesthesia may occur in combination with hyperaes- 
thesia. This association seems to be frequent clinically. 
Sexual acts are then confidently to be expected. The per- 
verse direction of sexual activity may be toward sexual 
satisfaction with the opposite or the same sex. Thus two 
great groups of perversions of sexual life may be distin- 
guished. 

I. Sexual Inclination Toward Persons of the Opposite 
Sex, with Perverse Activity of the Instinct 

1. Sadism. 1 Association of Active Cruelty and Violence 

with Lust. 

Sadism, especially in its, rudimentary manifestations, 
seems to be of common occurrence in the domain of sexual 
perversion. Sadism is the experience of sexual pleasurable 
sensations (including orgasm) produced by acts of cruelty, 
bodily punishment afflicted on one's own person or when 
witnessed in others, be they animals or human beings. It 
may also consist of an innate desire to humiliate, hurt, 
wound or even destroy others in order thereby to create 
sexual pleasure in one's self. 

Thus it will happen that one of the consorts in sexual 
heat will strike, bite 2 or pinch the other, that kissing de- 
generates into biting. Lovers and young married couples 
are fond of teasing each other, they wrestle together "just 

'So named from the notorious Marquis de Bade, whose obscene 
novels treat of lust and cruelty. In French literature the expression 
" Sadism " has been applied to this perversion. Eulenburg (" Klin. 
Handb. der Harn und Sexual -organe ") uses the term "active algo- 
lagnia " in connection with these phenomena. 

'Moll, Contr. Sexualempfindung, 3d ed., p. 160; Krafft-Ebing 
" Arbeit en" iv., p. 106; Idem, Leydcn's German clinic, vi. Sect. 2, 
p. 137; Eulenburg, Qrenzfragen des Nerven-und Seelenlebent, uci. 
p. 1. 



SEXUAL I NCI I N \ ' THE OPPOSITE BEX. 81 

for fun," imlulirr in all sorts of horseplay. The transition 
from these atavistic manifestations, which no doubt be- 
long to the sphere of physiological sexuality, to the most 
monstrous acts of destruction of the consort's life can be 
readily traced. 

Where the husband forces the wife by menaces and 
other violent means to the conjugal act, we can no longer 
describe such as a normal physiological manifestation, but 
; must ascribe it to sadistic impulses. It seems probable 
that this sadistic force is developed by the natural shyness 
and modesty of woman towards the aggressive manners of 
the male, especially during the earlier periods of married 
life and particularly where the husband is hypersexual. 
Woman no doubt derives pleasure from her innate coyness 
and the final victory of man affords her intense and refined 
gratification. Hence the frequent recurrence of these little 
love comedies. 

A further development of these sadistic traces may bo 
found in men who demand the sexual act in unusual places, 
for this seems to offer an opportunity to him to show his 
superiority over woman, to provoke her defense and delight 
in her subsequent confusion and abashment 

Case 14. One of my patients, hereditarily tainted, a 
crank, married to an extremely handsome woman of very 
vivacious temperament, became impotent when he saw her 
beautiful, pure white skin and her elegant toilet, but was 
quite potent with any ordinary wench, no matter how dirty 
(Fetichism). But it would happen that during a lonely 
walk with her in the country he would suddenly force her 
to have coitus in a meadow, or behind a shrub. The 
stronger she refused the more excited he became with per- 
fect potency. The same would happen in places where 
there was a risk of being discovered in the act, for instance, 
in the railway train, in the lavatory of a restaurant. But 
at home in his own bed he was quite devoid of cupido. 

In the civilized man of to-day, in so far as he is un- 
tainted, associations between lust and cruelty are found, 

ft 



82 PSYC1IOPATHIA SKXUALIS. 

but in a weak and rather rudimentary degree. If such 
therefore occur and in fact even light atrocious manifesta- 
tions thereof, they must be attributed to distorted disposi- 
tions (sexual and motoric spheres). 

They are due to an awakening of latent psychical dispo- 
sitions, occasioned by external circumstances which in no 
wise affect the normal individual. They are not accidental 
deviations of sentiment or instinct in the sense as given by 
the modern doctrine of association. Sadistic 
may often be traced back to early childhood and exist 
ing a period of life when their revival can by no manner 
of means be attributed to external impressions, much less to 
sexual temper. , 

Sadism must, therefore, like Masochism and the anti- 
pathic sexual instinct, be counted among the originary 
anomalies of the vita sexualis. It is a disturbance (a de- 
viation) in the evolution of psvchosexual processes sprout- 
ing from the soil of psychical degeneration. 

That lust and cruelty often occur together is a fact that 
has long been recognised and is frequently observed. Wri- 
ters of all kinds have called attention to this phenomenon. 1 

Blumroder ("Ueber Irresein," Leipzig, 1836, p. 51) 
saw a man who had several wounds in the pectoral muscle, 
which a woman, in great sexual excitement, had bitten at 
the acme of lustful feeling during coitus. The same authoi* 
("Ueber Lust und Schmerz," Friedreich's "Magazin fiir 
Seelenkunde, 1830, ii., 5) calls especial attention to the 
psychological connection between lust and murder. In re- 
lation to This, he especially refers to the Indian myths of 
Siva and Durga (Death and Lust) ; to human sacrifice with 
voluptuous mysteries; and to sexual instinct at puberty 
with a lustful impulse to suicide, with whipping, pinching, 
and pricking of the genitals, in the blind impulse to satisfy 
sexual desire. Lombroso ("Verzeni e Agnoletti," Rome, 

1 Cf. also Alfred de Musset's famous verses to the Andalusian 
girl : " Qu'elle est superbe en son de"sordre quand elle tombe les 
seins nus Qu'on la voit, bfente, ec tordre dans un baiser de r&fr et 
mordre 

En hurlant dea mots inconnus!" 



SEXUAL INCLINATION T"WAKI> TUB OPPOSITE SEX. 83 

1874) also cites numerous . .samples <f tin- occurrence of a 
munler with ^ivatlv increased lust. 

Hall quotes in hi* "( 'Unique St. Anne" the case of a 
powerful epileptic who during coitus bit off pieces of his 
consort's nose and swallowed them. 

Ferrlnni ( Archiv. delle p.-icopatie sessuali I. 1896, p. 
100) speaks of a young man who used to wrestle with his 

famorata before coitus, bit and pinched her during the 
t "because he felt otherwise no gratification." One day, 
however, he hurt the girl too much and she brought an ac- 
tion against him. 

On the other hand, when homicidal mania has been ex- 
^cited, lust often follows. Lombroso (op.' dt.) alludes to 
the fact mentioned by Mantegazza, that to the terrors of 
spoliation and plunder by bandits generally are added those 
of brutal lust and rape. 1 These examples form transitions 
to the pronounced pathological cases. 

The examples of the degenerate Ca^ars (Nero, Tiberi- 
us) are also instructive. They took delight in having 
youths and maidens slaughtered before their eyes. Not less 
so is the history of that monster, Marschalls Grilles de Rays 
(Jacob, "Curiosites de 1'histoire de France," Paris, 1858), 
who was executed in 1440, on account of mutilation and 
murder, which he had practised for eight years on more 
than 800 children. As the monster confessed it, it was 
from reading Suetonius and the descriptions of the orgies 
of Tiberius, Caracalla, etc., that the idea was joined of 
locking children in his castles, torturing them, and then 
killing them. This inhuman wretch confessed that in the 
commission of these acts he enjoyed inexpressible pleasure. 
He had two assistants. The bodies of the unfortunate chil- 



the excitement of battle the idea of lust forces its way 
into consciousness. Cf. the description of a battle, by a soldier, by 
(irillfiarzer: 

" And as the signal rang out, the armies met, breast to breast 
lut of the gods here, there, the murderous steel slays enemy, 
<;ivni and taken death and lift with wavering change- 
wildly raging in frenzy" ("Dream a Life," ^ct .). 



84 PSYCHOPATHIA 8EXUALJ8. 

dren were burned, and only a number of heads of partic- 
ularly beautiful children were preserved as memorials. 

Cf. Eulenburg, op. cit. p. 58, where he gives satisfac- 
tory proofs of Rays' insanity ; also, in "Die Zukunft, 

vii., Jahrg. No. 26; Bossard et Maulle, Gilles de Rays, 
dit Barbe-Bleu, Paris, 1886 (Champion) ; Michelet, hj^- 
toire de France, Tome vi., p. 316-326; Bibliotheque de 
Criminologie, t. xix., Paris, 1899, p. 245. 

In an attempt to explain the association of lust 
cruelty, it is necessary to return to a consideration of the 
quasi-physiological cases, in which, at the moment of most 
intense lust, very excitable individuals, who are otherwise 
normal, commit such acts as biting and scratching, which 
are usually due to anger. It must further be remembered 
that love and anger are not only the most intense emotions, 
but also the only two forms of robust (sthenic) emotion. 
Both seek their object, try to possess themselves of it, and 
naturally exhaust themselves in a physical effect on it; 
both throw the psycho-motor sphere into the most intense 
excitement, and thus, by means of this excitation, reach 
their normal expression. 

From this standpoint it is clear how lust impels to 
acts that otherwise are expressive of anger. 1 The one, like 
the other, is a state of exaltation, an intense excitation of 
the entire psycho-motor sphere. Thus there arises an im- 
pulse to react on the object that induces the stimulus, in 
every possible way, and with the greatest intensity. Juat 
as maniacal exaltation easily passes to raging destructive- 
ness, so exaltation of the sexual emotion often induces an 
impulse to spend itself in senseless and apparently harm- 
ful acts. To a certain extent these are psychical accom- 
paniments; but it is not simply an unconscious excitation 
of innervation of muscles (which also sometimes occurs as 
blind violence) ; it is a true hyperbole, a desire to exert 

*8chulz ("Wiener Med. Wochenschrift," No. 49, 1869) reports a 
remarkable case of a man, aged twenty-eight, who could perform 
coitus with his wife only after working himself into an artificial fit 
of anger. 



JUCUAL INCLINATION TOWARD THE OPPOSITE SEX. 85 

the utmost possible effect upon the individual giving rise to 
the stimulus. The most intense means, however, is the in- 
fliction of pain. 

Through such cases of infliction of pain during the most 
intense emotion of lust, we approach the cases in which a 
jeml injury, wound, or death is inflicted on the victim. 1 In 
eases the impulse to cruelty which may accompany the 
emotion of lust, becomes unbounded in a psychopathic in- 
Dividual; and, at the same time, owing to defect of moral 
feeling, all nonnal inhibitory ideas are absent or weak- 
ened. 

Such monstrous, sadistic acts have, however, in men, 
in whom they are much more frequent than in women, 
another source in physiological conditions. In the inter- 
course of the sexes, the active or aggressive role belongs to 
man ; woman remains passive, defensive.* It affords man 
great pleasure to win a woman, to conquer her; and in tho 
or* amandi, the modesty of woman, who keeps herself on 
the defensive until the moment of surrender, is an element 
of great psychological significance and importance. Under 
normal conditions man meets obstacles which it is his part 
to overcome, and for which nature has given him an ag- 
gressive character. This aggressive character, however, 
under pathological conditions may likewise be excessively 
developed, and express itself in an impulse to subdue abso- 
lutely the object of desire, even to destroy or kill it.* 

'Concerning analogous acts in rutting animals, vide Lombroso, 
The Criminal." 

'Among animals it is always the male who pursues the female 
with proffers of love. Playful or actual flight of the female is not 
Infrequently observed ; and then the relation is like that between the 
beast of prey and the victim. 

The conquest of woman takes place to-day in the social form of 
courting, in seduction and deception, etc. From the history of civili 
sation and anthropology we know that there have been times, as 
there are savages to-day that practice it, where brutal force, robbery, 
or even blows that rendered a woman powerless, were made use ot 
to obtain loves desire. It is possible that tendencies to such out- 
breaks of sadism are atavistic 

In the " JahrbUcher itir Psychologic,'' ii., p. 128, 8cMfr (Jena) 
refers to the reports of two cae by A. Payer. In the first 



86 PSYCHOPATHIA SKXl'ALIS. 

If both these constituent elements occur together the 
abnormally intensified impulse to. a violent reaction toward 
the object of the stimulus, and the abnormally intensified 
desire to conquer the woman ; then the most violent out- 
breaks of sadism occur. 

Sadism is thus nothing else than an excessive and mon- 
strous pathological intensification of phenomena, possible, 
too, in normal conditions in rudimental forms, which ac- 
company the psychical vita sexualis, particularly in males. 
It is of course not at all necessary, and not even the rule, 
that the sadistic individual should be conscious of his in- 
stinct. What he feels is, as a rule, only the impulse to cruel 
arid violent treatment of the opposite sex, and the colouring 
of the idea of such acts with lustful feelings. Thus arises 
a powerful impulse to commit the imagined deeds. In as 
far as the actual motives of this instinct are not compre- 
hended by the individual, the sadistic acts have the char- 
acter of impulsive deeds. 

When the association of lust and cruelty is present, not 
only does the lustful emotion awaken the impulse to 
cruelty, but vice versa; cruel ideas and acts of cruelty cause 
sexual excitement, and in this way are used by perverse 
individuals. 1 



states of great sexual excitement were induced by the sight of bat- 
tles or of paintings of them; in the second, by cruel torturing of 
small animals. It is added : " The pleasure of battle and murder is 
so predominantly an attribute of the male sex throughout the animal 
kingdom that there can be no question about the close relation exist- 
ing between this side of the masculine character and male sexuality. 
1 believe, too, that by unprejudiced observation I can show that, in 
men who are mentally and physically absolutely normal, the first 
indefinite and incomprehensible precursors of sexual excitement may 
be induced by the reading of exciting scenes of the chase and war 
t. e., they give rise to unconscious longings for a kind of satisfaction 
in warlike games (wrestling), in which the fundamental sexual im- 
pulse to the most perfect and intense contact with a companion is 
expressed, with the secondary thought of conquest more or less 
clearly defined." 

* It sometimes happens that an accidental sight of blood, etc., 
puts into motion the preformed psychical mechanism of the sadistic 
individual and awakens the instinct, 



SEXUAL. IN'CLINA , -1TK 8KZ. 87 

A differentiation of original and acquired cases of sad- 
ism is scarcely possible. Many individuals, tainted ab 
origine, for a long time do everything to conquer the per- 
verse instinct If they are potent, they are able for some 
time to lead a normal vita scxualis, often with the assist- 
ance of fanciful ideas of a perverse nature. Later, when 
the opposing motives of an ethical and aesthetic kind have 
been gradually overcome, and when oft-repeated experience 
has proved the natural act to give but incomplete satisfac- 
tion, the abnormal instinct suddenly bursts forth. Owing 
to this late expression, in acts, of an originally perverse dis- 
position, the appearances are those of an acquired perver- 
sion. As a rule, it may be safely assumed that this psycho- 
pathic state exists ab origine. 

Sadistic acts vary in monstrousness according to the 
power exercised by the perverse instinct over the individual 
thus afflicted, and in accordance with the strength of op- 
posing ideas that may be present, which nearly always are 
more or less weakened by original ethical defects, heredi- 
tary degeneracy, or moral insanity. Thus there arises a 
long series of forms which begins with capital crime and 
ends with paltry acts affording merely symbolic satisfaction 
to the perverse desires of the sadistic individual. 

Sadistic acts may be further differentiated according 
to their nature; either taking place after consummated 
coitus which leaves the libido nimia unsatisfied; or, with 
diminished virility, being undertaken to merely stimulate 
the diminished power; or, finally, where virility is abso- 
lutely wanting, as becoming simply an equivalent for im- 
possible coitus, and for the induction of ejaculation. In 
the last two cases, notwithstanding impotence, there is still 
intense libido; or there was, at least, intense libido in the 
individual at the time when the sadistic acts became a 
habit. Sexual hypenesthesia must always be regarded as 
the basis of sadistic inclinations. The impotence which oc- 
curs BO frequently in psychopathic and neuropathic indi- 
viduals here considered, resulting from excesses practised 
in early youth, is usually dependent upon spinal 



SS P8YCHOPATHIA 8EXUALIB. 

Often, too, there is a kind of psychical impotence, super- 
induced by concentration of thought on the perverse act 
with simultaneous fading of theidea of normal satisfaction. 
No matter what the external form of the act may be, the 
mentally perverse predisposition and instinct of the indi- 
vidual are essential to an understanding of it. 

(a) Lust-Murder 1 (Lust Potentiated as Cruelty, Murder- 
ous Lust Extending to Anthropophagy}. 

The most horrible example, and one which most point- 
edly shows the connection between lust and a desire to kill, 
is the case of Andreas Bichel, which Feuerbach published 
in his "Aktenmassige Darstellung merkwiirdiger Ver- 
brechen". 

B. puellas stupratas necavit et dissecuit. With reference 
to one of his victims, at his examination he expressed him- 
self as follows: "I opened her breast and with a knife 
cut through the fleshy parts of the body. Then I arranged 
the body as a butcher does beef, and hacked it with an axe 
into pieces of a size to fit the hole which I had dug up in the 
mountain for burying it. I may say that while opening 
the body I was so greedy that I trembled, and could have 
cut out a piece and eaten it." 

Lombroso, too ("Geschlechtstrieb und Verbrechen in 
ihren gegenseitigen Beziehungen". "Goltdammer's Archiv." 
Bd. xxx.), mentions cases falling in the same category. A 
certain Phillipe indulged in strangling prostitutes, post 
actum, and said : "I am fond of women, but it is sport for 
me to strangle them after having enjoyed them". 

A certain Grassi (Lombroso, op. dt., p. 12) was one 
night seized with sexual desire for a relative. Irritated by 
her remonstrance, he stabbed her several times in the ab- 

C/. " Metzger't ger. Arzneiw., herausgegeben von Remer," p 
539; " Klein's Annalen," x., p. 176; xviii., p. 311; Heinroth, " Syatem 
der psych. Med.," p. 270; Never Pitaval, 1855, 23 Th. ("Fall 
Blaize Ferragc"). 



SEXUAL INCLINATION TOWARD TIIK OPPOSITE BEX. 89 

n with a knife, and also murdered her father and 
imrl<- who attempted to hold him hack. Immediately there- 
after lie hastened to visit a prostitute in order to cool in 
her embrace his sexual passion. But this was not sufficient, 
for he then murdered his own father and slaughtered sev- 
eral oxen in the stable. 

1 1 cannot be doubted, after the foregoing, that a great 
number of so-called lust murders depend upon combined 
hypewesthesia and partrsthcsia sexualis. As a result of 
this perverse colouring of the feelings, further acts of 
bestiality with the corpse may result e.g., cutting it up 
and wallowing in the intestines. The case of Bichel points 
to this possibility. 

A modern example is that of Menesclou ("Annales 
d'hygiene publique"), who was examined by Lasegue, 
Brouardel and Motet, declared to be mentally sound, and 
executed. 

Case 15. A four-year-old girl was missing from her 
parents' home, 15th April, 1880. On 16th April, Menes- 
clou, one of the occupants of the house, was arrested. The 
forearm of the child was found in his pocket, and the head 
and entrails, in a half-charred condition, were taken from 
the stove. Other parts of the body were found in the water- 
closet The genitals could not be found. M., when asked 
their whereabouts, became embarrassed. The circum- 
stances, as well as an obscene poem found on his person, 
left no doubt that he had violated the child and then mur- 
dered her. M. expressed no remorse, asserting that his deed 
was an unhappy accident. His intelligence was limited. 
He presented no anatomical signs of degeneration; some- 
what deaf and scrofulous. 

Age twenty. 

Convulsions at the age of nine months. Later he suf- 
fered from disturbed sleep (enuresis nocturna) ; was nerv- 
ous, and developed tardily and imperfectly. With puberty 
he became irritable, showed evil inclinations, was lazy, in- 
tractable, and in all trades proved to be of no use. He grew 



90 PSYCHOPATHIA SEXUALIS. 

no better even in the House of Correction. He was made a 
marine, but there, too, he proved useless. When he re- 
turned home he stole from his parents, and spent his time 
in bad company. He did not run after women, but gave 
himself up passionately to masturbation, and occasionally 
indulged in sodomy with bitches. His mother suffered with 
mania menstrualis periodica. An uncle was insane, and 
another a drunkard. The examination of M.'s brain showed 
morbid changes of the frontal lobes, of the first and second 
temporal convolutions, and of a part of the occipital con- 
volutions. 

Case 16. Alton, a clerk in England, went for a 
walk out of town. He lured a child into a thicket. After- 
wards at his office he made this entry in his note-book: 
"Killed to-day a young girl; it was fine and hot." Tho 
child was missed, searched for, and found cut into pieces. 
Many parts, and among them the genitals, could not be 
found. A. did not show the slightest trace of emotion, and 
gave no explanation of the motive or circumstances of his 
horrible deed. He was a psychopathic individual, and oc- 
casionally subject to fits of depression with tcedium vitce. 
His father had had an attack of acute mania. A near rela- 
tive suffered from mania with homicidal impulses. A. was 
executed. 

Case 17. Jack the Kipper. On December 1, 1887, 
July 7, August 8, September 30, one day in the month of 
October and on the 9th of November, 1888 ; on the 1st of 
June, the 17th of July and the 10th of September, 1889, 
the bodies of women were found in various lonely quarters 
of London ripped open and mutilated in a peculiar fashion. 
The murderer has never been found. It is probable that he 
first cut the throats of his victims, then ripped open the 
abdomen and groped among the intestines. In some in- 
stances he cut off the genitals and carried them away; in 
others he only tore them to pieces and left them behind. 
He does not seem to have had sexual intercourse with his 



SEXUAL INCLINATION TOWAED THE OPPOSITE SEX. 91 

victims, but vary likely the murderous act and subsequent 
mutilation of the corpse were equivalents for the sexual 
act. (McDonald, le criminal type, 2 edit., Lyon, 1884 ; 
Spitzka, The Journal of Mental and Nervous Diseases, 
188, December; Kierman, The Medical Standard, 1888, 
Nov. and Dec.) 

Case 18. Vacher, the Ripper. On the 31st August, 
1895, Portalier, seventeen years old, a shepherd, was 
found naked in the field. The belly was ripped open and 
the body bore other wounds besides. Examination showed 
that the victim had been strangled first. On the 4th 
August, 1897, a tramp, named Vacher, was arrested on 
suspicion of having committed this crime. lie confessed 
to it as well as to numerous other acts of a similar nature 
that had been perpetrated in various parts of France since 
1894. He claimed that at the time when he committed the 
crimes he suffered from temporary insanity and irresistible 
impulse, in fact, was a madman. Medical examination, 
however, proved that Vacher was mentis compos when he 
committed these atrocious deeds, fled after their commis- 
sion and had a very clear memory of the facts. 

V. was born in 18G9 of honourable parents and be- 
longed to a mentally sound family. He never had a severe 
illness, was from his earliest infancy vicious, lazy and shy 
of work. When twenty he had immorally assaulted a small 
child. During his military service he had gained for him- 
self a very bad reputation and was in 1893 discharged from 
his regiment on account of "psychical disturbances" (con- 
fused talk, persecution-mania, threatening language, ex- 
treme irritability). In 1893 he wounded a girl because 
she refused to marry him, then made an attempt at suicide 
(he shot himself through the right ear, which left him deaf 
on that side and produced facial paralysis). He was sent 
to an insane asylum and there treated for persecution- 
mania. On April 1, 1894, he was dismissed as cured. He 
began to tramp about the country and committed the fol- 
lowing horrible crimes: On March 20, 1894, he strangled 



92 PSYCHOPATHIA SEXUALIS. 

Delhomme, twenty-one years old, cut her throat, trampled 
upon her abdomen, tore out a portion of her right breast 
and then had coitus with the corpse. The same atrocity, 
but without ravaging the bodies, he committed on Novem- 
ber 20, 1894, on a girl of the name of Marcel, 13 years 
of age, and on May 12, 1895, on another girl named 
Mortureux, 17 years of age. On August 24, 1895, he 
strangled and then ravaged a lady of the name of Morand, 
58 years old, and on the 22d he cut the throat of Allaise, 
a sixteen year old girl and attempted to rip her abdomen 
open. On September 29, he committed the same crime 
as later on on Portalier on Palet, a fifteen-year-old boy, 
but in this instance he also cut off the genitals of the boy 
and sexually assaulted the corpse. 

On the 1st of March, 1896, he attempted rape on 
Deronet, a girl eleven years old, but was scared off by 
the field police. On the 10th of September, he committed 
his usual atrocity on a Mrs. Mounier, just married, nine- 
teen years of age, and on the 1st of October, on Rodier, a 
shepherdess, fourteen years of age. He cut out her genitals 
and carried them away. Toward the end of May, 1897, 
he killed a tramp boy, fourteen years old, named Beaupied, 
by cutting his throat. The corpse he threw down into a 
well. On June 18th he murdered a shepherd boy, thirteen 
years old, named Laurent, and committed pederasty on 
the corpse. Soon afterward he made an attempt on a 
Mrs. Plantier, but she was rescued. Unfortunately they 
allowed him to go unpunished. 

Lacassagne, Professor of Forensic Medicine in Lyon, 
Pierrel, Professor of Psychiatry, and Rebatel, specialist 
on insanity, were the experts in this atrocious murder 
trial. They found no hereditary taints, no cerebral dis- 
ease, nor traces of epilepsy. V. was not particularly bright, 
very irascible from his earliest years, vicious and fond of 
maltreating animals. No one retained him long in service. 
He entered a monastery, but was soon dismissed as he 
began to masturbate his comrades. He could not find em- 
ployment on account of immorality and ill temper. He 



SEXUAL INCLINATION TOWABD THE OPPOSITE SEX. 93 

was not a drinker. In the army he was feared and 
shunned. One day when he was disappointed by not be- 
ing made a corporal, he flew into a passion, attacked his 
superior and became delirious. He was taken to the in- 
firmary and thence sent to the insane asylum. His com- 
rades did not consider him normal. During his spells of 
rage he was uncontrollable and considered dangerous. 
He always threatened others with cutting their throats, and 
was thought capable of doing such an act. He slept badly, 
constantly dreamed of murder, and often was delirious dur- 
ing the night, so that no one cared for sleeping near him. 

At the asylum he was found to suffer from persecution- 
mania and was considered a dangerous character. Never- 
theless he was dismissed as cured. 

Subsequently he became guilty of eleven murdeve, 
which are acts of sadism, lust murders. They consisted of 
strangling, cutting of the throat and ripping open of the 
abdomen, mutilation of the corpse, especially the genitals, 
eventually gratification of the sexual lust on the corpse. 

It was definitely proved that V. acted in cold blood, 
was quite conscious of his actions and suffered from no 
psychical abnormality. 

He committed the crimes in various sections of France, 
traversing the country in every direction. 

There were no marks of anatomical degeneration. His 
genitals were normally developed. In confinement he was 
lazy, irascible and quite intractable. Out of sheer stub- 
bornness and because he thought he had been slighted, he 
refused on one occasion all food for a period of seven 
days. On another occasion he flew into a frightful rage 
when permission to go to church was refused him. He 
spoke cynically of his crimes, showed no remorse, insisted 
that they were the outcome of madness and insanity, 
played the insane, hoping thus to be sent to an insane asy- 
lum whence escape is easier. The experts could establish 
no symptoms of mental disturbance. 

Resume of the experts: "V. is neither an epileptic 
nor subject to an impulsive disease. He is an immoral, 



94 PSYCHOPATHIA SEXUALIS. 

passionate man, who once temporarily suffered from a 
depressing persecution-mania, coupled with an impulse to 
suicide. Of this he was cured, a'nd thereafter became re- 
sponsible for his actions. His crimes are those of an 
antisocial, sadistic, bloodthirsty being, who considers him- 
self privileged to commit these atrocities because he was 
once upon a time treated in an asylum for insanity, and 
thereby escaped well merited punishment. He is a com- 
mon criminal and there are no ameliorating circumstances 
to be found in his favour." V. was sentenced to death. 
(Archives d' anthropologie criminelle, xiii., No. 78.) 

In such cases it may even happen that appetite for the 
flesh of the murdered victim arises, and in consequence of 
this perverse colouring of the idea, parts of the body may 
be eaten. 

Case 19. Leger, vine-dresser, aged twenty-four. 
From youth moody, silent, shy of people. He started out 
in search of a situation. Wandering about eight days in 
the forest he there caught a girl twelve years old ? violated 
her, mutilated her genitals, tore out her heart, ate of it, 
drank the blood, and buried the remains. Arrested, at 
first he lied, but finally confessed his crime with cynical 
cold-bloodedness. He" listened to his sentence of death 
with indifference, and was executed. At the post-mortem 
examination Esquirol found morbid adhesions between the 
cerebral membranes and the brain (Georgei, "Darstellung 
der Prozesse Leger, Feldtmann" etc., Darmstadt, 1827). 

Case 20. Tirsch, hospital beneficiary of Prag, aged 
fifty-five, always silent, peculiar, coarse, very irritable, 
grumbling, revengeful, was sentenced to twenty years' 
imprisonment for violating a girl ten years old. He had 
attracted attention on account of outbursts of anger from 
insignificant causes, and also on account of tcedium vitcc. 
In 1864, on account of the refusal of an offer of marriage 
which he made to a widow, he developed a hatred toward 
women, and on the 8th of July he went about with the 



SEXUAL 1N< UNA TK'N T<i\VAItI> THE OPPO-- . 95 

intention of killing ono of this hated sex. Vetulam <> 
rentem in silvam allcxit, coitum, poposcit, renit<-n(rm pros- 
travit, jn</ulum fcminw compfessit "furore captus". Cad- 
aver virya bctulcB desecta verberare voluit nequetamen id 
perfecit, quia conscientia sua haec fieri vctuit. culti'llu 
mammas et genitalia desecta domi coda proximis diebus 
cum globis comedit. On the 12th of September, when he 
was arrested, the remains of this meal were found. He 
gave as the motive of this act "inner impulse." He him- 
self wished to be executed, because he had always been an 
outcast. In confinement he showed great emotional irrita- 
bility and occasional outbursts of fury, preceded by refusal 
of food, which made isolation, lasting several days, neces- 
sary. It. was authoritatively established that the most of 
his earlier excesses were coincident with outbreaks of ex- 
citement and fury (Maschka, "Prager Vierteljahrsschrift," 
1866, i., p. 79. "Gauster bei Maschka, Handb. dor 
gerichtl. Medicin," iv., p. 489). 

In other cases of lust-murder, for physical and mental 
reasons (vide supra), violation is omitted, and the sadistic 
crime alone becomes the equivalent of coitus. The pro- 
totype of such cases is the following one of Verzeni. The 
life of his victim hung on the rapid or retarded occurrence 
of ejaculation. Since this remarkable case presents all 
the peculiarities which modern science knows concerning 
the relation of lust to lust-murder with anthropophagy, 
and especially since it was carefully studied, it receives 
detailed description here: 

Case 21. Vincenz Verzeni, born in 1849 ; since Jan- 
uary llth, 1872, in prison; was accused (1) of an attempt 
to strangle his nurse Marianne, four years ago, while she 
lay sick in bed; (2) of a similar attempt on a married 
woman, Arsuffi, aged twenty-seven; (3) of an attempt to 
strangle a married woman, Gala, by grasping her throat 
while kneeling on her abdomen; (4) on suspicion of the 
fallowing murders: 



96 PSYCHOPATHIA SEXUALI8. 

In December a fourteen-year-old girl, Johanna Motta, 
set out for a neighbouring village between seven and eight 
o'clock in the morning. As she did not return, her master 
set out to find her, and discovered her body near the village, 
lying by a path in the fields. The corpse was frightfully 
mutilated with numerous wounds. The intestines and 
genitals had been torn from the open body, and were found 
near by. The nakedness of the body and erosions on the 
thighs made it seem probable that there had been an 
attempt at rape; the mouth, filled with earth, pointed to 
suffocation. In the neighbourhood of the body, under a 
pile of straw, were found a portion of flesh torn from the 
right calf, and pieces of clothing. The perpetrator of 
the deed remained undiscovered. 

On 28th August, 1871, a married woman, Frigeni, aged 
twenty-eight, set out into the fields early in the morning 
As she did not return by eight o'clock, her husband started 
out to fetch her. He found her a corpse, lying naked in 
the field, with the mark of a thong around her neck, with 
which she had been strangled, and with numerous: wounds. 
The abdomen had been ripped open, and the intestines 
were hanging out. 

On August 29th, at noon, as Maria Previtali, aged 
nineteen, went through a field, she was followed by her 
cousin, Verzeni. He dragged her into a field of grain, 
threw her to the ground and began to choke her. As he let 
go of her for a moment to ascertain whether any one was 
near, the girl got up and, by her supplicating entreaty, in- 
duced Verzeni to let her go, after he had pressed her hands 
together for some time. 

Verzeni was brought before a court. He was then 
twenty-two years old. Cranium of more than average size, 
but asymmetrical. The right frontal bone narrower and 
lower than the left, the right frontal prominence being less 
developed, and the right ear smaller than the left (by 1 
centimetre in length and 3 centimetres in breadth) ; both 
ears defective in the inferior half of the helix; the right 
temporal artery somewhat atheromatous. Bull-necked; 






SEXUAL INCLINATION TOWARD Till OPPOOT1 SEX. 97 



development of the zygomw ami inferior maxilla ; 
[) nis greatly developed, franium wanting; slight divergent 
alternating st raltisimis ( insiitiiricncy of tin- internal rectus 
musolf, and myopia): Lombroso concluded from these 
signs of degeneration, that there was a congenital a 
of development of tlic riijht frontal bone. As seemed 
probable, Verzeni had a bad ancestry two uncles were 
cretins; a third, microcephalic, beardless, one testicle 
wanting, the other atrophic. The father showed traces 
of pellagrons degeneration, and had an attack of hypo- 
chondria pellagrosa. A cousin suffered from cerebral 
hypenemia ; another was a confirmed thief. 

Verzeni's family was bigoted and low-minded. He him- 
self had ordinary intelligence; knew how to defend himself 
well ; sought to prove an alibi and cast suspicion on others. 
There was nothing in his past that pointed to mental dis- 
ease, but his character was peculiar. He was silent and 
inclined to be solitary. In prison he was cynical. He 
masturbated, and made every effort to gain sight of women. 

Verzeni finally confessed his deeds and their motive. 
The commission of them gave him an indescribably 
pleasant (lustful) feeling, which was accompanied by erec- 
tion and ejaculation. As soon as he had grasped his vic- 
tim by the neck, sexual sensations were experienced. It 
was entirely the same to him, with reference to these sen- 
sations, whether the women were old, young, ugly, or 
beautiful. Usually, simply choking them had satisfied 
him, and he then had allowed his victims to live; in the 
two cases mentioned, the sexual satisfaction was delayed, 
and he had continued to choke them until they died. The 
gratification experienced in this garrotting was greater 
than in masturbation. The abrasions of the skin on Motta'a 
thighs were produced by his teeth, whilst sucking her 
blood in most intense lustful pleasure. He had torn out 
a piece of flesh from her calf and taken it with him to 
roast at home; but on the way he hid it under the straw- 
?tack, for fear his mother might suspect him. He also 
carried pieces of the clothing and intestines some distance, 

7 



98 PSYCHOPATHIA SKXK AI.IS. 

because it gave him great pleasure to smell and touch 
them. The strength which -he possessed in these moments 
of intense lustful pleasure was enormous. He had never 
been a fool ; while committing his deeds he saw nothing 
around him (apparently as a result of intense sexual ex- 
citement, annihilation of perception instinctive action). 
After such acts he was always very happy, enjoying a 
feeling of great satisfaction. He had never had pangs of 
conscience. It had never occurred to him to touch the 
genitals of the martyred women, or to violate his victims. 
It had satisfied him to throttle them and suck their blood. 
These statements of this modern vampire seem to rest on 
truth. Normal sexual impulses seem to have remained 
foreign to him. Two sweethearts that he had, he was 
satisfied to look at; it was very strange to him that he 
had no inclination to strangle them or press their hands, 
but he had not had the same pleasure with them as with 
his victims. There was no trace of moral sense, remorse 
and the like. 

Verzeni said himself that it would be a good thing if 
he were to be kept in prison, because with freedom he 
could not resist his impulses. Verzeni was sentenced to 
imprisonment for life (Lombroso, "Verzeni e Agnoletti," 
Rome, 1873). The confessions which Verzeni made after 
his sentence are interesting: 

"I had an unspeakable delight in strangling women, ex- 
periencing during the act erections and real sexual pleas- 
ure. It was even a pleasure only to smell female clothing. 
The feeling of pleasure while strangling them was much 
greater than that which I experienced while masturbating. 
I took great delight in drinking Motta's blood. It also 
gave me the greatest pleasure to pull the hair-pins out of 
the hair of my victims. 

"I took the clothing and intestines, because of the 
pleasure it gave me to smelt and touch them. At last my 
mother came to suspect me, because she noticed spots of 
semen on my shirt after each murder or attempt at one. 
I am not crazy, but in the moment of strangling my victims 



SEXUAL INCLINATION TOWARD THE OPPOSITE BEX. 99 

I saw nothing else. After the commission of the deeds I 
was satisfied and felt well. It never occurred to me to 
touch or look at the genitals or such things. It satisfied 
me to seize the women by the neck and suck their blood. 
To this very day I am ignorant of how a woman is formed. 
During the strangling and after it, I pressed myself on 
the entire body without thinking of one part more than 
another." 

Verzeni arrived at his perverse acts quite indepen- 
dently, after having noticed, when he was twelve years 
old, that he experienced a peculiar feeling of pleasure 
while wringing the necks of chickens. After this he had 
often killed great numbers of them and then sa*id that a 
weasel had been in the hen-coop (Lombroso, "Goltdammer's 
Archiv," Bd. xxx., p. 13). 

Lonibroso mentions an analogous case ("Goltdammer's 
Archiv") which occurred in Vittoria (Spain) : 

Case 22. A certain Gruyo, aged forty-one, with a 
blameless past life, having been three times married, 
strangled six women in the course of ten years. They 
were almost all public prostitutes and quite old. After 
the strangling he tore out their intestines and kidneys per 
vaginam. Some of his victims he violated before killing, 
others,, on account of the occurrence of impotence, he did 
not. He set about his horrible deeds with such care that 
he remained undetected for ten years. 

(b) Mutilation of Corpses. 

Following on the preceding horrible group of perver- 
sions, come naturally the necrophiles; in these cases, just 
as with lustful murderers and analogous cases, an idea 
which in itself awakens a feeling of horror, and before 
which a sane person would shudder, is accompanied by 
lustful feelings, and thus leads to the impulse to indulge 
in acts of necrophilia. 



100 PSYCHOPATlliA BJSJJS.CTALIS. 

The cases of mutilation of bodies mentioned in litera- 
ture seem to be of a pathological character; but, with the 
exception of that of Sergeant Bertrand (v. infra), they 
are far from being described and observed with accuracy. 
In certain cases there may be nothing more than the 
possibility that unbridled desire sees in the idea of death 
no obstacle to its satisfaction. The seventh case mentioned 
by Moreau, perhaps, belongs here. 

A man, aged twenty-three, attempted to rape a woman, 
aged fifty-three. Struggling, he killed her, and then vio- 
lated her, threw her in the water, and fished her out again 
for renewed violation. The murderer was executed. The 
meninges of the anterior lobes were thickened and ad- 
herent to the cortex. 

French writers have recorded numerous examples of 
necrophilia. 1 Two cases concerned monks performing 
the watch for the dead. In a third case the subject was 
an idiot, who also suffered from periodical mania, and 
after commission of rape was sent to an insane asylum, 
where he mutilated female bodies in the mortuary. 

In other cases, however, there is undoubtedly direct 
preference for a corpse to the living woman. When no 
other act of cruelty cutting into pieces, etc. is practised 
on the cadaver, it is probable that the lifeless condition 
itself forms the stimulus for the perverse individual. It 
is possible that the corpse a human form absolutely 
without will satisfies an abnormal desire, in that the 
object of desire is seen to be capable of absolute subjuga- 
tion, without possibility of resistance. 

Brierre de Boismont ("Gazette medicale," July 21st, 
1859) relates the history of a corpse-violator who, after 
bribing the watchman, had gained entrance to the corpse 
of a girl of sixteen belonging to a family of high social 
position. At night a noise was heard in the death- 
chamber, as if a piece of furniture had fallen over. The 



^Michea, Union m4d. 1849, Brierre, Gaz. mgd. 1849, July 21; 
Moreau (op. eit. ) p. 250, Epaulard, "Vampyrisme ( n&jrophilie, 
nficrosadism, ngcrophagie ) , Lyon, 1901. 



SEXUAL INCLINATION TOWAED THE OPPOSITE SEX. 101 

mother of the dead girl effected an entrance and saw a 
man dressed in his night-shirt springing from the bed 
where the body lay. It was at first thought that the man 
was a thief, but the real explanation was soon discovered. 
It afterwards transpired that the culprit, a man of good 
family, had often violated the corpses of young women. 
He was sentenced to imprisonment for life. 

The story of a prelate, reported by Tcuril 1 ("La prosti- 
tution contemporaine," p. 171), is of great interest as an 
example of necrophilia. From time to time he would 
visit a certain brothel in Paris and order a prostitute, 
dressed in white like a corpse, to be laid out on a bier. 
At the appointed hour he would appear in the room, 
which, in the meantime had been elaborately prepared as 
a room of mourning; then he would act as if reading a 
mass for the soul, and finally throw himself upon the 
girl, who, during the whole time, was compelled to play 
the role of a corpse. 1 

The cases in which the perpetrator injures and cuts 
up the corpse are clearer. Such cases come next to those 
of lust-murder, in so far as cruelty, or at least an impulse 
to attack the female body, is connected with lust. It is 
possible that a remnant of moral sense deters from the 
cruel act on a living woman, and possibly the fancy passes 
beyond lust-murder and rests on its result, the corpse. 
Here also it is possible that the idea of defenselessness of 
the body plays a role. 

Case 23. Sergeant Bertrand, a man of delicate phy- 

1 A similar case is related by Neri (" Archivio delle psicopatie 
sessuali," 189G, p. 109). A man, fifty years of age, used in a Lupanar 
only girls who clad in white, lay motionless feigning death. He 
violated the borly of his own sister, immissionc mentufa in os mortwt 
u*que ad ejaculationemf This monster had also fits of fetichism for 
crincg pubit pucllarum, and the trimmings of their fingernails; 
eating them caused strong sexual emotions. 

'Simon ("Crimes et del its," p. 200) mentions an experience of 
Lacassagne's, to whom a respectable man said that he was never 
intensely excited sexually except when a spectator at a funeral. 



102 PSYCHOPATIIIA SEXUALIS. 

sical constitution and of peculiar character; from child- 
hood silent and inclined to solitude. 

The details of the health of his family were not satis- 
factorily known; but the occurrence of mental diseases in 
his ancestors was ascertained. It was said that while he 
was a child he was affected with destructive impulses, 
which he himself could not explain. He would break what- 
ever was at hand. In early childhood, without teaching, 
he learned to masturbate. At nine he began to feel inclina- 
tions towards persons of the opposite sex. At thirteen 
the impulse to sexual intercourse became powerfully 
awakened in him. He now masturbated excessively. When 
he did this, his fancy always created a room filled with 
women. He would imagine that he carried out the sexual 
act with them and then killed them. Immediately there- 
after he would think of them as corpses, and of how he de- 
filed them. Occasionally in such situations the thought of 
carrying out a similar act with male corpses would come 
up, but it was always attended with a feeling of disgust. 

In time he felt the impulse to carry out such acts with 
actual corpses. For want of human bodieSj he obtained 
those of animals. He would cut open the abdomen, tear 
out the entrails, and masturbate during the act. He de- 
clared that in this way he experienced inexpressible 
pleasure. In 1846 these bodies no longer satisfied him. He 
now killed dogs, and proceeded with them as before. 
Toward the end of 1846 he first felt the desire to make 
use of human bodies. 

At first he had a horror of it. In 1847, being by ac- 
cident in a graveyard, he ran across the grave of a newly 
buried corpse. Then this impulse, with headache and pal- 
pitation of the heart, became so powerful that, although 
there were people near by, and he was in danger of de- 
tection, he dug up the body. In the absence of a con- 
venient instrument for cutting it up, he satisfied himself 
by hacking it with a shovel. 

In 1847 and 1848, during two weeks, as reported, the 
impulse, accompanied by violent headache, to commit bru- 



SEXUAL INCLINATION TOWARD THE OPPOSITE SEX. 109 

t uli ties on corpses actuated him. Under the greatest diffi- 
culties and dangers he satisfied this impulse some fifteen 
times. He dug up the bodies with his hands, in nowise 
sensible in his excitement to the injuries he thus inflicted 
on himself. When he had obtained the body, he cut it up 
with a sword or pocket-knife, tore out the entrails, and 
then masturbated. The sex of the bodies is said to have 
been a matter of indifference to him, though it was ascer- 
tained that this modern vampire had dug up more female 
than male corpses. 

During these acts he declared himself to have been in 
an indescribable state of sexual excitement. After having 
cut them up, he reinterred the bodies. 

In July, 1848, he accidentally came across the body of 
a girl of sixteen. Then, for the first time, he experienced 
a desire to carry out coitus on a cadaver. 

"I covered it with kisses and pressed it wildly to my 
heart. All that one could enjoy with a living woman is 
nothing in comparison with the pleasure I experienced. 
After I had enjoyed it for about a quarter of an hour, I 
cut the body up, as usual, and tore out the entrails. Then 
I buried the cadaver again." Only after this, as B. de- 
clared, had he felt the impulse to use the bodies sexually 
before cutting them up, and thereafter he had done it in 
three instances. The actual motive for exhuming the 
bodies, however, was then, as before, to cut them up; and 
the enjoyment in so doing was greater than in using the 
bodies sexually. The latter act had always been nothing 
more than an episode of the principal one, and had never 
quieted his desires; for which reason he had later on 
always mutilated the body. 

The medico-legal examiners gave an opinion of "mono- 
mania". Court-martial sentence to one year's imprison- 
ment. (Michea, "Union med.," 1849; Lunier, "Annal. 
meU -psycho.," 1849, p. 153; Tardieu, "Attentats aux 
moeurs," 1878, p. 114; Legrand, "La folie devant les tri- 
bun.," p. 524.) 



104 PSYCHOPAT1IIA SEXUALIS. 

Case 24. Ardisson, born., 1872, belonged to a family 
of criminals and insane. At school he learned readily ; he 
was not addicted to drink, had no epileptic antecedents, 
never had an illness, but was rather weakminded. The 
man who adopted him and with whom he lived, was a 
moral outcast. When A. came of puberty he practised 
masturbation, devorare solebat sperma proprium because 
"it would be a pity to lose it." He ran after the girls, but 
could not understand why they shunned him. Loco quo 
mulieres urinavcrant, lotium bibere solebat. He did not 
think that there was anything wrong about this. He was 
looked upon in the village as a venal felon. With his 
adopter he shared the favours of the beggar women that 
stayed over night at their house. He was fond of fornica- 
tion, was a mamma fetichist and loved mammas sugere. 
Later on he fell to necrophily. He exhumed cadavers of 
females ranging from three to sixty years of age, sucked 
their breasts, practised cunnilungus on them, but rarely 
coitus or mutilation. Once he carried away ; the head of 
a woman, at another time the whole corpse of a little girl 
three and one-half years old. After his ghoulish deeds he 
would re-arrange the grave properly. He lived isolated by 
himself, was at times very morose, never showed signs of 
heart. As a rule, however, he was not of an evil disposi- 
tion even when in prison. Several times he worked as a 
stonemason. Remorse and shame over his misdeeds were 
unknown to him. In 1892 he had for a while acted as a 
gravedigger. He deserted from the army and then took to 
begging from house to house. He loved to eat rats and 
cats. When arrested and returned to the regiment he de- 
serted again. He was not punished because he was not 
held responsible. Dismissed from the army he again be- 
came a gravedigger. When a girl of seventeen who had 
very prominent breasts was buried his old passion awoke 
again. He unearthed the cadaver and profaned it in his 
usual manner. This happened from now on very fre- 
quently. The head of one woman which he took home with 
him, he covered with kisses and called it his bride. He was 



I A I. l\ 1. 1. NATION TOWAItD Till. ori'OSITE SEX. 

caught after he had taken homo the body of a child three 
ami one-half years of age which he secreted in the straw. 
On this he gratified his sexual desires even whilst the 
putrid body was falling to pieces. The stench filling the 
house betrayed him. Laughingly he admitted everything. 
A. was small of stature, and prognathous and feeble; 
skull symmetrical; general tremor; genitals normal, with- 
out sexual emotion ; intelligence very limited ; devoid of all 
moral sense. A. was pleased with prison life. (Spaniard 
op. cit.) 

(c) Injury to Women (Stabbing, Flagellation, etc.). 

Following lust-murder and violation of corpses, come 
cases closely allied to the former, in which injury of the 
victim of lust and sight of the victim's blood are a delight 
and pleasure. The notorious Marquis de Sade, 1 after 
whom this combination of lust and cruelty has been named, 
was such a monster. Coitus only excited him when ho 
could prick the object of his desire until the blood came. 

1 Taxi I (op. cit.) pivcs more detailed accounts of this sexual 
monster, which must have been a case of habitual satyriasis, accom- 
panied by perverse sexual instinct. Sade was so cynical that he 
actually sought to idealise his cruel lasciviousness and to be the 
apostle of a theory based upon it. He became so bad (among other 
things he made an invited company of ladies and gentlemen erotic 
by causing to be served to them chocolate bonbons which contained 
cuit ha rides) that he was committed to the insane asylum at Charen- 
ton. During the revolution of 1700 he escaped. Then he wrote 
obscene novels filled with lust, cruelty and the most lascivious 
wenes. When Bonapurte became Consul, Sade made him a present 
cif his novels, magnificently bound. The Consul had the works 
destroyed and the author committed to Charenton again, where he 
died at the age of sixty-four. Sade was inexhaustible in his lasciv- 
ious publications, which were markedly intended for advertisement. 
Fortunately it is difficult to-day to obtain copies. Extant are: 
" Histoire de Justine," 4 vols. ; " Histoire de Juliette," 6 vols. ; 
Philosophic dans le boudoir," London, 1805. Interesting is Sade's 
biography by J. Janin, 1835. 

A scientific and very thorough study of Sadism has recently 
been made by Dr. Marciat, " Bibliotheque de criminologie " xix., 
1899 (Paris, Masson). It gives an analysis and table of contents 
of Sade's writings. cf. also Diihren, " The Marquis de Sade " 1900. 



10G PSYCHOPATH! A SKXUALIS. 

His greatest pleasure was to injure naked prostitutes and 
then dress their wounds. 

The case of a captain belongs here, mentioned by Bri~ 
erre de Boismont, who always compelled the object of his 
affection to place leeches ad pudenda before coitus, which 
was very frequent. Finally this woman became very 
anaemic and, as a result of this, insane. 

The following case, from my own practice, very clearly 
shows the connection between lust and cruelty, with desire 
to shed and see blood : 

Case 25. Mr. X., aged twenty-five; father syphi- 
litic, died of paretic dementia ; mother hysterical and neur- 
asthenic. He was a weak individual, constitutionally neur- 
opathic, and presented several anatomical signs of degen- 
eration. 

When a child, hypochondria and imperative concep- 
tions; later, constant alternation of exaltation and depres- 
sion. While yet a child of ten the patient felt a peculiar 
lustful desire to see blood flow from his fingers. There- 
after he often cut or pricked himself in the fingers, and 
took great delight in it. Very early, erections were added 
to this, and also if he saw the blood of others ; for example, 
when he once saw the servant-girl cut her finger it gavo 
him an intense lustful feeling. From this time his vita 
sexualis became more and more powerful. Without any 
teaching he began to masturbate, and always during the 
act there were memory-pictures of bleeding women. It 
now no longer sufficed him to see his own blood flow ; he 
longed to see the blood of young females, especially those 
that were attractive to him. He could scarcely overcome 
the impulse to violate two cousins and a certain servant. 

Any young woman, although not attractive, induced 
this impulse when she excited him by some peculiarity of 
dress or adornment, especially coral jewellery. At first he 
succeeded in overcoming these desires ; but in his imagina- 
tion thoughts of blood were ever present, inducing lustful 



SEXUAL INCLINATION TOWAKD THE OPPOSITE HEX. 107 

excitement An inner relation existed between thoughts 
and feelings. Often there were other cruel fancies, lit; 
imagined himself in the role of a tyrant who had the people 
shot in crowds with grape-shot. He would imagine a scene 
as it would be, if enemies were to take a city and mutilate, 
torture, kill and rape the young women. 

When in his normal state this patient, who had a mild 
disposition and was not morally defective, was ashamed 
of and horrified by such cruel, lustful fancies, which be- 
came at once latent, when his sexual excitement was satis- 
fied by masturbation. 

After a few years the patient became neurasthenic. 
Then simple imaginary representations of blood and scenes 
of blood sufficed to induce ejaculation. In order to free 
himself from his vice and his cruel imagination, he began 
to indulge in sexual intercourse with females. Coitus was 
possible, but only when the patient called up the idea 
that the girl's fingers were bleeding. Without the assist- 
ance of this idea no erection was possible. The cruel 
thought of cutting was limited to the woman's hand. At 
the time of greatest sexual excitement, simply the sight of 
the hand of an attractive woman was sufficient to induce 
most violent erections. Frightened by the popular stories 
about the injurious results of onanism, he abstained and 
fell into a condition of severe general neurasthenia, with 
hypochondriacal dysthymia and ta'dium vitce. Careful 
and watchful medical treatment cured the patient after a 
few months. He remained mentally well for three years; 
but became again very sensual, though very seldom he was 
troubled by his earlier ideas of flowing blood. He gave up 
masturbation altogether, and found satisfaction in natural 
sexual indulgence, remained virile, and it was no longer 
necessary for him to call up ideas of blood. 

The following case, reported by Tamowsky (op. cit., 
p. 61), shows that such lustful, cruel impulses may be 
simply episodical, and occur in certain exceptional states 
of mind in neurotic individuals; > 



108 PSYCHOPATHIA SEXUALIS. 

Case 26. Z., physician; neuropathic constitution, 
reacting badly to alcohol. Under ordinary circumstance8 
capable of normal coitus, but as soon as he had indulged 
in wine he found that his increased libido was no longer 
satisfied by simple coitus. In this condition he was com- 
pelled to prick the nates puellce, or to make stabs with' the 
lancet, to see blood, and feel the entrance of the blade into 
the living body, in order to have ejaculation and experi- 
ence complete satiety of his lust. 

The majority of those afflicted with this form of per- 
version seem insensible to the normal stimulus of woman. 
In the first case (25), the assistance of the idea of blood 
was necessary to obtain erection. The following is that 
of a man who, by masturbation, etc., in early youth, had 
diminished his power of erection so that the sadistic act 
took the place of coitus : 

Case 27. The girl-stabber of Bozen (reported by 
Demme, "Buch der Verbrechen," Bd. ii., p. 341). In 
1829, H., aged thirty, soldier, became the subject of legal 
investigation. At different times, and in different places, 
he had wounded girls with pocket-knives or penknives, by 
stabbing them in the abdomen, preferably in the genitals. 
He gave as a motive for these acts heightened sexual im- 
pulse, increasing to the intensity of fury, which found 
satisfaction only in the thought and act of stabbing persons 
of the female sex. This impulse would pursue him for 
days at a time. He would then pass into a confused mental 
state, which would clear away only when the impulse had 
been satisfied by the deed. In the act of stabbing he ex- 
perienced the same satisfaction as that produced by com- 
pleted coitus. This was increased by the sight of blood 
dripping from the knife. In his tenth year the sexual in- 
stinct became powerfully manifest. At first he yielded to 
masturbation, and felt physically and mentally weakened 
by it. Before he became a girl-stabber, he had satisfied his 
sexual lust in violation of immature girls, by causing them 



BMUAL INCLINATION TOWARD THE OPPOSITE SEX. 109 

to practise masturbation on him, and by sodomy. Gradu- 
ally the thought came to him how pleasurable it would be 
to stab a young and pretty girl in the genitals, and take 
delight in the sight of the blood running from the knife. 

Among his effects were found copies of the object* of 
phallic cult and obscene pictures painted by himself of 
Mary's conception, and of the "thought of God injected" 
into the lap of the Virgin. He was considered a peculiar, 
very irritable man, shy of people, fond of women, moody 
and glum. Of shame and regret for his deeds no traces 
were ever found. He was apparently a person 1 who had 
become impotent through early sexual excesses, and was 
thus predisposed, by the continuance of intense libido 
sexualis and heredity, to perversion of sexual life. 

Case 28. In the "sixties" the inhabitants of Leipzig 
were frightened by a man who was accustomed to attack 
young girls on the street, stabbing them in the upper-arm 
with a dagger. Finally arrested, he was recognised as a 
sadist, who at the instant of stabbing had an ejaculation, 
and with whom the wounding of the girls was an equivalent 
for coitus. (Wharion, "A Treatise on Mental Unsound- 
ness," 623. Philadelphia, 1873.) 1 

Impotence exists likewise in the next three cases. It 
may be psychical, however, since the principal tone of the 
vita sexualis lies in sadistic inclination and the normal ele- 
ments are distorted : 

Case 29. The girl-cutter of Augsburg (reported by 

l Cf. Kraust, " Psychologic des Verbrechens," 1884, p. 188; Dr. 
Hofer, " Annalen der Staatsarzneikunde," 8 Jahrgang, Heft 2 ; 
" Schmidt 1 't Jahrbucher," Bd. 69, p. 94. 

1 According to newspaper reports, in December, 1890, several 
similar attacks were made in Mainz. A young fellow between four- 
teen and sixteen years of age pressed against women and girls and 
stabbed them in the legs with a sharp-pointed instrument. He WM 
arrested, and seemed to be insane. Further details of the case are 
not known. 



110 PSYCHOPATHIA 8EXUALI8. 

Demme "Buch der Verbrechen," vii., p. 281). Bartle, 
wine-merchant. He was subject to lively sexual excite- 
ment at the age of fourteen, though decidedly opposed to 
its satisfaction by coitus, his aversion going so far as dis- 
gust for the female sex. At that time he already had the 
idea to cut girls, and thus satisfy his sexual desire. He 
refrained from it, however, because of lack of opportunity 
and courage. He disdained masturbation, but now and 
then had pollutions with erotic dreams of girls who had 
been cut. At the age of nineteen he for the first time cut a 
girl. During the act he had a seminal emission and ex- 
perienced intense pleasure. From that time the impulse 
grew constantly more powerful. He chose only young and 
pretty girls, and, as a rule, asked them before the deed 
whether they were still single. The ejaculation or sexual 
satisfaction occurred only when he was sure that he had 
actually wounded the girls. After such an act he always 
felt tired and bad, and was also troubled with qualms of 
conscience. Up to his thirty-second year he pursued this 
process of cutting, but was always careful not to wound the 
girls dangerously. From that time until his thirty-sixth 
year he was able to control his impulse. Then he sought 
to satisfy himself by simply pressing the girls on the arm 
or neck, but this gave rise to erections only and not to 
ejaculation. Then he sought to attain his object by prick- 
ing the girls with the knife left in its sheath, but this did 
not suffice. Finally, he stabbed with the open knife, and 
had complete success, for he thought that a girl when 
stabbed bled more and suffered more pain than when 
merely cut. In his thirty-seventh year he was detected and 
arrested. In his lodgings were found a collection of dag- 
gers, sword-canes, and knives. He said that the mere sight 
of these weapons, and still more the grasping of them, 
gave him an intense feeling of sexual pleasure, with vio- 
lent excitement. According to his own confession, he had 
injured in all fifty girls. His external appearance was 
rather pleasing. He lived in very good circumstances, but 
was peculiar and shy, 



SEXUAL IN' UK ATION TOWARD THK OPPOSITE SEX. 1 1 I 

Case 30. During tlii^ month of June, 1896, quite a 
number of young girls had been stabbed in the genitals in 
the stnct in broad daylight. On the 2nd of July the per- 
petrator was caught in the act. V., twenty years of age, 
was hereditarily heavily tainted ; when fifteen years old he 
had been sexually excited to a high degree at the sight of a 
woman's buttocks. From that time on it was this part of 
the female body which attracted him in a sensuous manner 
and became the object of his erotic fancies and dreams, ac- 
companied by pollutions. Soon this was coupled with the 
lascivious desire to slap, pinch or cut the genitals of women. 
At the moment when he in his dreams performed this act, 
pollution took place. Soon he was tempted to transfer his 
dreams into real practise. For a while he succeeded in 
mastering his morbid craving, but this produced feelings 
of anxiety and a copious perspiration would break out from 
his entire body. When orgasm and erection became very 
vehement, he would be overcome with fear and confusion 
to such an extent that the impulse to cut became irresist- 
ible. At that psychical moment ejaculation would take 
place, and he felt relieved in body and mind. Magnan in 
Thoinot's op. cit. p. 451. For more detailed account see 
Gamier in Annales d'hygiene publique, 1900, Feb., p. 
112.) 

Case 31. J. IT., aged twenty-six, in 1883 came for 
consultation concerning severe neurasthenia and hypochon- 
dria. Patient confessed that he had practised onanism 
since his fourteenth year, infrequently up to his eighteenth 
year, but since that time he had been unable to resist the 
impulse. Up to that time he had no opportunity to ap- 
proach females, for he had been anxiously cared for and 
never left alone on account of being an invalid. He had 
had no real desire for this unknown pleasure, but he acci- 
dentally learned what it was when one of his mother's 
maids cut her hand severely on a pane of glass, which she 
had brokrn while washing windows. While helping to 
stop the bleeding he could not keep from sucking up the 



112 PSYCHOPATHIA SEXUALIS. 

blood that flowed from the wound, and in this act he ex- 
perienced extreme erotic excitement, with complete orgasm 
and ejaculation. 

From that time on, he sought, in every possible way to 
see and, where practicable, to taste the fresh blood of 
females. That of young girls was preferred by him. He 
spared no pains or expense to obtain this pleasure. At first 
he availed himself of a young servant, who allowed her 
finger to be pricked with a needle or lancet at his request. 
When his mother discovered this, she discharged the girl. 
Then he was driven to prostitutes as a substitute, with suc- 
cess frequently enough, though with some difficulty. In 
the intervals he practised onanism and manustupration 
per feminam, which, however, never afforded him com- 
plete satisfaction, but, on the contrary, caused listlessness 
and self-reproach. On account of his nervous difficulties he 
visited many sanatoria, and was twice a voluntary patient 
in institutions. He used hydrotherapy, electricity, and 
strengthening cures, without particular success. For a 
time it was possible, by means of cold sitz-baths, mono- 
bromate of camphor, and bromides, to diminish his sexual 
excitability and onanistic impulse. However, when the 
patient felt himself free again, he would immediately fall 
into his old passion, and spare no pains or money to satisfy 
his sexual desire in the abnormal manner described. 

Of special interest for the scientific proof of sadism is 
a case related by Moll (vide case 29, ninth edition of this 
work (German) and recently published by Moll himself in 
his book on "Libido Sexualis," p. 500. 

It discloses clearly one of the hidden roots of sadism 
the impulse to complete subjugation of the woman, 
which here became consciously entertained. This is the 
more remarkable since it occurred in an individual de- 
cidedly timid, and in other respects modest and even ap- 
prehensive. The case also shows clearly that powerful 
libido which even impels the individual to overcome all 
obstacles, may be present, while at the same time coitus is 



SEXUAL INCLINATION TOWAKD THE OPPOSITE SKX. 1 I '.I 

not desired, because the principal intensity of feeling is, 
ab origine, connected with the cruel part of the sadistic 
(lustful and cruel) circle of ideas. This case also con- 
tains weak elements of masochism (v. infra). 

Cases are by no means infrequent in which men with 
perverse inclinations induce prostitutes, by paying them 
high prices, to allow themselves to be whipped and even 
wounded by them. Works on prostitution contain reports 
of them (vide Coffignon, "La Corruption a Paris," etc.). 

(d) Defilement of Women. 

The perverse sadistic impulse, to injure women and put 
contempt and humiliation upon them, is also expressed in 
the desire to defile them with disgusting or, at least foul 
things. 

The following case, published by Arndt ("Viertel- 
jahrsschr. f. ger. Medicin," N. F. xvii., H. 1), belongs 
here : 

Case 32. A., medical student at Greifswald, accu- 
satus quod iterum iterumque puellis honestis parentibus 
naiis in publico genitalia sua ebraj&s dependentia plane 
nudata quce antea summo amiculo (overcoat) tecta erant, 
ostenderat. Nonnunquam puellas fugientes secutus casque 
ad se attractas urina oblivit. HCBC luce clara facia suni; 
nunquam aliquid hcec faciens loculus est. 

A. was twenty-three years old, well built, neat in dress, 
and polite in manners. Indication of cranium progeneum; 
chronic pneumonia of the apex of the right lung; emphy- 
sema. Pulse, 60; in excitement not more than 70 to 80. 

itals normal. Occasional disturbances of digestion, 
and hardness of the abdomen, vertigo, excessive excitement 
of sexual desires, early led to onanism. The sexual desire 
r was directed toward a natural method of satisfac- 
tion. Occasional attacks of depression, or thoughts of de- 
precation of self, and of perverse impulses, for which he 

8 



114 PSYCHOPATHIA 8EXUAOS. 

could find no motive, such as laughing at serious things, 
throwing his money in the water, and running about in the 
pouring rain. The father of the culprit was of a nervous 
temperament, the mother subject to nervous headaches. A 
brother was subject to epileptic convulsions. 

From his youth the culprit presented a nervous tem- 
perament, was inclined to convulsions and attacks of syn- 
cope, and when severely scolded would fall into a state of 
momentary stiffness. In 1869 he studied medicine in Ber- 
lin. In 1870 he went to the war as a hospital assistant. 
His letters at this time betray peculiar torpidity and soft- 
ness. On his return home, in 1871, his emotional irrita- 
bility was noticed at once by those about him. Thereafter 
frequent complaints of bodily ailments; unpleasantness 
resulting from a love affair. In November, 1871, he pur- 
sued his studies diligently in Greifswald. He was con- 
sidered very gentlemanly. In confinement he was quiet, 
calm, and sometimes self-absorbed. His acts he attributed 
to painful sexual excitement, which of late had become 
excessive. He declared that he had been fully conscious 
of his perverse acts, and after committing them ; had always 
been ashamed of them. He had not experienced actual 
sexual satisfaction in their commission. He obtained no 
correct insight into his position. He considered himself a 
kind of martyr a victim to an evil power. Presumption 
of irresponsibility, as a result of absence of free will. 

The impulse to defile occurs also, paradoxically, in the 
aged, when there is a reappearance of sexual instinct, 
which, under such circumstances, is so often expressed in 
perverse acts. Thus Tarnowsky reports (p. 76) the follow- 
ing case : 

Case 33. I knew such a patient, who had a woman 
dressed in a decollete ball-dress lie down on a low sofa in a 
brightly lighted room. Ipse apud januam alius cubiculi 
dbscuraii constiiit adspiciendo aliquantulum feminam, ex- 
citatus in earn insiluit ct excrementa in siniis ejus deposuit. 



SEXUAL INCLINATION TOWARD THE OPPOSITE SEX. 115 

HOBC faciens ejaculationem quondam sc sentire confessua 
est. 

An officer of Vienna informed me that men, by means 
of large sums of money, induce prostitutes to suffer ut illi 
viri in ora earum spuereni et fasces et urinas in ora exple- 
rent. 1 

The following case by Dr. Pascal ("Igiene dell* 
amore") seems also to belong here: % 

Case 34. A man had an inamorata who would allow 
Iii in to blacken her hands with coal or soot. She then had 
to sit before a mirror in such a way that he could see her 
hands in it. While conversing with her, which was often 
for a long time, he looked constantly at her mirrored 
hands, and finally, after a time, he would take his leave, 
fully satisfied. 

The following case, communicated by a physician, may 
be of interest in relation to this subject: 

An officer was known in a brothel in K. only by the 
name of "Oil". "Oil induced erection and ejaculation 
only by having puell. publ. nudam step into a tub filled 
with oil, while he rubbed the oil all over her body. 

These 'acts lead to the presumption that certain cases 
of injury to the clothing of females (e.g., sprinkling them 
with sulphuric acid, ink, etc.) depend upon a perverse sex- 
ual impulse; at any rate the mdtive seems to be to inflict 
an injury, or pain of some sort, and those injured are 
always females, and the perpetrators males. In crimes of 
this kind, pains should always be taken to examine into the 
vita sexualis of the culprits. 

The case of Bachmann, given below, Case 120, throws 
a clear light on the sexual nature of such crimes; for, in 
this case, the sexual motive in the deed is proven. 



Tatril (" La Corruption," Paris, Noiret, p. 223) makes the 
same statements. There are also men who demand introductio lingmt 
mtretricit in onum. 



116 PSYCHOPATHIA SEXUALIS. 

Case 35. B., age twenty-nine, merchant, married, 
heavily tainted, since his sixteenth year masturbation by 
means of a pocket electric battery, neurasthenic, impotent 
at the age of eighteen, for a while absynth drinker on ac- 
count of unrequited love. One day meeting a nurse-maid 
wearing a white apron such as his love used to wear, he 
could not resist the temptation to steal the white apron. 
He took it home and after masturbating into it burn it with 
renewed masturbation. Returning to the street he met a 
woman wearing a white dress. The sight of it produced 
an impulse to stain the dress with ink. Having done it he 
went home revelling in the sensual situation thus provoked 
and again masturbated. At another time strolling about 
the street he amused himself with cutting the dresses of 
women with a penknife. He was arrested as a pick-pocket. 
At other times a stain on a lady's dress caused orgasm and 
ejaculation in him. He obtained the same results while 
burning with a cigar a hole into the clothing of women 
whom he passed. (Magnan, reported by v. Thoinot, at- 
tentats aux moeurs, p. 434, and by Gamier, annales d' hy- 
giene publ., 1900, March, p. 237.) 

Gamier (annales d' hygiene 1900, Feb'y-March) has 
given these cases of sadism special attention reducing them 
to fetichism (vide infra}. This is particularly apparent 
in case 35 in which the fetich consisted in a blue dress cov- 
ered with a white apron. The personality of the wearer 
was a matter of indifference, it was the fetich that fas- 
cinated, the impulse being irresistible. Gamier calls these 
cases Sadi-Fetichism and points out their social and for- 
ensic importance, suggesting confinement of such unfor- 
tunate individuals in an insane asylum. Destructive ac- 
tions like these towards the fetich which, properly speak- 
ing, is an object of desire and possession, this sadism on 
lifeless objects, may be explained by the fact that the fetich 
awakens sensual sensations coupled in sadistic natures with 
the pleasure derived from acts of cruelty and destruction. 
In fetichism, well-developed, the fetich itself ab- 
stracted from the personality of the wearer it dominates 



SEXUAL INCLINATION TOWARD THE OPPOSITE SEX. 117 

per se the whole vita sexualis, brings it into action and may 
under circumstances awaken kindred regions of a sadistic 
nature which find gratification in the field of the (imper- 
sonal) fetich. The sadistic act in itself is often enough an 
equivalent for coitus rendered impossible by physical and 
psychical impotence. It may be practised on boys, animals, 
persons of the same sex, without relation to paedophilia, 
zoophilia or homosexuality. 

It is remarkable and seems to prove the connection with 
lust-cruelty that at the moment of the destroying act against 
the fetich (cutting off girl's tresses, stabbing women, de- 
filing ladies' toilets, etc.) orgasm and ejaculation take place 
in the "sadi-fetichist." 

A. Moll (Zeitschr. f. Medicinalbeamte) has recently 
published a case which may be considered classical : 

An academically cultured man, age thirty-one years, 
heavily tainted by heredity, offspring from a marriage be- 
tween blood-relations, always shy and retired, used to rump 
about when growing into puberty (17) with the playfel- 
lows of his sister, girls about eleven years of age, and from 
the sight of their white underwear became a "laundry fet- 
ichist." He began to masturbate thinking of girls clad in 
white garments and manipulating during the act light- 
coloured pieces of clothing belonging to his female rela- 
tives. 

When twenty-three years of age he began coitus with 
girls dressed in white. At the age of twenty-five he saw a 
girl's white dress being bespattered with mud. This pro- 
duced a very strong sexual emotion in him and from that 
f time on he felt an irresistible impulse to defile the apparel 
of women, to crush and tear it. This impulse was par- 
ticularly provoked at the sight of women clad in white. He 
used liquor ferri sesqui-chlorati or ink and thus produced 
orgasm and ejaculation. At times he had dreams of white 
female underwear which were accompanied by pollution at 
the moment of touching or crushing it. Insanity could 
not be established. He was mulcted in the sum of 50 marks 
for unlawfully causing damage to personal property. 



118 PSYCHOPATHIA SEXUALIS. 

(e) Other Kinds of Assault on Females Symbolic Sadism. 

The foregoing groups do not exhaust the forms in which 
the sadistic impulse toward women is expressed. If the 
impulse is not overmastering, or if there is yet sufficient 
moral resistance, it may happen that the perverse inclina- 
tion is satisfied by an act that is apparently quite sense- 
less and silly, but which has nevertheless a symbolic mean- 
ing for the perpetrator. This seems to be the meaning of 
the two following cases : 

Case 36. (Dr. Pascal, "Igiene dell' amore".) A 
man was accustomed to go, on a certain day once a month, 
to an inamorata and cut her "fringe". This gave him the 
greatest pleasure. He made no other demands on the girl. 

Case 37. A man in Vienna regularly visited several 
prostitutes only to lather their faces and then to remove 
the lather with a razor, as if he were shaving them. He 
never hurt the girls, but became sexually excited ; and ejacu- 
lated during the procedure. 1 

. Ideal Sadism. 



Sadism may eventually manifest itself solely in the im- 
agination, i.e., in dream pictures which accompany the act 
of masturbation or accompany the process of pollution in 
sadistic fancies. 

That it remains an ideal act only may be due to want of 
opportunity or courage to put it into practical action or . 
that latent ethics forbid violence, or it may be that when 
debility of the centre of ejaculation is pronounced, a vivid 
sadistic impression suffices to provoke ejaculatory gratifica- 
tion. In this case sadism is merely an equivalent for coitus. 

1 Leo Taxil (op. cit., p. 224) relates that in Parisian brothels 
instruments are kept ready which look like knouts, but which are 
merely tubes filled with air, such as clowns use in circuses. Sadistic 
men use them to create for themselves the illusion that they are 
whipping women. 



SEXUAL INCLINATION T< >WARD THE OPPOSITE BEX. 119 

Case 38. D., agent, age twenty-nine years, family 
ilv t u i nt cil, masturbation at the age of fourteen, coitus 
at twenty, but without pronounced libido or satisfaction, 
hereafter masturbation preferred. At first these acts were 
accompanied by the thought of a girl whom he could mal- 
treat and subject to humiliating and infamous actions. 

Heading of acts of violence on women excited him sex- 
ually. But he did not like to see blood either on himself 
or on others. lie hated the sight of a naked woman. 

He never felt inclined to put his sadistic ideas into ac- 
tual practice for unnatural sexual intercourse he disliked. 

He could not account for his sadistic ideas. These 
statements he made at a consultation for neurasthenia. 

Case 39. Ideal sadism with "Podex-Fetichisin." 

1'.. ni;r twenty-two, of independent means, heavily 
tainted by heredity, by accident saw the governess chastis- 
ing his sister (fourteen years of age) ad podicem inter 
genua. This made a deep impression on him and hence- 
forth he had a constant desire to see and touch his sister's 
buttocks. By some clever stratagem he succeeded. When 
seven years old he became the play-fellow of two small 
girls, of which one was tiny and lean, the other rather 
pi ump. He played the role of the father chastising his 
children. The lean girl he simply spanked over the clothes. 
The other, however, allowed him to smack her bare bottom 
(she was then ten years old). This gave him great sexual 
pleasure and caused erection. 

One day, after being chastised in this manner the girl 
asked him to look at her pudenda. But he refused the in- 
vitation as this view did not interest him in the least. 

At the age of nine he became acquainted with a boy a 
little older than himself. One day they came across a pic- 
ture representing the scene of flagellation in a monk's mon- 
astery. P. soon persuaded his companion to enact the 
scene. The latter consented to playing the passive role 
and found delight in it. This was often repeated. On one 
occasion P. assumed the passive role but it gave 



120 PSYCHOPATHIA SEXUALIS. 

him no pleasure. This relation between the two con- 
tinued till they grew up into manhood, and P. always ejac- 
ulated during the flagellation. He dominated over his 
friend, who looked upon him as a superior being. Only 
twice whilst this friendship lasted did P. attempt this pro- 
cedure on other persons ; once on a nurse-maid whose bare 
bottom he smacked, and once in the street on a girl, eleven 
years old, whose cries, however, drove him to hasty flight. 

He never felt any inclination to masturbation, coitus 
with girls, nor antipathic sexual sensations. He confined 
himself to touch the buttocks of women when in a crowd, 
or of girls whilst mixing with them on the playground, to 
look under the dresses of women climbing the stairs of an 
omnibus or watch little girls undressing themselves. 

He practised "Sadism-Fetichism". His fancy revelled 
in situations in which he flagellated his younger brother, a 
nurse-maid or a nun; he invented stories which always 
ended in a scene of flagellation; answered advertisements 
such as : "Dame severe demande eleve" and derived the ut- 
most delight from the correspondence that followed ; made 
drawings of flagellation scenes, of bare female buttocks, 
ransacked the libraries for books containing sadistic writ- 
ings, made abstracts of the whole literature, collected 
pictures referring to this favourite subject and designed 
such himself in keeping with the progress he made in 
developing his perversion. 

The flights of his fancy rose from the exhibition of the 
naked buttocks, to smacking, flagellating and even teasing 
them, even to the murder of the owner. The latter act, 
however, frightened him. The ever recurring ejaculations 
finally brought on severe neurasthenia. He never could 
make up his mind to seek medical advice. At last he found 
a woman with whom he could have coitus as she permitted 
him to flagellate her during the act. 

(Regis, Archives d' anthropologie criminelle, N. 82, 
July, 1899.) 

Case 40. Merchant, forty years of age, abnormally 



SEXUAL INCLINATION TOWARD THE OPPOSITE SEX. 121 

early hetero- and hypersexuaiity. From his twentieth year 
occasionally coitus and faute de mieux masturbation. In 
consequence of fright (surprise during coitus) psychical 
impotence. Treatment unsuccessful. This affected his 
mind and he came near to despair. He now tried imma- 
ture girls with whom impotence could not put him to 
shame. His moral will power, still unimpaired, enabled 
him to resist this impulse, however, and he found satisfac- 
tion to go with girls legally of age and no longer innocent, 
but they must in appearance be younger than their years. 
In such cases his impotence disappeared. One day he saw 
a lady smiting the face of her daughter, fourteen years old. 
This produced at once violent erection and orgasm in him. 
The thought of it had the same result. From that time he 
found a mighty stimulant in seeing girls, no matter how 
young, beaten ; even reading or hearing of maltreatment of 
females had the same result. 

That the retarded sadism in this case was not acquired 
but only latent is evident from the fact that it ever existed 
in an ideal form. It was part of the sensual idea predom- 
inant in him that he introduced "extremitatem superiorem 
in vaginam femince usque ad scapulam" and groped about 
within. [Other cases of ideal sadism see Moll (Libido sex- 
ualis, pp. 324 and 500) ; Krafft, "Arbeiten," iv. p. 163.] 

(g) Sadism with Any Other Object Whipping of Boys. 

The sadistic acts with females just now described are 
also practised on other living, sensitive objects, children 
and animals. There may be a full consciousness that the 
impulse is really directed towards women, and that only 
faute de mieux the nearest attainable objects (pupils) are 
abused. But the condition of the perpetrator may be such 
that the impulse to cruel acts enters consciousness accom- 
panied only by lustful excitement, while its real object 
(which alone can explain the lustful colouring of such 
acts) remains latent. 

The first alternative suffices as an* explanation of the 



122 PSYCHOPATIIIA SEXUALIS. 

cases which Dr. Albert describes (Friedreich's "Blatter f. 
ger. Med.," p. 77, 1859), cases "in which lustful teacher* 
whipped their pupils on the naked buttocks without cause. 
We must think of the second alternative, the sadistic im- 
pulse with unconsciousness of its object, when the sight 
of punishment causes spontaneous sexual excitement in the 
witness and thus becomes the determining factor in his 
future vita sexualis, as in the following cases : 

Case 41. K., aged twenty-five, merchant, applied to 
me in the fall of 1889 for advice concerning an anomaly 
of his vita sexualis, which made him fear invalidism and 
impossibility of future happiness in marriage. 

Patient came of a nervous family. As a child he was 
delicate, weak and nervous. Healthy except for measles; 
later on he became more robust. 

At the age of eight, while at school, he saw the teacher 
punish the boys by taking their heads between his thighs 
and spanking them with a ferule. This sight caused the 
patient lustful excitement. "Without any idea of the 
danger and enormity of onanism," he satisfied himself with 
it, and from that time often masturbated, always calling 
up the memory-picture of a boy being punished. 

Thus it continued until his twentieth year. Then he 
learned the significance of onanism, was terribly fright- 
ened, and tried to overcome his impulse to masturbate ; but 
he fell into the practice of psychical onanism, which he re- 
garded as innocuous and morally defensible, and for which 
he made use of the memory-pictures of boys being whipped, 
previously mentioned. 

Patient now became neurasthenic, suffered with pollu- 
tions, and tried to cure himself by visiting brothels ; but he 
could not induce erection. Then he sought to obtain normal 
sexual feelings by means of social intercourse with ladies ; 
but he recognised that he was entirely insensible to the 
charms of the fair sex. 

The patient was an intelligent man, normally devel- 
oped, and of aesthetic taste. There was no inclination to 



SEXUAL INCLINATION TOWARD THE OPPOSITE BEX. 123 

persons of his own sex. My advice consisted of means to 
combat the neurasthenia and pollutions; interdiction of 
psychical and manual onanism ; avoidance of all sexual ex- 
citants ; and, possibly, hypnotic treatment to ultimately in- 
duce a return of the vita sexualis to its normal condition. 

Case 42. Abortive sadism. N., student, came under 
observation in December, 1890. He had practised mastur- 
bation from early youth. According to his statements, he 
became sexually excited when he saw his father whip the 
children, and, later, when he saw his companions whipped 
by the teacher. When a spectator of such scenes, he always 
experienced lustful feelings. He could not say exactly 
when this first occurred, but it may have been at about the 
age of six. He could not tell exactly when he began to mas- 
turbate, but he stated with certainty that his sexual in- 
stinct was first awakened by the punishment of others, and 
thus he unconsciously came to practise masturbation. The 
patient remembered clearly that from the age of four to 
the age of eight he was frequently spanked, and that this 
caused him pain, never lustful pleasure. 

Since he did not always have opportunity to see others 
whipped, he began to imagine how others were punished. 
This excited his lust, and he^ would then masturbate. 
Whenever he could, he managed to see others punished at 
school. Now and then he also felt desire to whip others. 
At the age of twelve he induced a comrade to allow him to 
whip him. lie found great sexual pleasure in it. When, 
however, his companion beat him in return he experienced 
nothing but pain. 

The impulse to beat others was never very strong. 
The patient experienced more satisfaction in filling his 
imagination with scenes of whipping. He never indulged 
in any other sadistic acts, and never had any desire to see 
blood, etc. Up to his fifteenth year his sexual indulgence 
consisted of masturbation, coupled with such fancies. After 
that (dancing lessons, association with girls) the early 
fancies disappeared almost entirely and were accompanied 



124: PSYCHOPATHIA 8EXUALIS. 

by but weak lustful feelings; so that the patient gave 
them up entirely. In their place came thoughts of coitus 
in a natural way, without anything sadistic. 

The patient indulged in coitus for the first time "on 
account of his health." He was potent, and the act 
gratified him. He then tried to abstain from masturbation, 
but was not successful, though he often indulged in 
coitus, and with more pleasure than he had in masturba- 
tion. He wished to be freed from masturbation as some- 
thing vicious. He had coitus once a month, but mastur- 
bated once or twice every night. He was sexually normal, 
excepting the masturbation. There was no neurasthenia; 
genitals normal. 

Case 43. P., aged 15, of high social position, came 
of an hysterical mother whose brother and father died in 
an asylum. Two children of the family died in early child- 
hood of convulsions. The patient was talented, virtuous, 
and quiet ; but at times he was very disobedient, stubborn, 
and of violent temper. He had epilepsy, and practised 
masturbation. One day it was learned that P., with money, 
induced a comrade of fourteen, B., to allow himself to 
be pinched in the arms, genitals, and thighs. When B. 
cried, P. became excited and struck at B. with his right 
hand, while with his left he made manipulations in the 
left pocket of his trousers. P. confessed that to maltreat 
his friend, of whom he was very fond, gave him peculiar 
delight; and that ejaculation while hurting his friend 
gave him much more pleasure than when he masturbated 
alone. (v. Gyurlcovechky , "Pathol. und Therapie der 
mannl. Impotenz.," p. 80, 1889). 

Case 44. K., fifty years of age, without occupation, 
heavily tainted, satisfied his perverse sexual feelings ex- 
clusively on boys of ten to fifteen years of age, whom he 
seduced to mutual masturbation. At the acme of the sit- 
uation he would pierce the lobe of the boy's ear. When 
this, later on, proved ineflicient, he cut off the lobe of a 



SEXUAL INCLINATION TOWABD THE OPPOSITE SEX. 125 

boy's ear. He was arrested and sentenced to five years* 
imprisonment (Thoinot, op. cit. f p. 452.) 

That in all these cases of sadistic abuse of boys there 
can be no thought of a combination of sadism and anti- 
pathetic sexual instinct, as often occurs (v. infra) in indi- 
viduals of inverted sexuality, is shown aside from the 
absence of all positive signs of it by a study of the next 
group, where, in association with the object of injury, 
animals, the instinct for women is seen to appear 
repeatedly. 

(h) Sadistic Acts wiih Animals. 



In numerous cases, sadistically perverse men, afraid 
of criminal acts with human beings, or who care only 
for the sight of the suffering of a sensitive being, make 
use of the sight of dying animals, 1 or torture animals, to 
stimulate or excite their lust. 

The case of a man in Vienna, which is reported by 
Hofmann in his "Text-Book of Legal Medicine," is note- 
worthy in relation to this. According to the evidence of 
several prostitutes, before the sexual act he was accus- 
tomed to excite himself by torturing and killing chickens 
and pigeons and other birds, and, therefore, was called 
"Hendlherr" (chickenmister). 

For the elucidation of such cases the observation of 
Lombroso is of value, according to whom two men had 
ejaculation when they killed chickens or pigeons, or wrung 
their necks. 

The same author, in his "Uomo delinquente," p. 201. 
speaks of a poet of some reputation, who became power- 
fully excited sexually whenever he saw calves slaughtered, 
and also at the sight of bloody meat. 

Mantegazza (op. cit. p. 114) relates that among degene- 
rate Chinese the practice prevails to sodomise geese and 
at the moment of ejaculation to cut off their heads. 

'Dimitri, the son of Ivan the Cruel, derived unspeakable pleas- 
ure when witnessing the death struggles of sheep, chickens and 
geese. ( Bibliotheque de Criminologie, xix., p. 278.) 



126 PSYCHOPATHIA SEXUALIS. 

Mantegazza ("Fisiologia del piacere," fifth ed., pp. 
394, 395) mentions the case of a man who once saw chick- 
ens killed, and from that time had a desire to wallow in 
their warm, steaming entrails, because he experienced a 
feeling of lust while doing it. 

Thus, in these and similar cases, the vita sexualis is 
so constituted ab origine that the sight of blood, death, 
etc., excites lustful feeling. It is so in the following 
case : 

Case 45. C. L., aged forty-two, engineer, married, 
father of two children ; from a neuropathic family ; father 
irascible, a drinker; mother hysterical, subject to eclamptic 
attacks. The patient remembers that in childhood he 
took particular pleasure in witnessing the slaughtering of 
domestic animals, especially swine. He thus experienced 
lustful pleasure and ejaculation. Later he visited slaughter- 
houses, in order to delight in the sight of flowing blood 
and the death throes of the animals. When he could find 
opportunity, he killed the animals himself, which always 
afforded him a vicarious feeling of sexual pleasure. 

At the time of full maturity he first attained to a 
knowledge of his abnormality. The patient was not 
exactly opposed in inclination to women, but close contact 
with them seemed to him repugnant. On the advice of 
a physician, at twenty-five he married a woman who 
pleased him, in the hope of freeing himself of his abnoi- 
mal condition. Although he was very partial to his wife, 
it was only seldom, and after great trouble and exertion of 
his imagination, that he could perform coitus with her; 
nevertheless, he begat two children. In 1866 he was in 
the war in Bohemia. His letters written at that time to 
his wife, were composed in an exalted, enthusiastic tone. 
He was missed after the battle of Koniggratz. 

If, in this case, the capability of normal coitus was 
much impaired by the predominance of perverse ideas, ill 
the following it seems to have been entirely repressed: 



SEXUAL INCLINATION TOWARD THE OPPOSITE SEX. 127 

Case 46. (Dr. Pascal, "Igiene dell' araore ") A 
gentleman visited prostitutes, had them purchase a living 
fowl or rabbit, and made them torture the animal. He 
particularly revelled in the sight of cutting off the heads 
and tearing out the eyes and entrails. If he -found a girl 
who would consent, and go about it right cruelly, he was 
delighted, and paid her and went his way without asking 
anything more or touching her. 

Interesting is the awakening of sadistic feelings to- 
ward animals as related in the following case of Fere: 

Case 47. B., thirty-seven years of age, tanner, 
tainted, began masturbation at the age of nine. One day, 
as he was about to masturbate with another boy at the 
corner of a street, where the gradient was very steep, a 
heavily laden dray pulled by four horses came along. The 
driver yelled at the horses and whipped them. The horses 
slipped about a good deal and made the sparks fly from 
the cobble stones. This excited B. very much and he 
ejaculated as one of the horses fell. Ever afterwards a 
similar occurrence would have the same effect on him 
and he went in search of it. If the difficulty was overcome 
without extra exertion on the part of the horse, or with- 
out the use of the whip, B. became only excited and he 
had to resort to masturbation or coitus to find final sat- 
isfaction. Even after he was married and had children, 
sadism continued. When one of his children fell ill with 
chorea, B. had hysterical attacks. (Fere, 1'instinct sexuel, 
p. 255). 

The last two sections, g and Ti, show that the suffering 
of any living being may become a source of perverse sexual 
enjoyment to sadistically constituted persons, and that 
there may be sadism with almost any [living] object. 
However, it would be erroneous and an exaggeration to try 
to explain by sadistic perversion all the remarkable and 
surprising acts of cruelty that occur, and to assume sadism 



128 PSTCHOPATHIA SEXUALIS. 

as the motive underlying all the horrors recorded in history 
or found in certain psychological manifestations among 
the peoples of the present time. 

Cruelty arises from various sources and is natural to 
primitive man. Compassion, in contrast with it, is a 
secondary manifestation and acquired late. The instinct 
to fight and destroy, so important an endowment in pre- 
historic conditions, is long afterwards operative; and, in 
the ideas engendered by civilisation, like that of "the 
criminal," it finds new objects, so long as its original 
object "the enemy" still exists. That not simply the 
death, but also torture of the conquered is demanded, is 
in part explained by the sense of power, which satisfies 
itself in this way, and in part by the insatiableness of the 
impulse of vengeance. Thus all horrors and historical 
enormities may be explained without recourse to sadism 
(which may often enough have been the motive, but 
should not be assumed as such, since it is a relatively 
rare perversion). 

At the same time, there is still another powerful 
psychical element to be taken into consideration, which 
explains the attraction which is still exerted by execu- 
tions, etc. ; viz., the pleasure which is produced by intense 
and unusual impressions and rare sights, in contrast to 
which, in coarse and blunted beings, pity is silent. 

But undoubtedly there are individuals for whom, in 
spite or even by reason of their lively compassion, all that 
is connected with death and suffering has a mysterious 
attraction who, with inward opposition, and yet follow- 
ing a dark impulse, occupy themselves with such things, 
or at least with pictures and notices of them. Still, this 
is not sadism, so long as no sexual element enters into 
consciousness; and yet it is possible that, in unconscious 
life, slender threads connect such manifestations with the 
hidden depths of sadism. 



SEXUAL INCLINATION TOWABD TUB OPPOSITE SEX. 

(t) Sadism in Woman. 

That sadism a perversion, though often met with in 
men is less frequent in women, may be easily explained. 
In the first place, sadism, in whirh the need of subju- 
gation of the opposite sex forms a constituent element, 
in accordance with its nature represents a pathological 
intensification of the masculine sexual character; in the 
second place, the obstacles which oppose the expression 
of this monstrous impulse are, of course, much greater for 
woman than for man. Yet sadism occurs in women, and 
it can only be explained by the primary constituent ele- 
ment the general hyper-excitation of the motor sphere. 
Only two cases have thus far been scientifically studied. 

Case 48. A married man presented himself with 
numerous scars of cuts on his arms. He told their origin 
as follows: When he wished to approach his wife, who 
was young and somewhat "nervous," he first had to 
make a cut in his arm. Then she would suck the wound 
and during the act become violently excited sexually. 

This case recalls the widespread legend of the vam- 
pires, the origin of which may perhaps be referred to such 
sadistic facts. 1 

In the second case of feminine sadism, for which P am 
indebted to Dr. Moll, of Berlin, by the side of the perverse 
impulse, as so frequently happens, there is anaesthesia in 
the normal activities of sexual life; and there are also 
traces of masochism (v. infra). 

Case 49. Mrs. H., of H., aged twenty-six, came of a 
family in which nervous or mental diseases are said not to 

1 The legend is especially spread throughout the Balkan penin- 
sula. Among the modern Greeks it has its origin in the myth of the 
Iami<r and marmolykcs blood-sucking women. Goethe made use of 
this in his " Bride of Corinth." The verses referring to vampirism, 
" suck thy heart's blood," etc., can be thoroughly understood only 
when compared with their ancient sources. 

Q 



130 PSYCHOPATH I A Si:XUALIS. 

have been observed ; but the patient herself presented sigas 
of hysteria and neurasthenia. Although married eight 
years and the mother of a child, Mrs. H. never had desire 
to perform coitus. Very strictly educated as a young girl, 
until her marriage she remained almost innocent of any 
knowledge of sexual matters. She had menstruated reg- 
ularly since her fifteenth year. Essential abnormality 
of the genitals was not apparent. To the patient coitus was 
not only not a pleasure, but even an unpleasant act, and 
repugnance to it had constantly increased. The patient 
could not understand how any one could call such an act 
the greatest delight of love, which to her was something far 
sublimer and unconnected with sensual impulse. At the 
same time it should be mentioned that the patient really 
loved her husband. In kissing him, too, she experienced 
a decided pleasure, which she could not exactly describe. 
But she could not conceive how the genitals can have 
anything to do with love. In other respects Mrs. H. was 
a decidedly intelligent woman of feminine character. 

Si oscula dat conjugi, magnam voluptatem percipit in 
mordendo eum. Gratissimum ei esset conjugem mordere 
eo modo ut sanguis fluat. Contenta esset, si loco coitus 
morderetur a conjuge ipsaeque eum mordere liceret. 
Tamen earn preniteret, si morsu magnum dolorem faceret. 
(Dr. Moll). 1 

In history there are examples of famous women who, 
to some extent, had sadistic instincts. These Messaliruis 
are particularly characterised by their thirst for power, 
lust, and cruelty. Among them are Valeria Messalina 
herself, and Catherine de' Medici, the instigator of the 
Massacre of St. Bartholomew, whose greatest pleasure 
was to have the ladies of her court whipped before her 
eyes, etc. 2 (Confer above.) 

1 Another case of Sadismvs femtnae is given by Moll, 3rd edit, 
of " Die Contr. Sexualempfindung," p. 507, case 29. It is the exact 
counterpart of Masochism in man and represents the ideal desire of 
the Masochist. 

* The gifted Henry von Kleist, who was beyond doubt mentally 



MASOCHISM. 131 

2. Masochism. 1 The Association of Passively Endured 
Cruelty and Violence with Lust 

ohism is the opposite of sadism. While the latter 
is the desire to cause pain am! use force, the former is 
the wish to suffer pain and be subjected to force. 

By masochism I understand a peculiar perversion of 
the psychical vita sexualis in which the individual affected, 
in sexual feeling and thought, is controlled by the idea of 
being completely and unconditionally subject to the will 
of a person of the opposite sex; of being treated by this 
person as by a master, humiliated and abused. This idea 
is coloured by lustful feeling; the masochist lives in 
fancies, in which he creates situations of this kind and 
often attempts to realise them. By this perversion his 
sexual instinct is often made more or less insensible to the 
normal charms of the opposite sex incapable of a normal 
vita sextialis psychically impotent. But this psychical 

abnormal, gives a masterly portrayal of complete feminine sadism in 
hia " Penthesilea." In scene xxii., Kleist describes his heroine pur- 
suing Achilles in the fire of love, and when he is betrayed into her 
hands, she tears him with lustful, murderous fury into pieces, and 
nets her dogs on him : " Tearing the armour from his body, she 
strikes her teeth in his white breast she and her dogs, the rivals, 
Oxus and Sphynx they on the right side, she on the left; and as 
I approached blood dripped from her hands and mouth." And later, 
when Penthesilea becomes satiated : " Did I kiss him to death T No. 
Did I not kiss him? Torn in pieces? Then it was a mistake; kissing 
rhymes with biting [in German, Kiisse, Bisse], and one who loves 
with the whole heart might easily mistake the one for the other." 
In recent literature we find the matter frequently treated, but par- 
ticularly in Kacher-Masorh'a novels, of which mention is made later 
on, and in Ernest von Wildenbruch't " Brunhilde," Rochildc'a " Le 
Marquise de Sade," etc. 

1 Literature, v. Krafft, Neue Forschungen aus dem Gebiete der 

Psychopath i:i S-\tialis, 2 Aufl. Idem, Arbeiten aus d. Gesammt- 

. ,1. l\\rhi:itrie u. Neuropathol., iv., p. 127-160. Moll, Die 

i 'nut rare Sexualempfindung, 3. Aufl., 27&Eulcnburg, Grenzfragen 

dos Nervon- und Seoh-nlolx-ns. xix., S.idismus u. Masochismus, 1902. 

Fuck*, Therapie der anomalen vita sexualis (Stuttgart, Enke) Beob. 

5 and 6. r. Xchrcnk \ otzing, Die Suggestions-Therapie, 1892. 

Keydrl. Viortoliahrsohr. f. jr>riehtl. Med., 1893, iv. 2 ( Interessante 

von Masochiftten ) . Bloch, Beitrftge z. Aetiol. d. Psychopi. 

sexualis, 2 Theil, Dresden. 1903. 



132 PSYCHOPATHIA 8EXUAXIS. 

impotence does not in any way depend upon a horror sexus 
alterius, but upon the fact that the perverse instinct finds 
an adequate satisfaction differing from the normal in 
woman, to be sure, but not in coitus. 

But cases also occur in which with the perverse im- 
pulse there is still some sensibility to normal stimuli, and 
intercourse under normal conditions takes place. In other 
cases the impotence is not purely psychical, but physical, 
i.e., spinal; for this perversion, like almost all other per- 
versions of the sexual instinct, is developed only on the 
basis of a psychopathic and, for the most part, hereditarily 
tainted individuality; and as a rule such individuals are 
given to excesses, particularly masturbation, to which the 
difficulty of attaining what their fancy creates drives them 
again and again. 

I feel justified in calling this sexual anomaly "Maso- 
chism," because the author Sacher-Masoch frequently made 
this perversion, which up to his time was quite unknown 
to the scientific world as such, the substratum of his writ- 
ings. I followed thereby the scientific formation of the 
term "Daltonism," from Dalton, the discoverer of colour- 
blindness. 

During recent years facts have been advanced which 
prove that Sacher-Masoch was not only the poet of Maso- 
chism, but that he himself was afflicted with this anomaly. 1 
Although these proofs were communicated to me without 
restriction, I refrain from giving them to the public. I 
refute the accusation that 'I have coupled the name of a 
revered author with a perversion of the sexual instinct, 
which has been made against me by some admirers of 
the author and by some critics of my book. As a man 
Sacher-Masoch cannot lose anything in the estimation of 
his cultured fellow-beings simply because he was afflicted 
with an anomaly of his sexual feelings. As an author 
he suffered severe injury so far as the influence and in- 
trinsic merit of his work is concerned, for so long and 

1 Cf. for corroboration Sacher-Magoch, biography by v. Eulenbwg: 
Grenzfragen des Nerven- und Seelenlebens, 1902, xxix., pp. 46-57. 



133 

whenever he eliminated his perversion from his literary 
efforts he was a gift*-! writer, and as such would have 
achieved real greatness had he been actuated by normally 
sexual feelings. In this respect he is a remarkable exam- 
ple of the powerful influence exercised by the vita sexual is 
be it in the good or evil sense <>ver the formation and 
direction of man's mind. 

The number of cases of undoubted masochism thus 
far observed is very large. Whether masochism occurs 
associated with normal sexual instincts, or exclusively 
controls the individual ; whether or not, and to what extent, 
the individual subject to this perversion strives to realise 
his peculiar fancies; whether or not, he has thus more or 
less diminished his virility depends upon the degree 
of intensity of the perversion in the single case, upon the 
strength of the opposing ethical and esthetic motives and 
the relative power of the physical and mental organisation 
of the affected individual. From the psychopathic point 
of view, the essential and common element in all these 
cases is the fact that the sexual instinct is directed to ideas 
of subjugation and abuse by the opposite sex. 

Whatever has been said with reference to the im- 
pulsive character (indistinctness of motive) of the resulting 
acts and with reference to the original (congenital) nature 
of the perversion in sadism, is also true in masochism. 

In masochism there is a gradation of the acts from 
the most repulsive and monstrous to the silliest, regulated 
by the degree of intensity of the perverse instinct and the 
power of the remnants of moral and aesthetic counter- 
motives. The extreme consequences of masochism, how- 
ever, are checked by the instinct of self-preservation, and 
therefore murder and serious injury, which may be com- 
mitted in sadistic excitement, have here in reality, so far 
as known, no passive equivalent. But the perverse de- 
sires of masochistic individuals may in imagination attain 
these extreme consequences (v. infra, case 50). 

Moreover, the acts to which masochists resort are in 
some cases performed in connection with coitus, i.e., as 



134 PBYCHOPATHIA SEXUALIS. 

preparatory measures; in others, as substitutes for coitus 
when this is impossible. This, too, depends only upon the 
condition of sexual power, which has been diminished for 
the most part physically and mentally by the activity of 
the sexual ideas in the perverse direction, and not upon 
the nature of the act itself. 

(a) The Desire for Abuse and Humiliation as a Means of 
Sexual Satisfaction. 

Case 50. Mr. Z., age twenty-nine, technologist, came 
for consultation because of fear of tabes. Father nervous, 
died tabetic. Father's sister insane. Several relatives very 
nervous and peculiar. On closer examination the patient 
was found to have sexual, spinal and cerebral asthenia. 
He presented no symptoms of tabes dorsalis. Questions 
concerning abuse of the sexual organs brought out a con- 
fession of masturbation practised since youth. In the 
course of the examination the following interesting psycho- 
sexual anomalies were discovered: At the age of five the 
vita sexualis began with the impulse to whip himself, as 
well as with the desire to see others whipped. In this 
he never thought of individuals as of the one sex or the 
other. Faute de mieux he practised flagellation on him- 
self, and, in time, this induced ejaculation. Long before 
this he had begun to satisfy himself with masturbation, 
and always during the act revelled in imaginary scenes 
of whipping. He twice visited brothels to have himself 
flogged by prostitutes. For this purpose he chose the pret- 
tiest girl he could find ; but he was disappointed, and did 
not even have an erection, to say nothing of ejaculation. 
He recognized that the flagellation was subsidiary, and that 
the idea of subjection to the woman's will was the impor- 
tant thing. He realised this on the second trial. When he 
had the "thought of subjection" he was perfectly suc- 
cessful. In time, by straining his imagination with maso- 
chistic ideas, he performed coitus without flagellation ; but 
he found little satisfaction in it, so that he performed 



MASOCHISM. 135 

sexual intercourse in a masochistic way. He found pleas- 
ure in masochistic scenes, in the sense of his original desire 
for flagellation, only when he was flagellated ad podicem, 
or, at least, only when he called up such a situation in 
imagination. At times of great excitability it was even 
sufficient if he told stories of such scenes to a pretty girl. 
He would thus have an orgasm, and usually ejaculation. 

A very effectual fetichistic idea was early associated 
with this. He noticed that he was attracted and satisfied 
only by women wearing high heels and short jackets 
("Hungarian fashion"). He did not know how he 
arrived at this fetichistic idea. Boys' legs with high heels 
also pleased him; but this charm was purely aesthetic, 
without any sensual colouring; and he said he had never 
noticed anything homosexual in himself. The patient 
referred his fetichism to his partiality for calves (legs). 
He was charmed by ladies' calves only when elegant shoes 
were on the feet. Nude legs feminine nudity in general 
did not in the least affect him sexually. A subordinate 
fetichistic idea for the patient was the human ear. It was 
a lustful pleasure for him to caress the handsome ears of 
people. With men this pleasure was slight, but with 
women it gave him great enjoyment. 

He also had a weakness for cats. He thought them 
simply beautiful, and their movements were very attractive 
to him. The sight of a cat could raise him from a feeling 
of the deepest depression. Cats seemed to him sacred ; he 
saw something divine in them! He did not know the 
reason for this idiosyncrasy. 

Of late he also frequently had sadistic ideas about 
punishing boys. In these imaginary flagellations both 
men and women played a part, but particularly the latter, 
and then his enjoyment was much more intense. 

The patient found that, besides what he recognised and 
felt as masochism, there was something else which he 
preferred to designate "pageism." 

While his masochistic fancies and acts were entirely of 
a coarse, sensual nature, his "pageism" consisted of the 



136 PSYCHOPATHIA SEXUALIS. 

idea of being a page to a beautiful girl. His conception 
was perfectly chaste, but piquant; his relation to her that 
of a slave, but absolutely , pure a mere platonic sub- 
mission. This revelling in the idea of serving such a 
"beautiful creature" as a page was coloured by a pleasur- 
able feeling, but this was in no way sexual. lie experi- 
enced in it an exquisite feeling of moral satisfaction, in 
contrast with sensually coloured masochism, and therefore 
he could but regard it as something of a different nature. 

At first sight there was nothing remarkable in tho 
patient's appearance ; but his pelvis was abnormally broad, 
the ilia were flat, and the pelvis, as a whole, tilted and 
decidedly feminine. Eyes, neuropathic. He also men- 
tioned that he often had itching and lustful irritation at 
the anus, and that there ("erogenous" area) ope digiti, ho 
could satisfy himself. 

The patient was troubled about his future. Help 
would be possible for him if he could but excite in himself 
an interest in women, but his will and imagination were too 
weak for that. 

What the patient designated as "pageism" does not 
differ in any way from masochism, as may be seen when 
it is compared with the following cases of symbolic 
masochism and others; and, further, upon the considera- 
tion that in this perversion coitus is avoided as an 
inadequate act, and from the fact that in such cases there 
is often a fantastic exaltation of the perverse ideal : 

Case 51. Ideal Masochism. Mr. X., technologist, 
twenty-six years old. Mother of nervous disposition ; suf- 
fered from neuralgia. In the father's family a case of 
spinal disease and one of psychosis. A brother suffered 
from nervousness. Mr. X. had only slight infantile affec- 
tions ; he learned easily at school, and developed normally. 
He was of manly appearance, but rather weakly and under 
medium size. The descent of the right testicle was im- 
perfect, but could be noticed in the inguinal canal. Penis 
normally formed, but rather small. 



At the age of five be felt sexual excitement whilst 
swinging on the cross-bar with legs crossed, and stretched 
out at full length, lie repeated the exercise several times, 
but forgot about the sensation until he grew up to maturer 
age. He then tried to induce this pleasurable feeling 
by repeating the exercise, but without success. 

At the age of seven he took part in a general fight 
between the pupils of the school which he attended, after 
which the victors rode on the backs of the vanquished. 
This impressed X. considerably. 

He thought the position of the prostrate boys a pleas- 
ant one, wanted to put himself in their place, imagining 
how by repeated efforts he could move the boy on his 
back near his face so that he might inhale the odour of 
his genitals. These thoughts, coupled with pleasurable 
feelings, often recurred to him afterwards, although they 
never occasioned real sensations of lust; in fact, he con- 
sidered these thoughts sinful and bad, and sought to 
repulse them. He claimed to have had no knowledge at 
that time of sexual matters. It is remarkable that the 
patient up to his twentieth year was periodically troubled 
with eneuresis nocturna. 

Up to the time of puberty these masochistic fancies 
to lie under the thighs of others, boys as well as girls, 
recurred periodically. Now the objects were chiefly 
girls, but these exclusively when puberty was completed. 
Little by little these situations gained a different mean- 
ing, for soon the culminating point was the consciousness 
to be absolutely subject to the will and whims of a fully 
developed girl, coupled with corresponding humiliating 
acts and attitudes. 

For instance, X. says : 

"I am lying on my back on the floor. The mistress 
stands over my head with one foot on my breast or she 
holds my head between her feet so that her genitals are 
directly in a line with my vision. Or she sits a-straddle 
"ii my chest or on my face, using my body as a table. If 
1 do not obey her commands promptly she locks me up 



138 PSYCHOPATHIA 8EXUALIS. 

in a dark W.C. and leaves the house to find pleasure 
elsewhere. She introduces me to her friends as her slave 
and turns me over as such to them as a loan. 

"She makes me perform the lowest menial work, wait 
upon her when she arises, in the bath et inter mictionem. 
At times she uses my face for the latter purpose and 
makes me drink of the voidance." 

X. claimed that he never practically put these ideas 
into effect for fear of not realising the anticipated pleasure. 

Once only he sneaked into the room of a pretty house- 
maid ut urinam puellce bibat; but he was too much dis- 
gusted to carry out the purpose. 

He stated that he fought in vain against these maso- 
chistic impulses, considering them of a painful and dis- 
gusting nature. They were still prevalent. He pointed 
out particularly that the humiliation connected with these 
imaginary acts was the principal attraction, and that the 
pleasure derived from causing pain to others was never 
associated with them. 

He preferred as "mistress" a slender maiden of about 
twenty years of age, with a pretty face, and wearing short 
light dresses. 

The ordinary intercourse with young women, dancing, 
or mixed society, never impressed him. 

With the period of puberty these masochistic ideas 
were at times accompanied by pollutions, but only weak 
emotions of lust. 

At one time the patient resorted to friction of the 
glans penis, but he could not induce erection, much less 
ejaculation, and instead of pleasure he produced disagree- 
able paralytic feelings. This saved him from masturba- 
tion. But after the age of twenty he often experienced 
lustful emotions with ejaculation when performing gym- 
nastic exercises on the horizontal bar, or when climbing 
poles or ropes. He never had a desire for sexual inter- 
course with women or for inverted sexual actions. At the 
age of twenty-six a friend urged him to coitus, but already 
on the way to the house "anxiety, restlessness, and decided 



MASOCHISM. 139 

disgust" crept over him. He became so excited, trembled 

all over, and broke out into a profuse perspiration, that 

<>uld not command an erection. Repeated attempts 

-<d complete failures, but he was able to control his 
mental and physical excitement a little better than the 
first time. 

Libido was never present. Masochistic imaginations 
gave no assistance, because his mental faculties at such 
times were "as if paralysed," and he "could not call 
up those intense imaginary representations which he 
found necessary for an erection." Thus he gave up all 
attempts at coitus, partly because libido was absent, 
and partly on account of his utter want of confidence 
in success. Only now and then he satisfied his weak 
sexual desires by the aid of gymnastic exercises. Oc- 
casionally, however, spontaneous or superinduced maso- 
chistic fancies (when awake) would cause erection, but 
never ejaculation. 

Pollutions occurred at periods of six weeks. 

The patient was highly intellectual, of refined man- 
ners, and a little neurasthenic. He complained that when 
in society the feeling obtruded itself constantly that he was 
being observed. This caused him worry and embarrass- 
ment, although he was fully aware that all this was naught 
but imagination. He loved solitude, for fear that others 
might find out his sexual abnormality. 

This impotence did not cause him pain, for he had 
scarcely any desire. Nevertheless he would consider the 
cure of his oita sexualis a great boon, since so much 
depended upon it in social life, and he would be more self- 
possessed and manlier when among others. 

\\\< present existence he considered a misery, and his 
life a burden. 

Case 52. X., man of letters, aged twenty-eight, 
tainted. Sexually hypersesthetic from childhood. At the 
age of six he had dreams of being whipped ad naies by a 
woman. Upon awakening, intense lustful excitement ; thui 



140 PSYCHOPATHIA 8EXUALIS. 

he came to practise onanism. When eight years old he 
once asked the cook to whip him. From his tenth year, 
neurasthenia. Until his twenty-fifth year he had dreams of 
flagellation or similar fancies when awake, and indulged 
in onanism. Three years ago he had an impulse to have 
himself whipped by a puella. The patient was dis- 
appointed, for neither erection nor ejaculation occurred. 
At twenty-seven, another effort, with the thought to en- 
force erection and ejaculation. This was finally made 
possible by the following artifice: While coitus was 
attempted the puella had to tell him how she flogged 
mercilessly other impotent men, and threaten him with 
the same. Besides this, it was necessary for him to fancy 
that he was bound, entirely in the woman's power, help- 
less, and most painfully beaten by her. Occasionally, in 
order to become potent, it was necessary to have himself 
actually bound. Thus coitus was possible. Pollutions 
were accompanied by lustful feeling only when he (infre- 
quently) dreamed that he was abused, or that he looked 
on while one puella whipped the other. He never had a 
real lustful pleasure in coitus. The only things in women 
that interested him were the hands. Powerful women with 
big fists were his preference. At the same time, his desire 
for flagellation was only ideal ; for with his great cutaneous 
sensitiveness at the most a few strokes were sufficient. 
Blows from men were repugnant to him. He wished to 
marry. From the impossibility of asking a decent woman 
to perform flagellation and the doubt about being potent 
without flagellation sprang his embarrassment and desire 
to recover. 

Passive Flagellation and Masochism. 

Case 53. D., age thirty-two, sculptor, hereditarily 
tainted, marks of degeneration, constitutionally neuro- 
pathic, neurasthenic, weakly in his earlier years. First 
emotions of sexuality at the age of seventeen; it devel- 
oped slowly and exclusively in a hetero-sexual, but maso- 
chistic direction. He craved for floggings at the hands 



MASOCHISM. 141 

of a pretty woman (bu* no hand-fetichisin). He preferred 
women of haughty and imperious appearance. 'He never 
ought to put his masochistic desires into real practice. 
He could not explain them. 

On four occasions he tried coitus but without success, 
He practised masturbation, which caused severe neuras- 
thenia, accompanied by phobia, whereupon he sought med- 
ical advice. 

In three of the foregoing cases for the most part passive 
flagellation serves him that is subject to this perversion of 
masochism as an expression of the desired situation of 
subjection to the woman. The sum<- means is needed by 
a large number of masochists. But passive flagellation is 
a process which, as is known, has a tendency to induce 
erection reflexly by irritation of the nerves of the buttocks. 1 
This effect of flagellation is used by weakened debauchees 
to help their diminished power; and this perversity not 
perversion is very common. It is, therefore, necessary to 
ascertain in what relation the passive flagellation of the 
masochists stands to those dissipated individuals who are 
not psychically perverse, but physically weakened. 

It is not difficult to show that masochism is some- 
thing essentially different from flagellation, and more 
comprehensive. For the masochist the principal thing 
is subjection to the woman ; the punishment is only the 
expression of this relation the most intense effect of it 
he can bring upon himself. For him the act has only a 
symbolic value, and is a means to the end of mental satis- 
faction of his peculiar desires. On the other hand, the 
individual that is weakened and not subject to masochism 
and who has himself flagellated, desires only a mechanical 
irritation of his spinal centre.. 

Whether in a given case it is simple (reflex) flagella- 
tion or masochism is made clear by the individual's state- 
ments, and often by the secondary circumstances. The 
determination depends upon the following facts : 

In the first place, the impulse to passive flagellation 
*C/. tupra, Introduction. 



142 PSYCHOPATHIA SEXUALW. 

exists in the masocbist ab origine. The desire is felt before 
there has been any experience of the reflex effect, often 
first in dreams, as, for example, in case 55, v. infra. 
Secondly, with the masochist, as a rule, flagellation is only 
one of many and various punishments which come into 
his mind as fancies and are often realised. In these other 
punishments and the frequent acts expressing purely sym- 
bolic humiliations which occur by the side of flagellations, 
there can, of course, be no thought of a reflex physical 
irritative effect. Thirdly, it is significant that, in the 
masochist when the desired flagellation is carried out, it 
need have no aphrodisiac effect at all. Very often, indeed, 
there is a more or less defined disappointment; in fact, 
always, if the masochist is not successful in his desire to 
create by means of the prearranged programme the illu- 
sion of the desired situation (to be in the woman's power), 
so that the woman ordered to carry out the act seems to 
be nothing more than the executive agent of his own will. 
In reference to this important point, compare the three 
foregoing cases and case 58. 

Between masochism and simple (reflex) flagellation, 
there is a relation somewhat analogous to that existing 
between inverted sexual instinct and acquired pederasty. 
It does not lessen the value of this opinion that, in the 
masochist, the flagellation may also have the known reflex 
effect; or that a whipping received in childhood may have 
aroused lust for the first time, and thus simultaneously 
excited the latent masochistically constituted vita sexualis. 
In this event, the case must be characterised by the con- 
ditions mentioned above under the heads of "secondly" 
and "thirdly" in order to be masochistic. If the details 
of the origin of the case are not known, other circum- 
stances, such as those mentioned above under "secondly' 
would make it clearly masochistic. This is illustrated in 
the following two cases : 

Case 54. A patient of Tarnowsky's had a person in 
his confidence rent a house during hia attacks, and instruct 



MASOCHISM. 143 

its personnel (three prostitutes) in what was to be done 
with him. Whenever he came there he was undressed, 
manustuprated and flagellated as ordered. He pretended 
to offer resistance, and begged for mercy; then, as 
ordered, he was allowed to eat and sleep. But in spite 
of protest he was kept there, and beaten if he did not sub- 
mit Thus the affair would go on for some days. When 
the attack was over he was dismissed, and he returned to 
his wife and children, who had no suspicion of his disease. 
The attacks occurred once or twice a year (Tarnowsky, 
op. cit.) 

Case 55. X., aged thirty-four, greatly predisposed, 
suffered with antipathic sexual instinct. For various rea- 
sons he had no opportunity to satisfy himself with men, 
in spite of great sexual desire. Occasionally he dreamed 
that a woman whipped him, and then had a pollution. 

Through this dream he came to have prostitutes beat 
him as a substitute for love with men. Occasionally he 
would obtain a prostitute, undress himself completely 
(while she was not to take off her chemise), and have 
her tread upon him, whip and beat him. Qua re summa 
libidine affectus pedem femince lambii quod solum eum 
libidinosum facere poiest: turn ejaculationem assequitur. 
Then disgust at the morally debasing situation occurred, 
and he retired as quickly as possible. 

Case 56. A gentleman of high standing, age twenty- 
eight years, would go to a house of prostitution once a 
month. lie always announced his coming, with a note 
reading thns: "Dear Peggy, I shall be with you to-mor- 
row evening between 8 and 9 o'clock. Whip and knout! 
Kindest regards. . . ." 

He always arrived at the appointed time carrying a 
whip, a knout and leather straps. After undressing he 
had himself bound hand and foot, and then flogged by the 
girl on the soles of his feet, his calves and buttocks until 
ejaculation ensued. Other desires or wishes he never ex- 



144 PSYCHOPATIIIA SEXUALIS. 

pressed. The fact that he disdained coitus seems to point 
to the fact that he resorted to this method simply as a 
means to gratify his masochistic inclination and not as a 
ruse to restore potency. 

Cases occur, however, in which passive flagellation 
alone constitutes the entire content of the masochistic 
fancies, without other ideas of humiliation, etc., and 
without well-defined consciousness of the real nature of 
this expression of submission. Such cases are difficult to 
differentiate from those of simple reflex flagellation. A 
knowledge of the primary origin of the desire, before any 
experience of reflex stimuli (v. supra, under "first"), is the 
only thing that renders the differential diagnosis certain, 
if weighed with the circumstance that genuine masochists 
are perverse from early youth, and that the realisation of 
their desires is scarcely ever accomplished or proves a 
disappointment (v. supra, under "thirdly") ; for the whole 
thing chiefly belongs to the realm of imagination. 

The following is a case of typical masochism in which 
the whole circle of ideas peculiar to this perversion 
appears completely developed. This case, in which there 
is a detailed personal description of the whole psychical 
state, is different from case 49 in the llth edition only in 
that there is here no thought of a realisation of the perverse 
fancies, and that, notwithstanding the perversion of the 
vita sexualis, normal stimuli are so far effectual that sexual 
intercourse is really possible under normal conditions. 

Case 57. "I am thirty-five years old, mentally and 
physically normal. Among all my relatives, in the direct 
as well as in the lateral line, I know of no case of mental 
disorder. My father, who at my birth was thirty years 
old, as far as I know had a preference for voluptuous, large 
women. 

"Even in my early childhood I loved to revel in ideas 
about the absolute mastery of one man over others. The 
thought of slavery had something exciting in it for me, 
alike whether from the standpoint of master or servant. 



MASOCHISM. 145 

That one man could possess, sell or whip another, caused 
me intense excitement; and in reading 'Uncle Tom's Cabin* 
(which I read at about the beginning of puberty) I had 
erections. Particularly exciting for me was the thought 
of a man being hitched to a waggon in which another 
man sat with a whip, driving and whipping him. Until 
my twentieth year these ideas were purely objective and 
sexless i.e., the one in subjugation in my fancy was 
another (not myself), and the master was not necessarily a 
woman. These ideas were, therefore, without effect on my 
sexual desires i.e., on the way in which they took practi- 
cal shape. Although these ideas caused erections, yet I 
have never masturbated in my life, and from my nine- 
teenth year I had coitus without the help of these ideas 
and without any relation to them. I always had a great 
preference for elderly, voluptuous, large women, though I 
did not scorn younger ones. 

"After my twenty-first year my ideas became objective, 
and it became an essential thing that the 'mistress' 
should be a woman over forty years old, tall and power- 
ful. From this time I was always in my fancies the subject; 
the 'mistress' was a rough woman, who made use of 
me in every way, also sexually; who harnessed me to 
a carriage and made me take her for a drive, whom I 
must follow like a dog, at whose feet I must lie naked 
and be punished i.e., whipped by her. This was the 
constant element in my ideas, around which all others 
were grouped. In these fancies I always found endless 
pleasurable comfort which caused erection, but never 
ejaculation. As a result of the induced sexual excitement, 
I would immediately seek a woman, preferably one corre- 
sponding exteriorly with my ideal, and have coitus with 
her without any actual aid of my fancies, and some- 
times also without any thought of them during the act. 
I had, however, also inclination toward women of a 
different kind, and had coitus with them without being 
impelled to it by my fancy. 

"Notwithstanding all this, my life was not exceedingly 

10 



146 PSYCHOPATHIA SEXUALIS. 

abnormal sexually; yet these ideas were certain to occur 
periodically, and they have remained essentially un- 
changed. With growing sexual desire, the intervals 
constantly grew shorter. At the present time the attacks 
come every two or three weeks. If I previously were to 
have coitus, the occurrence of the fancies would, perhaps, 
be postponed. I have never attempted to realise my very 
definite and characteristic ideas i.e., to connect them 
with the world without me but I have contented myself 
with revelling in the thoughts, because I was convinced 
that my ideal would not allow even an approach to 
realisation. The thought of a comedy with paid pros- 
titutes always seemed so silly and purposeless, for a per- 
son hired by me could never take the place of my imagina- 
tion of a 'crtrel mistress'. I doubt whether there are sadis- 
tically constituted women like Sacher-Masoch's heroines. 
But, if there were such women, and I had the fortune ( !) 
to find one, still, in a world of reality, intercourse with her 
would ever seem only a farce to me. Indeed, I can say 
that, were I to become the slave of a Messalina, I believe 
that owing to the other necessary renunciations my desired 
manner of life would soon pall on me, and in my lucid 
intervals I should make every effort to obtain my freedom 
at all hazards. 

"Yet I have found a way in which to induce, in a 
certain sense, a realisation. After my sexual desire has 
been intensely excited by revelling in my fancy, I go to a 
prostitute and there call up before my mind's eye with 
great intensity some scene of the kind mentioned, in 
which I play the principal role. After thinking of such 
a situation for about half an hour, with a constantly re- 
sulting erection, I perform coitus with increased lustful 
pleasure and strong ejaculation. After the latter, the 
vision fades away. Ashamed, I depart as quickly as 
possible, and try not to think of the affair. Then for 
about two weeks I have no more such ideas ! indeed, after 
a particularly satisfactory coitus, it may happen that until 
the next attack I have not even any sympathy whatever 



MASOCHISM. 147 

xith masochistic ideas. But tho next attack is sure to 
sooner or later. I must, however, state that I also 
have coitus without being prepared by such ideas, especi- 
ally, too, with women that are acquainted with me and my 
position, and in whose presence I abhor such fancies. 
Under the latter circumstances, however, I am not always 
potent, while, with masochistic ideas, my virility is perfect. 
It does not seem superfluous to add that otherwise in my 
thought and feeling I am very aesthetic, and despise any- 
thing like maltreatment of a human being. Finally, I will 
not leave un mentioned the fact that the form of address is 
of importance. In my fancies it is essential that the 'mis- 
tress' address me in the second person (Du), while I 
must address her in the third (Sie). This circumstance 
of being thus familiarly addressed (Du) by a person so in- 
clined, as the expression of absolute mastery, has from 
my youth given me lustful pleasure, and does to-day. 

"I had the fortune to find a wife who is in everything, 
but especially sexually, attractive to me; though, as I 
scarcely need say, she in no way resembles my masochistic 
ideals. She is gentle, but voluptuous, for without the 
latter characteristic I cannot conceive such a thing as 
sexual charm. The first few months of married life were 
normal sexually; the masochistic attacks did not occur, 
and I had almost lost all thought of masochism. Then 
came the first confinement and the necessary abstinence. 
Punctually, then, with the occurrence of libido came the 
masochistic fancies again, which, in spite of my great love 
for my wife, necessitated coitus with another, with the 
accompaniment of masochistic ideas. It is here worthy 
of note that coitus maritalis, which was later resumed, did 
not prove sufficient to banish the masochistic ideas, as 
masochistic coitus always does. As for the essential 
element in masochism, I am of the opinion that the ideas 
i.e., the mental element are the end and aim. 

"If the realisation of the masochistic ideas (i.e., passive 
flagellation, etc.) be the desired end, then it is in opposi- 
tion to the fact that the majority of masochists never 



148 PSYCHOPATHIA BEXUALI8. 

attempt realisation; or when this is attempted great 
disappointment occurs, or at any rate the desired satis- 
faction is not obtained. 

"Finally, I should mention that, according to my 
experience, the number of masochists, especially in big 
cities, seems to be quite large. The only sources of such 
information are since men do not reveal these things 
statements by prostitutes, and since they agree on the 
essential points, certain facts may be assumed as proved. 

"Thus there is the fact that every experienced prosti- 
tute keeps some suitable instrument (usually a whip) for 
flagellation, but it must be remembered that there are 
men who have themselves whipped simply to increase 
their sexual pleasure. These, in contrast with masochists, 
regard flagellation as a means to an end. 

"On the other hand, almost all prostitutes agree that 
there are many men who like to play 'slave' i.e., like 
to be so called, and have themselves scolded and trod upon 
and beaten. As has been said, the number of masochists 
is larger than has yet been dreamed. 

"As you can imagine, your chapter on this subject 
has made a deep impression on me. I should like to 
have faith in a cure, in a logical cure, so to speak, in 
accordance with the motto: 'Tout comprendre c'est tout 
guerir'. 

"Of course the word cure is to be taken with some 
limitation, and there must be a distinction made between 
general feelings and concrete ideas. The former can never 
be removed; they come like a streak of lightning, are 
there, and one does not know whence or how. 

"But the practice of masochism in imagination by 
means of concrete associated ideas can be avoided, or at 
least restricted. 

"Now the thing is changed. I say to myself: What! 
you busy your mind with things which not only the 
aesthetic sense of others, but also your own, disapproves? 
You regard that as beautiful and desirable which, in your 
own judgment, is at once ugly, coarse, silly, and impossi- 



MASOCHISM. 149 

ble? You long for a situation which in reality you can 
never obtain? This opposing idea has an immediate in- 
hibitory and undeceiving effect, and breaks the point of the 
fancy. In fact, since reading your book (early this year) 
I have actually not revelled in my fancy, though the 
masochistic tendencies have recurred at regular intervals. 

"I must also confess that, in spite of its marked patho- 
logical character, masochism is not only incapable of 
destroying my pleasure in life, but it does not in the least 
affect my outward life. When not in a masochistic state, 
as far as feeling and action are concerned, I am a perfectly 
normal man. During the activity of the masochistic 
tendencies there is, of course, a great revolution in my 
feeling, but my outward manner of life suffers no change; 
I have a calling that makes it necessary for me to move 
much in public, and I pursue it in the masochistic con- 
dition as well as ever." 

The author of the foregoing lines also sends me the 
following notes : 

I. "Masochism, according to my experience, is under 
all circumstances congenital, and never acquired by the 
individual. I know positively that I was never spanked; 
that my masochistic ideas were manifested from my earliest 
youth, and that, as long as I have been capable of think- 
ing, I have had such thoughts. If the origin of them had 
been the result of a particular event, especially of a 
beating, I should certainly not have forgotten it It is 
characteristic that the ideas were present before there was 
any libido. At that time the ideas were absolutely sexless. 
I remember that when a boy it affected (not to say ex- 
cited) me intensely when an older boy addressed me in the 
second person (Du) while I spoke to him in the third 
(Sie). I would keep up a conversation with him and have 
this exchange of address (Du and Sie) take place as often 
as possible. Later, when I had become more mature 
sexually, such things affected me only when they occurred 
with a woman, and one relatively older than myself. 



150 PSYCHOPATHIA SEXUALIS. 

II. "Physically and mentally I am in all respects mas- 
culine. I have a superabundant growth of beard, and my 
whole body is very hairy. In my relations to the female 
sex that are not masochistic the dominating position of 
the man is an indispensable condition, and any attempt to 
change it would meet with my energetic opposition. I 
am energetic, if not over-courageous'; but the want of 
courage is not manifest when my pride is injured. I am 
not sensitive to events in nature (thunder storms, storma 
at sea, etc.). 1 

"Again, my masochistic tendencies have nothing femi- 
nine or effeminate about them ( ?). To be sure, in these, 
the inclination to be sought and desired by the woman is 
dominant; but the general relation desired with her is 
not that in which a woman stands to a man, but that of 
the slave to the master, the domestic animal to its owner. 
If one regards the ultimate aim of masochism without 
prejudice, it must be acknowledged that its ideal is the 
position of a dog or horse. Both are owned by masters 
and punished by them, and the masters are responsible to 
no one. Just this unlimited power of life and death, as 
exercised over slaves and domestic animals, is the aim and 
end of all masochistic ideas. 

III. "The foundation of all masochistic ideas is libido, 
and as this ebbs and flows, so do the masochistic fancies. 
On the other hand, as soon as the ideas are present, they 
greatly intensify the libido. I am not by nature exces- 
sively sensual. However, when the masochistic ideas 
occur I am impelled to coitus at any cost (for the most 
part I am driven to the lowest women) ; and if these 
impulses are not soon obeyed, libido soon becomes almost 
satyriasis. One is almost justified in looking upon this as 
a circulus vitiosus. 

"Libido occurs either in the course of time or as the 
result of especial excitement (also of a kind that is not 

1 This difference of courage in the face of events in nature, on 
the one hand, and in the face of conflict with will-power, on the 
other, is certainly remarkable, even though it is the only indication 
of effeminacy apparent in this case. 



MASOCHISM. 151 

masochistic e.g., Visaing). Tn spite <f its manner of ori- 
gin, tins lil>i<lo, by virtue of the masochistic ideas it engen- 
, is soon transformed into a masochistic and impure 
libido. 

"Moreover, there is no doubt that external accidental 
impressions, particularly loitering in the streets of a 
large city, greatly intensify the desire. The sight of 
beautiful and imposing female forms, in nature as well as 
in art, is exciting. For those subject to masochism at 
least during the attacks the whole external world be- 
comes masochistic. The box on the ear administered by 
the teacher to the pupil and the crack of the driver's whip 
make deep impressions on the masochist, while they leave 
him indifferent or annoy him when he is not in the maso- 
chistic state. 

IV. "In reading Saclier-Masoch it struck me that in 
masochists now and then there was also an undercurrent 
of sadistic feeling. I have now and then discovered in 
myself sporadic feelings of sadism. I must remark, how- 
ever, that the sadistic feelings are not so marked as the 
masochistic. Apart from the fact that they appear but 
seldom, and then only in a manner as accessories, these 
sadistic fancies never leave the sphere of abstract feeling, 
and, above all, never take the form of concrete, connected 
ideas. The effect on libido t however, is the same with 
both." 

If this case is remarkable on account of the complete 
development of the psychical state which constitute; 1 ! 
masochism, the following is noteworthy because of the 
great extravagance of the acts resulting from perversion. 
The case is also particularly suited to make clear the 
reason for the subjection and humiliation at the hands of 
the woman, and the peculiar sexual colouring of the 
resulting situations : 

Case 58. Mr. Z., official, aged fifty; tall, muscular, 
healthy. Said to come of healthy parentage, but his father 



152 PSYCHOPATHIA SEXUALIS. 

was thirty years older than his mother. A sister, two 
years older than Z., suffered with delusions of persecu- 
tion. There was nothing remarkable in Z.'s external ap- 
pearance. Skeleton entirely masculine; abundant beard, 
but no hair on trunk. He characterised himself as a man 
of sanguine temperament, who could not refuse others any- 
thing; though irascible and quick-tempered, he was quick 
to regret outbursts. 

Z. claimed that he had never masturbated. From his 
youth there had been nightly pollutions, in which girls 
played part, but the sexual act never. For example, he 
dreamed that a pleasing woman lay heavily on him, or that 
as he lay sleeping on the grass she playfully walked up his 
back. Z. had always been averse to coitus with women. 
This act seemed bestial to him. Nevertheless, he was 
drawn to women. It was only in the society of beautiful 
women and girls that he felt well and in his place. Ho 
was very gallant, without being forward. 

A voluptuous woman of beautiful form, and particu- 
larly with a pretty foot, when seated, had the power to 
thrown him into intense excitement. He was impelled to 
offer himself as a chair, in order "to support such grand 
beauty". A kick, a box on the ear from her, would be 
heaven to him. He had a horror at the thought of coitus 
with her. He felt the need to serve woman. He thought 
how much ladies liked to ride. He revelled in the thought 
how fine it would be to be wearied by the burden of a 
beautiful woman in order to give her pleasure. He painted 
the situation in all colours; thought of the beautiful foot 
armed with spurs, the beautiful calves, the soft, full 
thighs. Every beautiful mature woman, every pretty 
female foot, always excited his imagination; but he never 
betrayed the peculiar feelings that seemed to him abnor- 
mal, and was able to control himself. But he felt no need 
to fight against them; on the contrary, it would have 
grieved him to be compelled to give up the feelings that 
had become so dear to him. 

At the age of thirty-two Z. happened to make the 



MASOCHISM. i:.:i 

ac<|imintance of an attractive woman, aged twenty-seven, 
>'. L" had been separated from her husband, and whom 

uml in n. (1. I lc took her and worked for her with- 
out any selfish motive, for months. One evening she 
impatiently demanded sexual satisfaction from him, and 
almost used violence. Coitus was successful. Z. took 
tin' woman, lived with her, and indulged in coitus moder- 
ately, but coitus was more a burden than a pleasure; 

ions became weak, and he could no longer satisfy the 
woman. She finally declared that she would not have 
intercourse with him, because he only excited without 
satisfying her. Though he loved the woman very much, 
he could not give up his peculiar fancies. After this he 
lived with her only in friendly relations, and deeply re- 
gretted that he could not serve her in the way she desired. 
Fear of how she would receive his propositions and a 
feeling of shame kept him from confessing. He found a 
substitute in his dreams. Thus, for example, he dreamed 
that he was a proud, fiery steed, ridden by a beautiful 
lady. He felt her weight, the bit he had to obey, the 
pressure of the thighs on his flanks; he heard her 
beautiful, joyous voice. The exertion threw him into a 
perspiration, the touch of the spurs did the rest, and 
always induced pollution with great lustful pleasure. 
Under the influence of such dreams, seven years ago Z. 
overcame his reluctance, in order to experience such 
things in reality. He was successful in creating a suitable 
opportunity. He speaks of it as follows: "I knew how 
to arrange it so that on an occasion she would of her own 
will seat herself on my back. Then I endeavoured to 
make this situation as pleasant as possible, and easily 
arranged it so that on the next occasion she said spon- 
taneously, 'Come, give me a little ride!' Being of tall 
stature, both hands braced on a chair, I made my back 
horizontal, and she mounted astride, after the manner of 
a man. I then did the best I could to imitate the move- 
ments of a horse, and loved to have her treat me like 
a horse, without consideration. She could beat, priok, 



154 PSYCIIOPATIIIA SEXUALIS. 

scold, or caress me, just as she felt inclined. I could 
carry on my back persons weighing from sixty to eighty 
kilos, for half or tli roc-quarters of an hour, without inter- 
ruption. At the end of this time I usually asked for a 
rest. During this the intercourse between the mistress 
and me was perfectly harmless, and without any relation 
to what had preceded. After about a quarter of an hour 
I was rested and placed myself again at the disposal of 
the mistress. When time and circumstances allowed it, 
I did this three or four times in succession. It sometimes 
happened that I practised it both in the morning and 
afternoon. After it I never felt weary or had uncomfort- 
able feelings, but on such days I had very little appetite. 
When possible, I liked best to bare my trunk, that I might 
feel the riding-whip more sharply. The mistress had to 
be decent. I liked her best in pretty shoes and stockings, 
with short closed drawers reaching to the knee; with the 
upper portion of her person completely dressed, and with 
hat and gloves." 

Mr. Z. further said he had not performed coitus in 
seven years, but he thought he was potent. The riding was 
a perfect substitute for that "bestial act," even when 
ejaculation was not induced. 

For eight months Z. had determined to give up his 
masochistic play, and had kept his determination. But 
he thought that if a woman only moderately pretty were to 
address him directly and say, "Come, I want to ride you," 
he would not be strong enough to withstand the tempta- 
tion. Z. wished to know whether his abnormality was 
curable, whether he was unworthy as a vicious man, or an 
invalid deserving pity.. 

Even in the foregoing series of cases, with other things, 
the act of being walked upon has played a role as a means 
of expressing the masochistic situations of humiliation and 
pain. The exclusive and most extensive use of this means 
for perverse excitation and satisfaction, which has caused 
me to arrange a special group, because it forms the tran- 



MASOCHISM. 153 

sition to another kind of perversion (vide infra (6), is 
shown in the following classical case of masochism, re- 
ported by Hammond (op. cit., p. 28) from an observation 
by Dr. Cox 1 of Colorado : 

Case 59. X., a model husband, very moral, the father 
of several children, had times i.e., attacks in which he 
visited brothels, chose two or three of the largest girls, 
and shut himsolf up with them. He bared the upper 
portion of his body, lay down on the floor, crossed his 
hands on his abdomen, closed his eyes, and then had the 
girls walk over his naked breast, neck and face, urging 
them at every step to press hard on his flesh with the 
heels of their shoes. Sometimes he wanted a heavier girl, 
or some other act still more cruel than this procedure. 
After two or three hours he had enough. He paid 
the girls with wine and money, rubbed his blue bruises, 
dressed himself, paid his bill, and went back to his busi- 
ness, only to give himself the same strange pleasure again 
after a few weeks. 

Occasionally it happened that he had one of the girls 
stand on his breast, and the others then turn her around 
until his skin was torn and bleeding from tlio turning of the 
heels of her shoes. Frequently one of the girls had to 
stand on him in such a way that one shoe was over the eyes, 
with its heel pressing on one eye, while the other shoe 
rested across his neck. In this position he endured the. 
pressure of a person weighing about l. r >0 pounds for four or 
five minutes. The author speaks of dozens of similar cases 
that are known to him. Hammond prrsnnu'*, with reason, 
that this man had become impotent for intercourse with 
women ; that in this strange procedure he found an equiva- 
lent for coitus ; and that, when the heels drew blood, he had 
pleasant sexual feelings, accompanied by ejaculations. 

Case 60. X., gentleman belonging to upper class 

1 " TransnHions of the Colorado State Medical Society," quoted 
in the "Alienist and Neurologist," April, 1883, p. 345. 



156 PSYCHOPATHIA SEXUALIS. 

of society ; age sixty-six ; father hypersexual ; two brothers 
said to be masochists. X. claimed that his masochism dates 
back to early childhood. At the age of five he asked little 
girls to undress him and spank his naked bottom. Later 
on he arranged with other boys or girls in playing teacher 
with him to flog him. With the age of fifteen he began 
to imagine that girls ambushed and then beat him. At 
that time he had no idea as yet of the sexual meaning of 
such proceedings, in fact he was still unaware of the viia 
sexualis. His craving for being beaten by women stead- 
ily increased. At the age of eighteen he learned how to 
satisfy it and had the first pollution during the act. When 
nineteen first coitus with complete satisfaction and potency 
and without masochistic representations. Normal sexual 
intercourse until he was twenty-one, when a girl suggested 
a masochistic scene. He accepted, and from that time 
never had coitus without a masochistic adventure pre- 
ceding it. He soon recognized the -fact that the stimulus 
proceeded from the idea to be in the power of a woman 
rather than from the act of violence itself. He succeeded 
in making a happy marriage, free from masochistic ideas, 
but admitted that from time to time he had to seek relief 
in some masochistic act with a girl, even though he then 
had grand children. The masochistic scene was always the 
prelude to coitus. He showed no psychopathic symptoms 
and was free from other perversions. He pointed out the 
frequency of masochism and the clever methods often ap- 
plied by so-called masseuses. According to his experience 
masochism is of frequent occurrence in England, and 
English women are easily persuaded to practise it 

Case 61. L., artist, age twenty-nine; nervous disease 
and tuberculosis of frequent occurrence in family. Vita 
sexualis suddenly aroused in him at the age of seven 
whilst being caned ad podicem ; at ten, masturbation. Dur- 
ing the act he always thought of some one flagellating him. 
In later years nocturnal pollutions were always accompa- 
nied by dreams of flagellation. The wish to be flogged 



MASOCHISM. 157 

was ever present in his mind since he was ten years old. 
From eleven to eighteen he had inclinations to persons 
of his own sex, though they never overstepped the bounds 
of boyish friendship. During this homosexual period he 
was forever agitated by the desire to be beaten by his 
companion. 

At nineteen coitus, but without sufficient erection or 
gratifying pleasure. His heterosexual inclinations were 
always towards women older than himself. He was in- 
different towards young girls. His craving for flagellation 
increased with the years. 

At twenty-five he fell violently in love with a woman 
much older than himself, but marriage he refused. The 
woman made every effort in her power to win him over 
to natural sexual intercourse. Although he detested the 
state of affairs and professed undieing love for the woman 
he insisted that his sexual feelings for her were only of a 
masochistic character. Now and then he succeeded in 
persuading her to flagellate him. 

His sexual needs being strong he had girls flagellate 
him. He claimed that flagellation was the only adequate 
sexual act during which he could experience really pleas- 
urable ejaculation. Coitus was of minor importance and 
only on rare occasions did he couple it with the act of 
flagellation, probably on account of psychical impotence. 

Nevertheless the two acts affected him in a different 
manner. Coitus seemed to improve him both mentally 
and physically, whilst flagellation had bodily exhaustion 
and moral depression in its wake. He was persuaded that 
masochism in him was a pathological condition; on that 
ground he came for advice. 

His appearance was undeniably masculine, his con- 
duct decent and beyond criticism. He complained of 
cerebral neurasthenia (weakness of mind, of will power, 
absent-mindedness, irritability, shyness, anxiety of mind, 
pressure in the head, etc.). Genitals normal. Erections 
only in the morning. 

He inclined to the belief that if he could find a woman 



158 PSYCHOPATHIA BEXUALI8. 

whom he could love, he might strip off his masochistic in- 
clination in wedlock. 

Therapeutic advice: auto-combating of masochistic 
thoughts, impulses and acts, if necessary, with the aid of 
hypnotic suggestion; strengthening of the nervous sys- 
tem, and removing manifestations of irritating weakness 
by antineurasthenic treatment. 

The cases of masochism thus far described, and the 
numerous analogous cases mentioned by those who report 
them, form a counterpart to the previously described 
Group "c" of sadism. Just as in sadism men excite 
and satisfy themselves by maltreating women, so in maso- 
chism the same effect is sought in the passive reception 
of similar abuse. 1 But Group "a" of the sadists that 
of lust-murder strange as it may seem, is not without its 
counterpart in masochism. In its extreme consequences, 
masochism must lead to the desire to be killed by a person 
of the opposite sex, in the same way that sadism has its 
acme in active lust-murder. But the instinct of self- 
preservation opposes such a result, so that the extreme is 
not actually carried out. When, however, the whole 
structure of masochistic ideas is purely psychical, in the 
imagination of such individuals even the extreme may be 
reached, as the following case shows : 

Case 62. A middle-aged man, married, and the 
father of a family, who had always led a normal vita sex- 
ualis, but who came of a very nervous family, made the 
following communication: In his early youth he was 
powerfully excited sexually at the sight of a woman 
slaughtering an animal with a knife. From that time, 
for many years, he had revelled in the lustfully coloured 
idea of being stabbed and cut, and even killed, by women 
with knives. Later on, after the beginning of normal 
sexual intercourse, these ideas lost completely their per- 
verse stimulus for him. 

1 Instructive instances are given by Seydel, " Vierteljahrsschr. f. 
ger. Med.," 1893, Heft 2, pp. 275, 276. 



159 

This case should bo compared with the statements 
according to \vhirh men find sexual pleasure in being 
lightly priekod with knives in the hands of women, who 
at the same time threaten them with death. 

Such fancies, perhaps, give the key to an understand- 
ing of the following strange case, for which I am indebted 
to a communication from Dr. Korber, of Rankau, in 
Silesia : 

Case 63. "A lady makes me the following communi- 
cation : While still a young and innocent girl, she was 
married to a man of about thirty years. On their wedding 
night he forced a bowl with soap into her hands, and 
without any expression of endearment wanted her to 
lather his chin and neck (as if for shaving). The inex- 
perienced young wife did it, and was not a little astonished 
during the first weeks of married life to learn its secrets in 
absolutely no other form. Her husband always told her 
that it gave him the greatest delight to have his face 
lathered by her. Later, after she had sought the advice 
of friends, she induced her husband to perform coitus, and 
had three children in the course of time (by him, she 
states with every assurance). The husband was industrious 
and reliable, but a moody man, with short temper; by 
occupation a merchant." 

It may be inferred that this man conceived the act of 
being shaved (i.e., the lathering as a preparatory measure) 
as a rudimentary, symbolic realisation of ideas of injury or 
death, or of fancies about knives, like those the man pre- 
viously mentioned had had in his youth, and by means of 
which he had been sexually excited and satisfied. The 
ct sadistic counterpart to this case, looked upon in 
the same light, is offered by observation 37, which is a 
case of symbolic sadism. 

Symbolic Masochism. 
At any rate, there is a whole group of masochists who 



160 PSYCHOPATH I A SEXDALI8. 

satisfy themselves with the symbolic representations of 
situations corresponding with their perversion; a group 
which corresponds with Group "a" and "e" of sadism. 
Thus, just as the perverse longings of the masochist may 
on the one hand advance to "passive lust-murder" (to be 
sure, only in imagination), so, on the other hand, they 
may be satisfied with simple symbolic representations of 
the desired situations, which otherwise are expressed in 
acts of cruelty, (this, of course, taken objectively, goes 
much farther than the idea of being murdered, but in 
fact not so far, owing to the determining subjective con- 
ditions). Cases similar to 63 may be here described, in 
which the acts desired and planned by the masochists have a 
purely symbolic character, and to a certain extent serve to 
define the desired situation. 

Case 64. (Pascal, "Igiene dell' amore".) Every 
three months a man of about forty-five years would visit 
a certain prostitute and pay her ten francs for the follow- 
ing act. The puella had to undress him, tie his hands and 
feet, bandage his eyes, and draw the curtains of the win- 
dows. Then she would make her guest sit down on a 
sofa, and leave him there alone in a helpless position. 
After half an hour she had to come back and unbind him. 
Then the man would pay her and leave perfectly satisfied, 
to repeat his visit in about three months. 

In the dark this man seems to have extended this 
situation of being helpless in the hands of a woman by 
the aid of imagination. The following case, in which 
again a complicated comedy in the sense of masochistic 
desires is played, is still more peculiar : 

Case 65. (Dr. Pascal, ibid.} A gentleman in Paris 
was accustomed to call on certain evenings at a house 
where a woman, the owner, acceded to his peculiar desire. 
He entered the salon in full dress, and she, likewise in 
evening toilette, had to receive him with a very haughty 



MASOCHISM. 161 

manner. He addressed her as ''Marquise," and she had 
to call him "<lrar Count". Thru he spoke of his good for- 
tune in iimlin^ her alone, of his love for her, and of a 
lover's interview. At this the lady had to feel insulted. 
The pseudo-count grew bolder and bolder, and asked the 
pseudo-marquise for a kiss on her shoulder. "There is an 
angry scene; the bell is rung; a servant, prepared for the 
occasion, appears, and throws the count out of the house. 
He departs well satisfied, and pays the acton in the farce 
handsomely." 

Case 66. X., age thirty-eight, engineer, married, 
father of three children, married life unmarred. Visited 
periodically a prostitute who had to enact, previous to 
coitus, the following comedy. As soon as he entered her 
compartment she took him by the ears, and pulled him all 
over the room, shouting: "What do you want here? Do 
you know that you ought to be at school ? Why don't you 
go to school?" She would then slap his face and flog 
him soundly, until he knelt before her begging pardon. 
She then handed him a little basket containing bread and 
fruit, such as children carry with them to school. He 
remained renitent until the girl's harshness produced or- 
gasm in him, when he would call out: "I am going! I am 
going!" and then performed coitus. 

It is pyobable that this masochistic comedy may have 
arisen from some scenes enacted during his schooltime and 
that in this wise libido became associated with them. Fur- 
ther details of X.'s vita sexualis are not known. (Dr. 
Carrara, in Archivio di Psichiatria xxix., 4). 

Ideal Masochism. 

A distinction must be made between "symbolic" and 
"ideal" masochism. In the latter the psychical perver- 
sion remains entirely within the spheres of imagination 
and fancy, and no attempt at realisation is made. (Cf. 

11 



162 PSYCHOPATHIA 8EXUALIS. 

cases 57 and 62.) Two other cases of ideal masochism 
are quoted here. The first is that of an individual men- 
tally and physically tainted, bearing degenerative signs, in 
whom mental and physical impotence occurred early : 

Case 67. Mr. Z., aged twenty-two, single, was 
brought to me by his father for medical advice, because ho 
was very nervous and plainly sexually abnormal. Mother 
and maternal grandmother were insane. His father begat 
him at a time when he was suffering severely from ner- 
vousness. 

Patient was said to have been a very lively and talented 
child. At the age of seven he was noticed to practise 
masturbation. After his ninth year he became inattentive, 
forgetful, and did not progress in his studies, constantly 
requiring help and protection. With difficulty he got 
through the Gymnasium, and during his time of freedom 
had attracted attention by his indolence, absent-minded- 
ness, and various foolish acts. 

Consultation was occasioned by an occurrence in the 
street, in which Z. had forced himself on a young girl in a 
very impetuous manner, and in great excitement had tried 
to have a conversation with her. 

The patient gave as a reason that by conversing with 
a respectable girl he wished to excite himself so that he 
could be potent in coitus with a prostitute ! 

His father characterised him as a man of perfectly 
good disposition, moral but lazy, dissatisfied with himself, 
often in despair about his want of success in life, indolent, 
and interested in nothing but music, for which he possessed 
great talent. 

The patient's exterior his plagiocephalic head, his 
large, prominent ears, the deficient innervation of the 
right facialis about the mouth, the neuropathic expression 
of the eyes indicated a degenerate, neuropathic indi- 
vidual. 

Z. was tall, of powerful frame, and in all respects of 
masculine appearance. Pelvis masculine, testicles well 



MASOCHISM. 163 

developed, penis remarkably large, mons veneris with 
abundant hair. The right testicle much lower than the 
left, the cremasteric reflex weak on both sides. The 
patient was intellectually below the average. He felt 
his deficiency, complained of his indolence, and asked to 
have his will strengthened. His awkward, embarrassed 
manner, timid glances, and relaxed attitude pointed to 
masturbation. The patient confessed that from his seventh 
year until a year and a half ago he practised it, years at a 
time, from eight to ten times daily. Until a few years 
ago, when he became neurasthenic (cephalic pressure, loss 
of mental power, spinal irritation, etc.), he said he always 
found great sensuous pleasure in it. Since then this had 
been lost, and the desire to masturbate had disappeared. 
He had constantly grown more bashful and indolent, less 
energetic, and more cowardly and apprehensive. He had 
lost interest in everything, and attended to his business 
only from a sense of duty, feeling very low-spirited. He 
had never thought of coitus, and from his standpoint as 
an onanist, he could not understand how others could find 
pleasure in it 

Investigation in the direction of inverted sexual in- 
stinct gave a negative result. He said he never was drawn 
toward persons of his own sex ; he rather thought he had 
now and then had a weak inclination for females. He 
asserted that he came to masturbate independently. In 
this thirteenth year he first noticed ejaculations as a result 
of masturbatic manipulations. 

It was only after long persuasion that Z. consented to 
entirely unveil his vita sexualis. As his statements which 
follow show, he may be classified as a case of ideal maso- 
chism, with rudimentary sadism. The patient distinctly 
remembered that at the age of six, without any cause, he 
had "ideas of violence". He was compelled to imagine 
that a servant girl spread his legs apart and showed his 
genitals to another; that she tried to throw him into cold 
or hot water in order to cause him pain. These "ideas of 
violence" were attended with lustful feelings, and became 



164 PSYCHOPATHIA 8EXT7ALIS. 

the cause of masturbatic manipulations. Later the patient 
called them up voluntarily, in order to incite himself to 
masturbation. They also played a part in his dreams; 
but they never induced pollution, apparently because the 
patient masturbated excessively during the day. 

In time, to these masochistic "ideas of violence" 
others of a sadistic nature were added. At first they were 
scenes in which boys forcibly practised onanism on one 
another, or cut off the genitals. He often imagined him- 
self such a boy, now in an active, now in a passive role. 
Later he busied himself with mental pictures of girls and 
women exhibiting themselves to one another. He revelled 
in the thought, for example, of a servant girl spreading 
another girl's legs apart and pulling the genital hair; or 
in the thought of boys treating girls cruelly, and pricking 
and pinching their genitals. 

Such ideas also always induced sexual excitement, but 
he never experienced any impulse to carry them out 
actively or to have them performed on himself passively. 
It satisfied him to use them for masturbation. Later on, 
with diminishing sexual imagination and libido these ideas 
and impulses had become infrequent, but their content 
remained unchanged. The masochistic "ideas of violence" 
predominated over the sadistic. Whenever he saw a lady, 
he had the thought that she had sexual ideas like his own. 
In this way, in part, he explained his embarrassment in 
social intercourse. Having heard that he would get rid 
of his burdensome sexual ideas if he were to accustom 
himself to natural sexual indulgence, he had twice at- 
tempted coitus, though he only experienced repugnance, 
and was not confident of success. On both occasions the 
attempt was a fiasco. The second time he made the attempt 
he felt such aversion that he pushed the girl away and fled. 

The second case is the following observation pladed 
at my disposal by a colleague. Even though it be aphor- 
istic, it seems particularly suited to throw a clear light on 
the distinctive element of masochism the consciousness 
of subjection, in its peculiar psycho-sexual effect : 



MASOCHISM. 165 

Case 68. Z., aged twenty-seven, artist, powerfully 
built, of pleasing appearance, said to be free from hered- 
itary taint. Healthy in youth, since his twenty-third year 
he had been nervous and inclined to be hypochrondriacal. 
Although he bragged of sexual indulgence he was not very 
virile. In spite of associations with females, his relations 
with them were limited to innocent attentions. At the 
same time, his covetousness for women who were cold 
toward him was remarkable. Since his twenty-fifth 
year he had noticed that females, no matter how ugly, 
always excited him sexually whenever he discovered any- 
thing domineering in their character. An angry word 
from the lips of such a woman was sufficient to give him 
the most violent erections. Thus, one day he sat in a cafe 
and heard the (ugly) female cashier scold the waiters in a 
loud voice. This threw him into the most intense sexual 
excitement, which soon induced ejaculation. Z. required 
the women with whom he was to have sexual intercourse 
to repulse and annoy him in various ways. He thought 
that only a woman like the heroines of Sacher-Masoch'a 
romances could charm him. 

These cases of ideal masochism plainly demonstrate 
that the persons afflicted with this anomaly do not aim at 
actually suffering pain. The term "algolagnia," therefore, 
as applied by Schrenck-Notzing and by v. Eulenburg to 
this anomaly, does not signify the essence, i.e., the psy- 
chical nucleus of the element of masochistic sentiment and 
imagination. This essence consists rather of the lustfully 
coloured consciousness of being subject to the power of 
another person. The ideal, or even actual, enactment of 
violence on the part of the controlling person, is only the 
means to the end, i.e., the realisation of the sentiment. 

Cases like this, in which the whole perversion of the 
vita sexualis is confined to the sphere of imagination to 
the inner world of thought and instinct and only acci- 
dentally comes to the knowledge of others, do not seem to 
be infrequent. Their practical significance, like that of 



166 PSYCHOPATHIA SEXUALIS. 

masochism in general (which has not the great forensic 
importance of sadism), is confined to the psychical im- 
potence to which such individuals, as a rule, become 
subject ; and to the intense impulse to solitary indulgence, 
with adequate imaginary ideas, and all its consequences. 

That masochism is a perversion of uncommonly fre- 
quent occurrence is sufficiently shown by the relatively 
large number of cases that have thus far been studied 
scientifically, as well as by the agreement of the various 
statements reported. 

The works concerning prostitution in large cities also 
contain numerous statements concerning this matter. 1 

It is interesting and worthy of mention that one of the 
most celebrated of men was subject to this perversion 
and describes it in his autobiography (though somewhat 
erroneously). From "Jean Jacques Rousseau's Confes- 
sions" it is evident that he was affected with masochism. 

Rousseau, with reference to whose life and malady 
Mobius (''J. J. Rousseau's Krankheitsgeschichte." Leipzig, 
1890) and Chatelain ("La folie de J. J. Rousseau," Neu- 
chatel, 1891) may be consulted, tells in his "Confessions" 
(part i., book i.) how Miss Lambercier, aged thirty, greatly 
impressed him when he was eight years old and lived with 
her brother as his pupil. Her solicitude when he could 
not immediately answer a question, and her threats to 

1 L6o Taxil (op. cit., p. 228) describes masochistic scenes in 
Parisian brothels. The man affected with this perversion is there 
also called " slave." 

Coffignon (" La corruption a Paris") has a chapter in his book 
entitled " Les Passionels " which contains contributions to this sub- 
ject. 

The strongest proof of the frequency of masochism lies in the 
fact that it openly appears in newspaper advertisements. For 
instance, the following advertisement appeared in the "Hannover- 
aches' Tageblatt," 4th December, 1895: 

" Sacher-Masoch. 109,404. Ladies interested in the works, and 
who embody the female characters, of this author are requested to 
send their address, under No. R. 537, to the offices of this paper. 
Strictest discretion." Another similar advertisement appeared in 
the same number. 



MASOCHISM. 167 

punish him if In- <1M nt Irani well, made the deepest 
imjiression on him. When one day he had blows at her 
hands, with the feeling of pain and shame he also experi- 
1 sensuous pleasure, that incited a great desire to be 
whipped by her again. It was only for fear of disturbing 
the lady that Rousseau failed to make other opportunities 
to experience this lustful, sensual feeling. One day, how- 
ever, he unintentionally gave cause for a whipping at Miss 
Lambercier's hands. This was the last; for Miss Lam- 
bercier must have noticed something of the peculiar effect 
of the punishment, she did not allow the eight-year-old 
boy to sleep in her room any more. From this time 
Rousseau felt a desire to have himself punished by ladies 
pleasing to him, a la Lambercior, but he asserts that until 
he became a youth he knew nothing of the relation of the 
sexes to each other. As is known, Rousseau was first in- 
troduced to the real mysteries of love in his thirteenth year, 
and lost his innocence through Madame de Warrens. Till 
then he had had only feelings and impulses attracting him 
to woman in the nature of passive flagellation, and other 
masochistic ideas. 

Rousseau describes in extenso how he suffered, with his 
great sexual desires, by reason of his peculiar sensuousness, 
which had undoubtedly been awakened by his whippings, 
for he revelled in desire, and could not disclose his long- 
ings. It would be erroneous, however, to suppose that 
Rousseau was concerned merely with flagellation. Fla- 
gellation only awakened ideas of a masochistic nature. 
At least in these ideas lies the psychological nucleus of his 
interesting study of self. The essential element with 
Rousseau was the feeling of subjection to the woman. 
This is clearly shown by the "Confessions," in which 
he expressly emphasises that "Etre aux genoux d'une 
rnaitresse imperieuse, obeir a ses ordres, avoir des pardons 
a lui demander, etaient pour moi de tres douces jouis- 
sances." 

This passage proves that the consciousness of subjec- 



168 PSYCHOPATHIA 8EXUALI8. 

tion to and humiliation by the woman was the most 
important element. 

To be sure, Rousseau was himself in error in supposing 
that this impulse to be humiliated by a woman had arisen 
by association of ideas from the idea of flagellation: 

"N'osant jamais declarer mon gout, je 1'amusais du 
moins par des rapports qui m'en conservaient 1'idee". 

It is only in connection with the numerous cases of 
masochism, the existence of which has now been estab- 
lished, and among which there are so many that are in no 
wise connected with flagellation, showing the primary and 
purely psychical character of this instinct of subjection 
it is only in connection with these cases that a complete 
insight into Rousseau's case is obtained and the error de- 
tected into which he necessarily fell in the analysis of his 
own condition. 

Binet ("Revue Anthropologique," xxiv., p. 256), who 
analyses Rousseau's case in detail, justly calls attention to 
its masochistic significance when he says: "Ce qu'aime 
Rousseau dans les femmes, ce n'est pas seulement le 
sourcil fronce, la main levee, le regard severe, 1'attitude 
imperieuse, c'est aussi 1'etat emotionnel, dont ces faits 
sont la traduction exterieure; ill aime la femme fiere, 
dedaigneuse, 1'ecrasant a ses pieds du poids de sa royale 
colere". 

The solution of this enigmatical psychological fact 
Binet finds in his assumption that it is an instance of 
fetichism, only with the difference that the object of the 
fetichism i.e., the object of individual attraction (fetich) 
is not a portion of the body like a hand or foot, but a 
mental peculiarity. This enthusiasm he calls "amour 
spiritualiste" in contrast with "amour plastique" as mani- 
fested in ordinary fetichism. 

This deduction is acute, but it is only a term by which 
to designate a fact, not a solution of it. Whether an 
explanation is possible, will later occupy our attention. 



MASOCHISM. 169 

There were also elements of masochism (and sadism) 
in the French writer C. P. Baudelaire, who died insane. 

Baudelaire came of an insane and eccentric family. 
From his youth he was psychically abnormal. His vita 
sexualis was decidedly abnormal. He had love-affairs 
with ugly, repulsive women negresses, dwarfs, giantesses. 
About a very beautiful woman he expressed the wish to 
see her hung up by her hands and to kiss her feet. This 
enthusiasm for the naked foot also appears in one of his 
fiercely feverish poems as the equivalent of sexual indulg- 
ence. He said women were animals who had to be shut 
up, beaten and fed well. The man displaying these 
masochistic and sadistic inclinations died of paretic de- 
mentia. (Lombroso, "The Man of Genius".) 

In scientific literature, the conditions constituting 
masochism have not received attention until recently. 
Tarnowsky, however ("Die krankhaften Erscheinungen 
des Geschlechtssinns," Berlin, 1886), relates that he has 
known happily married, intellectual men, who from time 
to time felt an irresistible impulse to subject themselves 
to the coarsest, cynical treatment to scoldings or blows 
from passive or active pederasts or prostitutes. It is 
worthy of remark that, as Tarnowsky observes, in certain 
cases blows, even when they draw blood, do not bring the 
desired result (virility, or at least ejaculation during 
flagellation) by those given to passive flagellation. "The 
individual must then be undressed by force, his hands tied, 
fastened to a bench, etc., during which he shams opposi- 
tion, scolds, and pretends to resist. Only under such 
circumstances do the blows induce excitement leading to 
ejaculation." 

0. Zimmerman's work, "Die Wonne des Leids," Leip- 
zig, 1885, also contributes much to this subject, 1 taken 
from history and literature. 

1 However, the domain of masochism must be sharply differen- 
tiated from the principal subject of that work, which is, that love 
contains an element of suffering. Unrequited love has always been 



lYO PSYCHOPATHIA SEXUALIS. 

More recently this matter has attracted fuller attention. 

A. Moll, in his work, "Die Contrare Sexualempfin- 
dung," pp. 133 and 151 et seq., Berlin, 1891, quotes a 
number of cases of complete masochism in individuals of 
inverted sexuality, and among them that of a man suffer- 
ing with sexual perversion, who sent written instructions, 
containing twenty paragraphs, to a man engaged for this 
purpose, who was to treat and abuse him like a slave. 

In June, 1891, Mr. Dimitri von Stefanowsky, Deputy 
Government Attorney in Jaroslaw, Russia, informed Vne 
that, about three years before, he had given his attention 
to the perversion of the vita sexualis designated "maso- 
chism" by me, and called "passivism" by him; that a 
year and a half previously he had prepared a paper on the 
subject for Professor von Kowalewsky for the Russian 
"Archives of Psychiatry" ; and that in November, 1888, 
he had read a paper on this subject, considered in its legal 
and psychological aspects, before the Law Society of Mos- 
cow (printed in the "Juridischer Boten," the organ of 
the society, in Nos. 6 to 8). 1 

V. Schrenck-Notzing devotes in his work "Therapeutic 
Suggestions in Psychopathia Sexualis" (Stuttgart, 1892), 
several paragraphs to masochism and sadism and quotes 
several observations of his own. 

Professor E. DeaJc of Buda Pesth, points out that the 
favourite thought of the masochist, viz. : to be used by a 
female person as a beast of burden, may be found in the 
old-Indian Literature, e.g., in "Pantschatandra" (Benfey, 
Vol. ii., Book iv.) in the form of a narrative: "Woman's 
Wiles," the gist of which is: The wife of King Nenda (in 
t 

described as " sweet, but sorrowful," and poets speak of " blissful 
pain " or " painful bliss." This must not be confounded, as Z. does, 
with the manifestations of masochism, any more than should be the 
characterisation of an unyielding lover as " cruel." It is remark- 
able, however, that Hamerling ("Amor und Psyche," iv. Gesang) 
uses perfect masochistic pictures, flagellation, etc., to express this 
feeling. 

1 Cf. his recent paper on " Passivisimus " in the " Archives 
d'Anthropologie Criminelle," 1892, vii., p. 294. 



MASOCHISM. 171 

consequence of some love quarrel) was very angry with 
JUT husband, but despite of his most earnest entreaties 
would not be reconciled. Ho says to her: "Love, without 
thee I cannot exist. I throw myself at thy feet and im- 
plore thee to be kind to me." She replies : "If thou wilt 
let me put a bit in thy mouth, mount thee arid goad thee 
on to run and neigh like a horse, I will forgive thee." 
He did it. (Cf. t Case 58 of this book !) 

Benfey found a similar story in a Buddhistic narra- 
tive which is published in "Memoires sur les contrees' occi- 
dentales par Hionen Thsang, traduit du Chinois par St. 
Julien," i., 124. 

Sacher-Masoch's writings have repeatedly been men- 
tioned in this book. 

Many perverts refer to this author as having given 
typical descriptions of their psychical conditions. 

Zola has a masochistic scene in his "Nana," also in 
"Eugene Rougon." The "decadent" literature of recent 
times in France and Germany often has for a theme 
sadism and masochism. According to v. Stefanowsky the 
tendency of the Russian novel lies in the same direction. 
Johann George Forster (1754-94) mentions in his 
"Travels" that the same idea underlies the Russian folk- 
lore. Stefanowsky finds the type of the "Passivist" in an 
English tragedy by Otway: "Venice preserved," and re- 
fers also to Dr. Luiz's "Les fellatores. Moeurs de la deca- 
dence," Paris, 1888 (Union des bibliophiles). 

Johannes Wedde (social-democrat agitator, died 1890), 
of Hamburg, advocates in his lyrics the subjection of man 
to woman who should be mistress instead of handmaid. 
(Cf. Max Hoffmann, "Magazin," v. 29, 2, 96). 

A striking example of masochism may also be found in 
northern literature by J. P. Jacobsen, "Niels Lyne." 

(b) Latent Masochism Foot- and Shoe-Fetichists. 

Following the group of masochists is the very numer- 
ous class of foot- and ehoe-fetichists. This group forms 



172 PSYCHOPATHIA SEXUALIS. 

the transition to the manifestations of another independent 
perversion, i.e., fetichism itself j but it stands in closer 
relationship to masochism than to the latter, for which 
reason it is placed here. 

By fetichists (v. page 218) I understand individuals 
whose sexual interest is concentrated exclusively on cer- 
tain parts of the female body, or on certain portions of 
female attire. One of the most frequent forms of this 
fetichism is that in which the female foot or shoe is the 
fetich, and becomes the exclusive object of sexual feeling 
and desire. It is highly probable, and shown by a correct 
classification of the observed cases, that the majority 
and perhaps all of the cases of shoe fetichism, rest upon 
a basis of more or less conscious masochistic desire for 
self-humiliation. 

In Hammond's case (case 59) the satisfaction of a 
masochist was found in being trod upon. In cases 55 and 
58 they also had themselves trod upon. In case 59, equus 
eroticus, the person loved a woman's foot, etc. In the 
majority of cases of masochism the act of being trod upon 
with feet plays a part as an easily accessible means of 
expressing the relation of subjection. 1 

Case 69. Z., age 28, hereditarily and constitutionally 
neuropathic, claimed to have had pollution at the age of 
eleven, when he was chastised by his mother ad podicem. 
He often recalled the scene as a pleasurable experience. At 
the age of thirteen he developed a weakness for ladies' 

1 (Moll, " Untersuchungen tiber Libido Sexualis, Bd. i., 2 Theil, 
Beob. 36, p. 320.) However, against the theory that foot- and 
shoe-fetichism is a manifestation of (latent) masochism, Dr. Moll 
(op. cit., p. 136) raises the objection that it is still unexplained 
why the fetichist so often prefers boots with high heels, to boots and 
shoes of a particular kind buttoned or laced. To this objection it 
may be remarked that in the first place the high heels characterise 
the shoes as feminine, and in the second place, that in spite of the 
sexual character of his inclination, the fetichist demands all kinds 
of aesthetic qualities in his fetich; also the interesting theories 
advanced by Restif de la Bretonne [himself foot- fetichist], and 
quoted in Mott's work, op. cit., pp. 498 and 499, footnote. 



MASOCHISM. 173 

boots with high heels. He pressed them between his thighs 
and thus produced ejaculation. The very thought of it 
sufficed to effect the desired result He soon added to 
this fancy the idea that he lay at the feet of a pretty girl 
and allowed her to kick him with her pretty boots. This 
caused ejaculation. Until he was twenty-one he never 
had desire for coitus or the female genitals. From twenty- 
one to twenty-five he suffered from tuberculosis, during 
which period the masochistic* inclination almost disap- 
peared. After recovery he tried coitus for the first time, 
but when he saw the nude form of the girl his desire van- 
ished completely. He now confined himself to his maso- 
chistic fancies, but hoped that some day he would meet 
with the ideal woman who by means of sadistic acts might 
lead him to normal sexual intercourse. 

Such cases are numerous in which, within a fully 
developed circle of masochistic ideas, the foot and the 
shoe or boot of a woman, conceived as a means of humili- 
ation, have become the objects of special sexual interest 
Through numerous degrees that are easily discriminated 
they form the demonstrable transition to other cases in 
which the masochistic inclinations retreat more and more 
to the background, and little by little pass beyond the 
threshold of consciousness, while the interest in women's 
shoes, apparently absolutely inexplicable, alone remains in 
consciousness. Frequent cases of shoe-lovers, which, like 
all cases of fetichism, possess forensic interest (theft of 
shoes), occupy a position midway between masochism and 
fetichism. The majority or all may be looked upon as 
instances of latent masochism (the motive remaining un- 
conscious) in which the female foot or shoe, as the maso- 
chist's fetich, has acquired an independent significance. 

In cases 70 and 71 the female shoe possesses a subor- 
dinate interest, but unmistakable masochistic desires play 
an important part: 

Case 70. Mr. X., aged twenty-five, parents healthy, 



174 PSYCHOI'ATHIA SEXUALIS. 

never ill before, placed the following autobiography at 
my disposal: "I began to practise onanism at the age of 
ten, without ever having any lustful thoughts during the 
act. Yet at that time I am sure of this the sight and 
touch of girls' elegant boots had a peculiar charm for me ; 
my greatest desire was also to wear such shoes, a wish 
that was occasionally fulfilled at masquerades. But I was 
also troubled by a very different thought: my ideal was to 
see myself in a position of humiliation; I would gladly 
have been a slave, and whipped; in short, I wished to 
receive the treatment that one finds described in many 
stories of slavery. I do not know whether the reading of 
such stories gave rise to my wish, or whether it arose spon- 
taneously. 

"Puberty began at the age of thirteen; with the 
occurrence of ejaculation lustful pleasure increased, and E 
masturbated more frequently, often two or three times a 
day. From my twelfth to my sixteenth year, during the 
act of onanism, I always had the idea that I was forced to 
wear girls' boots. The sight of an elegant boot, on the 
foot of a girl at all pretty, intoxicated me; I inhaled the 
odour of the leather with avidity. In order to smell 
leather during the act of onanism, I bought a pair of 
leathern cuffs, which I smelled while I masturbated. My 
enthusiasm for ladies' leathern shoes remains the same 
to-day; only, since my seventeenth year, it has boon 
coupled with the wish to become a servant, to blacken 
shoes for distinguished ladies, to put on and take off their 
shoes for them, etc. 

"My dreams at night are made up of shoe-scenes: 
either I stand before the show-window of a shoe-shop 
regarding the elegant ladies' shoes, particularly buttoned 
shoes, or I lie at a lady's feet and smell and lick her 
shoes. For about a year I have given up onanism and go 
ad puellas; coitus takes place by means of intense thought 
of ladies' buttoned shoes ; or, if necessary, I take the shoe 
of the puella to bed with me. I have never suffered from 
mv former onanism. I learn easily, have a good memory, 



MASOCHISM. 175 

and have never had a headache in my life. This much 
concerning myself. 

"A few words about my brother: I am thoroughly 
n.nvinced that he is also a shoe-fetichist. Of the many 
facts that demonstrate this to me, it is only necessary to 
mention that it is a great pleasure for him to have a cer- 
tain cousin (a very beautiful girl) tread upon him. As for 
the rest, I might undertake to tell whether a man who 
stands before a shoe-shop and regards the shoes on exhibi- 
tion is a "foot-lover" or not. This anomaly is uncom- 
monly frequent. When in the circle of my acquaintance 
I turn the conversation to the question of what woman's 
charm is, I very frequently hear it said that it is much 
more in attire than in nudity ; but every one is careful not 
to reveal his especial fetich. I think an uncle of mine is 
also a shoe-fetichist." 

Case 71. Z., twenty-eight years, official, comes from 
neuropathic mother. Father died early; as to his family 
and health no information obtainable. Z. was from early 
childhood nervous and impressionable; began early to 
masturbate on his own accord; with puberty he became 
neurasthenic, avoided onanism for a while, but was trou- 
bled with pollutions very frequently; recovered somewhat 
at a hydropathic institute; experienced strong libido to- 
wards woman, but never succeeded in coitus partly on ac- 
count of diffidence in his power, partly from fear of in- 
fection. This upset him very much, especially as he re- 
lapsed faute de mieux into his secret habit. 

Z., during a searching consultation about his vita sex- 
ualis, proved to be fetichist as well as masochist, and 
revealed interesting relations between these two anoma- 
lies. He asserted that since his ninth year he had a weak- 
ness for women's shoes. This, he claimed, was caused by 
seeing at that time a lady mounting a horse whilst an 
attendant held the stirrup for her. This sight excited him 
very much, it constantly recurred to his imagination, ever 
increasing his lustful feelings. Later on his sensations 



176 PSYCHOPATHIA SEXUALIS. 

during pollution were connected with women in high 
boots. Laced boots with high heels charmed him most 
especially when this idea was associated with the lustful 
thought that a woman trod upon him with her heel, and 
that he, whilst kneeling, kissed a woman's shoes. The 
only interesting thing about a woman was her shoe. Im- 
pressions of odour did not play any part in this. The 
shoe as such was insufficient; it must be worn by woman. 
Whenever he saw a woman with laced boots he became 
excited and masturbated. He believed that he could not 
command virile power with any woman unless her feet 
were clad with laced boots. 

Faute de mieux he made a drawing of such a boot, and 
whilst masturbating revelled in gazing at it. 

The following case is not only instructive because of 
the relations shown therein to exist between shoe-fetich- 
ism and masochism, but is also of interest on account 
of the cure of the vita sexualis brought about by the 
patient himself. 

Case 72. Mr. M., thirty-three years of age, of good 
family, which on the maternal side for generations had 
shown manifestations of psychical degeneration, extend- 
ing even to cases of moral insanity. The mother was 
neuropathic and characterologically abnormal. Himself 
strong, well built, but neuropathic; began as a small boy 
to practise onanism spontaneously. When twelve years 
of age peculiar dreams of being tortured, whipped and 
kicked by men and women, especially by the latter. When 
about fourteen a weakness for women's boots came over 
him. They caused sexual excitement; he was forced to 
kiss and press them to him; this produced erection and 
orgasm, followed by masturbation. But these acts were 
also accompanied by masochistic ideas of being kicked 
and tortured. 

He recognized that his vita sexualis was abnormal, 
and at the age of seventeen he sought a cure in coitus. 



MASOCHISM. 177 

lie found himself quite impotent. At eighteen another 
:.}! proved a failure; he continued masturbation 
assisted by shoe-fetichism and masochistic fancies. 

At the age of nineteen he heard by accident a man 
speak of flagellation by a girl as a means to bring about 
virility. He now felt that he had found his remedy, and 
hastened to carry out the advice just received, but waa 
completely disappointed. The whole situation disgusted 
him so thoroughly that no erection resulted. 

He made no more similar attempts, and satisfied him- 
self in the accustomed manner. When he was twenty- 
seven he met by accident a sympathetic and galante girl, 
became intimate, and complained to her about his impo- 
tence. She laughed at him, and said that at his age and 
with his constitution this was impossible. 

He gained self-confidence, but only after fourteen days 
of the greatest intimacy and with the aid of shoe-fetichism 
and masochistic fancies he obtained power. This lasted 
several months. His condition improved, he could do 
without the secret aids, and his abnormal fancies became 
latent. Then for three years, on account of psychical 
impotence with other women, he yielded again to mastur- 
bation and his former fetichism. With his thirtieth year 
he entered again upon sympathetic relations with another 
girl ; but as he felt himself incapable of coitus without the 
aid of masochistic situations, he instructed her to treat 
him as her slave. She played her part well, made him 
kiss her feet, whipped him with a switch, and trod upon 
him. But it was all in vain. He only felt pain and 
utter confusion, and soon had these assaults discontinued. 
Ideal masochistic situations, however, aided him at times 
to accomplish coitus. 

But he found little satisfaction under these circum- 
stances. Then he came across my book on "Psychopathia 
Sexualis," and found out the real condition of his anomaly. 
He wrote to his former acquaintance and entered again 
upon intimate relations with her, but told her definitely 
that the former absurd scenes of "slavery" must not. be 

12 



178 PSYCIIOPATJIIA 8EXUALIS. 

enacted again, and that under no circumstances, even 
though he request it himself, must she enter upon his 
masochistic ideas. 

In order to free himself of shoe-fetichism he adopted 
the following plan. He bought a lady's elegant boot 
and made daily these suggestions to himself whilst kissing 
the boot repeatedly: "Why should I have erections 
when kissing this boot, which is after all only a piece 
of ordinary leather?" This practice little by little 
stripped the object of its fetichistic charm. The erections 
disappeared, and finally the boot impressed him only as 
a boot. Intimate intercourse with the sympathetic per- 
son ran parallel with this suggestive self-treatment, and 
although at first he could not produce virility without the 
assistance of masochistic ideas, these latter gradually 
disappeared. 

He was so pleased with his cure that he came to thank 
me for the valuable help he had found in the perusal of 
my book, which had shown him the right way to remedy 
his defect. 

Since then he wrote that he was completely cured, 
that he met with no difficulties in his sexual intercourse, 
although from time to time masochistic representations 
faintly reappeared without, however, leaving any im- 
pression on his mind. 

Case 73. Reported by Mantegazza in his "Anthropo- 
logical Studies," 1886, p. 110. X., American, of good 
family, mentally and morally well constituted; from the 
beginning of puberty capable of being excited sexually 
only by a woman's shoe. Her body and naked or 
stockinged foot made no impression on him; but the 
foot, when covered with the shoe, or a shoe alone, in- 
duced erection and even ejaculation. Sight alone was 
sufficient for him in the case of elegant shoes i.e., shoea 
of black leather, buttoning up the side and having very 
high heels. His sexual desire was powerfully excited by 
touching, kissing, or putting such shoes on his feet. 



MASOCHISM. 179 

enjoyment was increased by driving nails through the 
soles so that their points would penetrate his feet while 
walking. This caused him terrible pain, but he had real 
lustful feeling at the same time. His greatest enjoyment 
was to kneel down before the elegant clad feet of ladies 
and have them step on him. If the wearer be an ugly 
woman, the shoes would not affect him, and his fancy 
would cool. If the patient had empty shoes only at his 
disposal, his fancy would create a beautiful woman wear- 
ing them, and ejaculation would result. His nightly 
dreams were of the shoes of beautiful women. He con- 
sidered the exposure of ladies' shoes in show-windowi 
immoral, while talk about the nature of woman seemed 
to him harmless, but in bad taste. X. attempted coitus 
several times without success, ejaculation never occurred. 

In the following case the masochistic as well as the 
sadistic element is in evidence (cf. "Torture of Animals," 
under "Sadism") : 

Case 74. A young, powerful man, aged twenty-six. 
Nothing in the opposite sex excited his sensual feeling 
except elegant shoes on the feet of a buxom woman, es- 
pecially when they were made of black leather, and had 
high heels. The shoes without the wearer were sufficient. 
It gave him the greatest pleasure to see, touch and kiss 
tliein. The feminine foot, when bare or covered with a 
stocking, had no effect on him. Since childhood he had 
a weakness for ladies' fine shoes. 

X. was potent; during the sexual act the female must 
be elegantly dressed and, above all, have on pretty shoes. 
At the height of sexual excitement cruel thoughts about 
the shoes arose. He was forced to think with delight of the 
death agonies of the animal from which the leather was 
taken. Sometimes he was impelled to take chickens and 
other animals with him to Phryne, in order to have her 
tread on them with her pretty shoes for his pleasure. He 
called this "sacrificing to the feet of Venus." At other 



180 PSYCHOPATHIA 8EXUALIS. 

times he had the woman walk on him with her shoes on, 
the harder the better. 

Until the previous year it was sufficient since he 
did not take the slightest sensual pleasure in women 
to caress ladies' shoes that pleased him, thus attaining 
ejaculation and complete satisfaction (Lombroso, "Arch, di 
psichiatria," ix., fascic. iii.). 

The next case reminds one of case 73, on account 
of the interest in the nails of the shoes (as capable of 
inflicting pain) ; and of 74, on account of the slight ac- 
companying sadistic element : 

Case 75. X., aged thirty-four, married; of neuro- 
pathic parentage; suffered severely from convulsions as 
a child; remarkably precocious, but one-sided in develop- 
ment (could read at age of three) ; nervous from childhood. 
At the age of seven he manifested an inclination to finger 
shoes, especially the nails of women's shoes. The mere 
sight, but still more the touching of the shoe nails and 
counting them, gave him indescribable pleasure. 

At night he gave himself up to imagining how his 
cousins had their measures taken for shoes; how he 
nailed horse-shoes on to one of them or cut her feet off. 
In time the shoe-scenes came upon him during the day, 
and involuntarily induced erection and ejaculation. Fre- 
quently he took the shoes of female occupants of the 
house; and if he touched them with his penis he had an 
ejaculation. For a long time, when a student, it was 
possible for him to control his ideas and inclinations ; but 
there came a time when he was compelled to listen to 
female footsteps on the pavement, which, like the sight 
of the nails being driven into ladies' shoes, or the sight 
of shoes in the windows of the boot-shops, always swayed 
him with feelings of lustful pleasure. He married, and 
during the first months of his married life was free from 
these desires. Gradually he became hysteropathic and 
neurasthenic. 



MASOCHISM. 181 

At this stage ho began to have hysterical attacks when 
the shoemaker spoke to him of nails in ladies' shoes or of 
driving nails in the same. The reaction was still greater 
if lie chanced to see a pretty lady with shoes well beset 
with nails. In order to induce ejaculation it was only 
necessary for him to cut soles out of pasteboard and beset 
them with nails; or he would buy ladies' shoes, have 
them beset with nails in the shop, and at home scrape 
th -in on the ground, and finally touch them with the 
end of his penis. Moreover, lustful shoe-visions occurred 
spontaneously, in which he satisfied himself by masturba- 
tion. 

X. was otherwise intelligent, skilful in his calling, but 
powerless in combating his perverse inclinations. lie 
presented phimosis; penis short, expanded at the root, and 
incapable of complete erection. One day the patient 
allowed himself to masturbate when excited by the sight 
of ladies' shoes beset with nails in front of the window, 
of a shoe-shop, and thus became a criminal (Blanche 
"Archiv. de Neurologie," 1882, No. 22). 

Reference may be made here to a case of inverted 
sexuality, to be described later, Case 137, in which the 
principal sexual interest was in the boots of male servants. 
The desire was to be trod upon by them, etc. 

Case 76. (Dr. Pascal "Igiene dell' amore".) X., 
merchant; from time to time (but particularly in bad 
weather) had the following desire: He would accost 
some prostitute and ask her to go to a shoe-shop with 
him, where he would buy her the handsomest pair of 
shoes made of patent leather, under the condition that 
she would put them on immediately. When this had 
taken place, she had to go about in the street, walking 
in manure and mud as much as possible, in order to soil 
the shoes. Then X. would lead the person to a hotel, 
and, almost before they had reached a room, he would 
cast himself upon her feet, feeling an extraordinary plea- 



182 PSYCIIOPATIIIA SEXUALIS. 

sure in licking them with his lips. When he had cleaned 
the shoes in this manner, he paid her and went his way. 

From these cases it may be plainly seen that the shoe 
is the fetich of the masochist, and apparently because of 
the relation of the dressed female foot to the idea of being 
trod upon and other acts of humiliation. When, therefore, 
m other cases of shoe-fetichism, the female shoe appears 
alone as the excitant of sexual desire, one is justified in 
presuming that masochistic motives have remained latent. 
The idea of being trod upon, etc., remains in the depths 
of unconscious life, and the idea of the shoe alone, the 
means for such acts, rises into consciousness. Cases which 
would otherwise remain wholly inexplicable are suffi- 
ciently explained. 1 Here one has to do with latent maso- 
chism which may always be assumed as the unconscious 
motive, when not infrequently the origin of the fetichism 
can be proved to arise from an association of ideas with 
some particular event, as in cases 113 and 114. 

Such cases of desire for ladies' shoes, without conscious 
motive and without demonstrable origin, are really innu- 
merable. 2 Three cases are here given as examples: 

Case 77. Minister, aged fifty. From time to time he 
went to houses of prostitution under the pretext of renting 
a room. He entered it with a girl. Then he lustfully 
regarded her shoes, took one off, osculatur et mordet cal- 
igam libidine captus. Ad genitalia denique caligam pre- 
mit, ejaculat semen semineque ejaculate exillas pedusque 
terit; then he awoke from his sexual ecstasy. He begged 
the woman to allow him to keep the shoe for a few days, 
and always, at the appointed time, returned it with thanks 
(Cantaranot, "La Psichiatria," v., p. 205). 

1 Compare the instructive case of Moll, Libido sexualis, p. 320. 

2 There is apparently a connection between foot-fetichism and 
the fact that certain persons of this kind, whom coitus does not 
satisfy, or who are unable to perform it, find a substitute for it 
in tritw membri inter pedes mulieris. 



MASOCHISM. 183 

Case 78. Z., Student, aged twenty-three; of a 
tainted family. Sister was insane; brother suffered with 
hil^ifrid i-ir His. The patient, peculiar from childhood, 
had frequent attacks of hypochondriacal depression, icedi- 
um vitce, and felt that he was being slighted. In a con- 
sultation on account of mental trouble, I found him to be 
a very perverse hereditarily predisposed man, with neu- 
rasthenic and hypochondriacal symptoms. A suspicion of 
masturbation was confirmed. Patient made interesting 
disclosures concerning his vita sexualis. At the age of ten 
he was powerfully attracted by the foot of one of his com- 
rades. At twelve he became an enthusiast for ladies' feet. 
It gave him a delightful sensation to revel in the sight of 
thoin. At fourteen he began to masturbate, thinking, at 
the same time, of the beautiful foot of a lady. At this 
time he revelled in the sight of the feet of his three-year- 
old sister. The feet of other females that attracted him 
induced sexual excitement. Only women's feet no other 
part of them interested him. The thought of sexual 
intercourse with women excited his disgust. He had never 
attempted coitus. After his twelfth year he had no interest 
in the feet of male individuals. The style of covering 
of the female foot was indifferent to him; it was only 
necessary that the person seemed to be sympathetic. The 
thought of enjoying the feet of prostitutes was disgusting 
to him. For years he had been in love with his sister's 
feet. If he could but obtain her shoes, the sight of them 
powerfully excited his sensuality. Kissing or embracing 
his sister did not have this effect. His greatest delight 
was to embrace and kiss the foot of a sympathetic woman, 
when ejaculation would result with a lively pleasurable 
sensation. Often he was impelled to touch his genitals 
with one of his sister's shoes; but he had been able, thus 
far, to master this impulse, especially for the reason that 
for two years (owing to progressive irritable weakness of 
the p'nitul-) the simple sight of the foot had induced 
ejaculation. From his relatives it was ascertained that 
}l.e patient had a silly admiration for the feet of his sister; 



184 PSYOHOPATHIA SEXUALI8. 

so that she avoided him and sought to hide her feet from 
him. The patient looked upon his perverse sexual impulse 
as pathological, and was painfully affected by the fact that 
his vile fancy had for its object his sister's foot. He 
avoided opportunity as much as he could, and sought to 
help the matter by masturbation when, as in dreams 
accompanied by pollution, ladies' feet filled his imagina- 
tion. However, when the impulse became too powerful 
he could not avoid gaining a partial sight of his sister's 
foot. Immediately after ejaculation he would become 
angry with himself at having been weak again. His 
partiality for his sister's foot had cost him many a sleep- 
less night. He often wondered that he could still love 
his sister. Although it seemed right to him that she 
should conceal her feet from him, yet he was often 
irritated because the concealment caused him to have 
pollutions. The patient gave assurances, confirmed by 
his relatives, of being moral in other respects. 

Case 79. S., New York, was accused of being a 
street-thief. Numerous cases of insanity in his ancestry; 
father, brother and sister mentally abnormal. At seven 
years, violent cerebral concussion twice. At thirteen, 
struck by a beam. At fourteen S. had violent attacks of 
headache. Accompanying these attacks, or immediately 
after them, peculiar impulse to take the shoes of female 
members of the family as a rule, only one at a time 
and hide them in some out-of-the way corner. Taken to 
task, he would lie, or declare that he had no recollection 
of the affair. The passion for shoes was unconquerable, 
and made its appearance every three or four months. 
On one occasion he attempted to take a shoe from the 
foot of one of the servants, and on another he stole his 
sister's shoe from her bedroom. In the spring two ladies 
had their shoes torn from their feet in the open street. 
In August, S. left his home early in the morning to go 
to his work as a printer. A moment afterwards he tore 
the shoe from a girl's foot in the open street, fled to his 



MASOCHISM. 185 

place of work, and tin-re waa arrested as a street-thief, 
lit- <1 'dared that hr did not know much of his act; that 
it 1 1 ad come upon him like a stroke of lightning, at the 
sight of the shoe, that he must possess himself of it, but 
for what purpose he did not know. He had acted while 
in a state of unconsciousness. The shoe, as he correctly 
indicated, was found in his coat In confinement he was 
so much excited mentally that an outbreak of insanity 
was feared. Discharged, he stole his wife's shoes while 
she was asleep. His moral character and habits of life 
were blameless. He was an intelligent workman; but 
irregularity of employment, that soon followed, made him 
confused and incapable of work. Pardoned (Nichols, 
"Am. Journal of Insanity," 1859 ; Beck, "Med. Jurispru- 
dence," vol. i., p. 732, 1860). 

Dr. Pascal (op. cit.) has some similar cases, and many 
others have been mentioned to me by colleagues and 
patients. 

(c) Disgusting Acts for the Purpose of Self -Humiliation 
and Sexual Gratification Latent Masochism Kopro- 
lagnia. 

Whilst in the manifestations thus far described the 
aesthetic sentiment is at least, so far as appearances go, 
saved, and the lustful situation is kept within the confines 
of a symbolic or ideal character, there are many cases in 
which the desire for sexual gratification by self-humilia- 
tion before woman finds expression in acts which defile the 
moral and aesthetic feeling of the normal man. 

Impressions obtained through the senses of smell and 
taste, which in the normal man produce orfy feelings 
of nausea and disgust, are made the basis of the most 
vivid emotions of lust, producing in the perverse subject 
mighty impulses to orgasm and even ejaculation. 

An analogy with the excesses of religious enthusiasm 
can be even traced. The religious enthusiast, Antoinette 



186 PSYCHOPATHIA 8EXUALIS. 

Bouvignon de la Porte, used to mix with her food excreta 
in order to mortify herself (Zimmefmann, op. cit., p. 124). 
The beatified Marie Alacoque licked up with her tongue 
the excrement of sick people to "mortify" herself, and 
sucked their festering toes. The analogy with sadism is 
also of interest in this connection because here also mani- 
festations in the sense of varnpyrism and anthropophagy 
arising from disgusting appetites of the organs of taste 
and olf action produce lustful feelings (cf. case 59, Bichel, 
Menesclou, f. Beob. 18, 19, 20, 22). This impulse to dis- 
gusting acts might well be named KOPROLAGNIA. Its 
relations to Masochism (as a subordinate form) have been 
indicated in case 51. The subsequent observation will 
render them clearer. 

In some cases it would appear as if the masochistic 
element were unknown to the perverse subject and tho 
instinct for nauseating acts alone were present (latent 
masochism). A striking instance of masochistic kopro- 
lagnia (combined with perverse sexuality) may be found in 
case 114 of the eighth edition of this work. The subject 
of this case revels not only in the thought of being the 
slave of the beloved, referring for this purpose to Sacher- 
Masoch's "Venus in Furs," sed etiam sibi fingit amatum 
poscere ut crepidas sudore diffluentes olfaciat ejusque ster- 
core vescaiur. Delude narrat, quid non habeat, quce con- 
fingat et exoptet, eorum loco suas crepidas sudore infectas 
olfacere suoque stercore vesci, inter quce facta pene erecto 
se voluptate perturbari semenque ejaculari. 

Case 80. Masochism Koprolagnia. Z., fifty-two 
years of age; high position; father phthisical; family 
claimed to be untainted; always nervous, only child, de- 
posed to have had peculiar emotions since he was seven, 
when by chance he saw the servants take off their boots 
and stockings preparatory to scrubbing the floors of the 
house. Once he begged one of the maids to show him her 
toes and feet before she washed them. When he began 
going to school and reading books, be fait forcibly drawn 



MASOCHISM. 187 

TO literature which contained descriptions of refined cruelty 
and tortures, especially when they were executed at the de- 
mands of women. He simply devoured novels dealing 
with slavery and bondage, and whilst reading them, IK? 
became so excited that he began masturbation. What. 
i i d him most was to imagine that he was the slave 
of a pretty young lady of his acquaintance who allowed 
hi in after a long walk, pcdes lambere* proecipue plautas et 
spatia inter diyitos. He thought of the young lady as 
particularly cruel and enjoying tortures and whippings 
meted out to him. These fancies were accompanied by 
masturbation. At the age of fifteen whilst revelling in 
such fiction, he let a poodle dog lick his feet. One day 
he noticed how a pretty servant girl in his own home 
let a poodle dog lick her toes whilst she was reading. 
This caused in him erection and ejaculation. He per- 
suaded the girl to let this happen frequently whilst he 
looked on. After a while he took the place of the poodle 
and ejaculated every time. 

From his fifteenth to his eighteenth year he was at 
a boarding-school and had no opportunity for practising 
such evil habits. He was satisfied to excite himself every 
few weeks with the perusal of literature treating on cruel- 
ties committed by women, imagining all the time that he 
was licking the feet of such women. This produced 
ejaculation accompanied by the highest lustful excitement. 
The female organs had never any attraction for him. and 
he never felt sexually drawn towards men. When lie ha<l 
attained puberty he solicited girls and had coitus with 
them, but always sucked their feet before the act. Ho 
would do this also, inter actum, and asked the girls to tell 
him with what cruelties they. would afflict him in case 
he did not lick their toes quite clean. Z. affirms that he 
very often succeeded in this, and that the whole action 
was always pleasing to the girls. 



This .lis^Mi-tin^ impulse is also referred to in case 68 of the 
edition of tliis work. It scorns to occur especially with 

ko;>ml:ii:iiist8 and fetid 



188 PSYOIIOPATHIA 8EXUALIS. 

He was especially attracted by the feet of well-bred 
women that were deformed by narrow boots and had not 
been washed for several days, but he could stomach only 
"slight, natural deposits, such as one may find upon the 
feet of clean well-bred ladies, also discolorations from the 
stockings, whilst sweating feet excited him only in imagin- 
ation, but in reality disgusted him". "Cruel tortures" 
also existed for him only in imagination as a means to 
excitement; he abhorred them and never craved for them 
in reality. Nevertheless they played a pre-eminent part 
in his fancy, and he never neglected to instruct the women 
with whom he kept in masochistic touch how they were 
to write him threatening letters. From the collection of 
such letters placed at my disposal by Z. one is given here 
because it clearly illustrates the line of thought and 
sentiment : 

"Lambitor sudoris pedum mulierum! I take the ut- 
most delight in conjuring up the moment when you will 
lick my toes, especially after a long walk. A facsimile of 
my foot I shall send you soon. It will intoxicate me like 
nectar when you will lick up my sudor pedum. And if you 
will not do it voluntarily, I shall force you to it; I shall 
treat you as my meanest slave. You shall witness how 
another favoritus sudorem pedum mihi lambit, whilst you 
shall whine like a dog under the lashes of my servants. 
I shall declare you outlawed. I shall find the most 
exquisite pleasure in seeing you in pain, breathing your 
last under the most cruel tortures, licking my toes in 
extreme agony. . . . You challenge my cruelty very 
well, I shall crush you under my foot like a worm. . . . 
You ask me for a stocking ? . I shall wear it longer than 
usual. But I demand that you kiss it and lick it ; that you 
soak the foot of it in water and then drink the latter. 
If you do not carry out my pleasure absolutely, I shall 
chastise you with my riding-whip. I demand uncon- 
ditional obedience. If you do not obey, I shall have you 
whipped with the knout, I shall make you walk over 
a floor well-spiked with sharp nails, I shall have you 



MASOCHISM. 189 

battinaded and cast to the lions in the cage. It will 
give me th<> utmost delight to see how the wild beasts 
enjoy your flesh." 

In spite of such ridiculous tirades, ordered by himself, 
Z. looked upon them as a means to satisfy his perverse 
sexuality. These sexual monstrosities, which to him were 
only a congenital anomaly, he did not consider unnatural, 
although he admitted them to be disgusting to the nor- 
mally constituted man. Otherwise he appeared to be a 
decent sort of a man with rather refined manners, but his 
otherwise meagre aesthetic sentiments were overbalanced by 
sensuality which gratified his perverse desires. 

Z. gave me an insight into his correspondence with 
the literary champion of masochism, Sacher-Masoch. 

One of these letters, dated 1888, shows as a heading 
thf picture of a luxuriant woman, with imperial bearing, 
only half covered witli furs and holding a riding- whip as 
if ready to strike. Sacher-Masoch contends that "the 
passion to play the slave" is widespread, especially among 
the Germans and Russians. In this letter, the history of 
a noble Russian is related who loved to be tied and 
whipped by several beautiful women. One day he found 
his ideal in a pretty young French woman and took her 
to his home. 

According to Sacher-Masoch, a Danish woman yielded 
her favour to no man until he acted the part of slave to 
her for a considerable time. Amanlrs coagere solebat, ut 
pedes suos et podicem lambeant. She had her adorers put 
in chains and whipped until they obeyed her lambendo 
pedes. Once she had the "slave" fastened to her bed- 
posts and thus made him witness her granting the highest 
favour to another. After the latter left her she had the 
fcttored "slave" whipped by her servants until he yielded 
lambere podicem domincB. 

If these assertions were true which, of course, cannot 
be accepted from the poet without definite proof, they 
would constitute remarkable proofs of sadismus femina- 
rum. At any rate they are psychologically interesting in- 



190 PSYCHOPATHIA SEXUAIJS. 

stances of thoughts and sentiments specific to masochism 
(my own observations, "Centralblatt fur Krankheiten der 
Harn- und Sexualorgane," vi., 7). 

Case 81. Z., aged twenty-four; Russian civil serv- 
ant; mother neuropathic, father psychopathic. Z. was in- 
telligent, of refined manners, physically normal, of pleas- 
ing appearance and aesthetic tastes ; never had a severe ill- 
ness. Claimed to have been of a nervous disposition from 
infancy ; had like his mother neuropathic eyes and latterly 
suffered from cerebral asthenic troubles. Perversio vitce 
sexualis caused him much worry, bordering on despair, 
deprived him of self-esteem and tempted him to suicide. 

What oppressed him was the unnatural desire recurring 
every four weeks for mictio mulieris in os suum. As cause 
he gave the following facts, interesting on account of 
their genetic importance. When six years of age he put 
his hand by accident sub podicem puellce who sat next to 
him in school. This caused him pleasure and he repeatedly 
did so. The memory of these pleasant situations strongly 
aroused his fancy. 

Puerum decem annorum serva educatrix libidine mota 
ad corpus suum appressit et digitum ejus in vaginam intro- 
duxit. Quum postea fortuitu digito nasum ietigit, odore 
ejus valde delectatus fuit. 

This immoral act developed into a lustful fancy which 
made him believe vinctus inter femora mulieris cumbere, 
coactus, ut dormiat sub ejus podice et ut bibat ejus urinam. 

With the thirteenth year these fictions disappeared. 
At fifteen first coitus, at sixteen second, quite normal and 
without fanciful representations. 

Deficiente pecunia et magna libidine perturbatus mas- 
turbatione earn satiabat. 

At seventeen perverse ideas recurred. They became 
more powerful and he struggled against them in vain. 

At eighteen he yielded to the impulse. Quum 
mulier qucedam in os ei minxit, maxima voluptate affect us 
est. He then had coitus with the vile woman. Since then, 



MASOCHISM. 191 

he felt the necessity (,. repent the disgusting act every four 
weeks. 

After indulging in this perverse action he was ashamed 
of himself and disgust overcame him. Ejaculations ac- 
eompanird the act but seldom, but it produced erections 
and orgasm and whenever ejaculation missed, he gratified 
himself with coitus. 

During the intervals between these excessive impulses 
hf was quite free from perverse thoughts and desires as 
well as from ideal masochism and fetichistic relations. 
Libido during these intervals was but slight and easily 
gratified in the normal fashion without the assistance of 
perverse fiction. He often travelled miles from his coun- 
try seat to the city to satisfy his cravings when these spells 
came over him. 

Again and again the patient refined as he was and 
disgusted with his own perversity sought to resist the 
morbid impulse, but in vain; restlessness, anxiety, trem- 

' 

jsyehiei. rt- 

ihcatmn of - . 

: ly, but was at >. rcoine v 

contempt for himself border' 

ntal struggles enen 

plained of debility of memory, absent -mimie-. 
impotence, and cerebral pressure. His last hope was that 
ni'-dical science might succeed in freeing him from this 
monstrous affliction and in re-establishing his moral self. 

Case 82. Masochism Fetichism Koprolagnia. 
B., aged thirty-one, official, family neuropathically tainted, 
nervous from early childhood, weakly, nocturnal frights. 
I-'irst pollution at the age of sixteen. At seventeen fell 
in love with a French woman, twenty-eight years old and 
anything but pretty. Had a special weakness for her 
shoes. Whenever he could do so without being observed, 
he would cover them with kisses. This gave him sensual 
delights; but it never caused ejaculation. At that time 



192 PSYCHOPATHIA SEXUALIS. 

according to his statement, he had no knowledge of the 
difference in sexes. He could not understand his weakness 
for shoes. After he attained the age of twenty-two he had 
coitus about once a month, but did not derive psychical 
gratification from the act. One day he met a prostitute 
in the street whose haughty demeanor, fascinating eye and 
challenging mien made a peculiar impression on him. He 
felt an impulse to throw himself at her feet, kiss them, and 
follow her like a dog or slave. Her "majestic" feet clad 
in patent leather boots especially captivated him. He 
trembled with voluptuous excitement. During the night 
he could not find sleep for the thought of the woman 
haunted him. He imagined that he was kissing this 
woman's feet. This fancy superinduced ejaculation. Shy 
by nature, he now resorted to psychical masturbation, and 
having a dislike for prostitutes, he shunned henceforth the 
society of women altogether. He revelled in the thought 
of the pretty foot of an imperious woman and associated 
this thought with the olfactory impression he would re- 
ceive from its proximity. In erotic dreams he would fol- 
low such wome.ri. T!li. Tvouiu begin 'to 'fail ,ind the woman 
ug her skirts would show her pretty foot, ankle and 
calf, encased in a silken stocking. As soon as he grasped 
and fondled the warm form, so soft and yet so firm, he 
would ejaculate. On rainy days he used to patrol the streets 
to see such scenes in reality. If he saw what he came for 
he would carry away the impression in his memory and 
it became the object of his nightly dreams and acts of 
psychical masturbation. To hasten the act he would sniff 
his own socks, kiss, bite and chew them. His dreams and 
libidinous ecstasies were also mingled with fancies of a 
purely masochistic character, e.g., a woman but slightly 
clad stood in front of him holding a whip in her hand, 
whilst he knelt at her feet like a slave. She would cut 
him with the whip, put her foot on his neck, face or mouth, 
till he consented secretum inter digitos nudos pedis ejus 
bene clans exsugere. During this mental act he would 
smell of his own feet, the odor of which was repulsive to 



MASOCHISM. 193 

him when in his normal state. He would vary these prac- 
tices with acts of "poderfetichism" by using a girl's 
Ira were et stercus proprium naribus appositum. At other 
(ilia's the cunnus feminat would be his fetich and he would 
practise ideal c mini lingua. For assistance he would use 
pieces cut from the armpits of a woman's undervest, or 
stockings, or shoes. After six years, during which neu- 
rasthenia had increased whilst the imaginative power 
had waned, he lost all power to accomplish these 
act* of psychical onanism and came down to the 
level of a common masturbator. He, later on, be- 
came acquainted with a girl of a similar masochistic ten- 
dency, and coitus became possible for both, but always 
by having recourse to some masochistic situation. But the 
old fetichistic fascinations reappeared and he found 
greater pleasures in appeasing this perverse appetite than 
in coitus, which he performed only honoris causa. The 
end of this cynical sexual existence was a marriage after 
his mistress had forsaken him with a woman who had 
the same perverse inclinations as himself. They had chil- 
dren, but found sexual gratification chiefly in masochistic 
marital acts. (Centralblatt fur Krankheiten der Harn- 
und Sexual organe, vi., 7.) 

Other cases of Cantarano's (loc. cit.) belong here (mic~ 
iio even dcfcecatio puellce ad linguam viri ante actum) con- 
sumption of confects smelling like faces, in order to be- 
come potent; and also the following case, likewise com- 
municated to me by a physician : 

"A Russian prince, who was very decrepit, was ac- 
customed to have his mistress turn her back to him and 
defecate on his breast; this being the only way in which 
he could excite the remnant of libido." 

Another supported a mistress in unusually brilliant 
style, with the condition that she ate marchpane exclu- 
sively. Ut libidinosus fiat et ejaculate possit excrementa 
feminw ere excipit. A Brazilian physician tells me of 

13 






194 PSYC1IOPATHIA SEXUALIS. 

several cases of defcecatio feminae in os viri that have como 
to his knowledge. Such cases occur everywhere, and are 
not at all infrequent. All kinds of secretions saliva, 
nasal mucus, and even aural cerumen are used in 
way and swallowed with pleasure ; and oscula ad nates and 
even ad anum are indulged in. Dr. Moll (op. cit. f p. 135) 
reports the same thing of a man affected with inverted 
sexuality. The perverse desire to practise cunnilingus, 
which is very wide-spread, probably has its root frequently 
in masochistic impulses. 

Evidently the case quoted by Cantarano ("La Psichia- 
tria," v., p. 207) belongs here also, in which coitus is 
preceded by morsus et succio of the woman's toes which 
have not been washed for some time. Also a case quoted 
by me in the eighth edition of this book, cf. ibid., case 68. 

Stefanowsky ("Archives de 1'Anthropologie crimi- 
nelle," 1892, vol. vii.) knows of a Russian merchant qui 
valde delectatus fuit bibendo ae quce puella lupanarii jusso 
suo in vas spuerunt. 

Neri, "Archivio delle psicopatie sessuali," p. 198 : 
Workman, aged twenty-seven, heavily tainted, tic in the 
face, troubled with phobia (especially agoraphobia) and 
alcoholism. Summa ei fit voluptas, si meretrices in os ejus 
faces et urinas deponunt. Vinum supra corpus scortorum 
effusum defluens ore ad meretricis cunnum adposito excipit. 
Valde delectatur, si, sanguinem menstrualem ex vagina ef- 
fluentem sugere potest. He is fetichist of ladies' gloves and 
slippers, osculatur calceos sororis, cujus pedes sudorc ma- 
dent. Libido cjus turn dcmun maxime satiatur, si a puellis 
insultatur, immo vero verberatur, ut sanguis exeat. Dum 
verberatur, genibus nixus veniam et clementiam pueUa 
expetit, deinde masturbare incipit. 

Pelanda ("Archivio di Psichiatria," x., fascicolo 3, 4) 
relates the following case : 

Case 83. W., aged forty-five, predisposed, was given 
to masturbation at the age of eight. A decimo sexto anno 



MASOCHISM. 195 

lihidines suas bibendo recentem feminarum urinam satia- 
rit. Tanta erat voluptas urinam bibentis ut nee aliquid 
olfaceret nee saperei, hcec faciens. After drinking he al- 
ways experienced disgust and ill-feeling, and made firm 
it inns to do it no more in the future. Once he had 
the same pleasure in drinking the urine of a nine-year-old 
boy, with whom he once practised fellatio. The patient 
suffered from epileptic insanity. 

Still older cases belong here, which Tardieu ("Etude 
medico-legale sur les attentats aux moeurs," p. 206) ob- 
served in senile individuals. He describes as "Renifleurs" 
persons "qui in sccretos locos nimirum theatrorum porticos 
convenientes quo complures femince ad micturiendum fes- 
tinani, per nares urinali odore excitati, illico se invicem 
polluunt". The "Stercoraires" that Taxil ("La prostitu- 
tion contemporaine") mentions are, in relation to this 
subject, unique. 

Eulenburg relates further monstrous facts belonging to 
this section. Cf. Zulzer's "Klin. Handbuch der Ham- 
und Sexualorgane," iv., p. 47. 

(d) Masochism in Woman. 

In woman voluntary subjection to the opposite sex is 
a physiological phenomenon. Owing to her passive role 
in procreation and long-existent social conditions, ideas of 
subjection are, in woman, normally connected with the 
idea of sexual relations. They form, so to speak, the 
harmonics which determine the tone-quality of feminine 
feeling. 

Any one conversant with the history of civilisation 
knows in what a state of absolute subjection woman was 
always kept until a relatively high degree of civilisation 
was reached; 1 and an attentive observer of life may still 

1 The laws of the early middle ages gave the husband the right 
to kill the wife; those of the later middle ages, the right to beat 
her. The latter right was used freely, even by those of high stand- 






196 PSYCHOPATHIA SEXUALIS. 

easily recognise how the custom of unnumbered genera- 
tions, in connection with the ^-passive role with which 
woman has been endowed by Nature, has given her an 
instinctive inclination to voluntary subordination to man; 
he will notice that exaggeration of customary gallantry 
is very distasteful to women, and that a deviation from 
it in the direction of masterful behaviour, though loudly 
reprehended, is often accepted with secret satisfaction. 2 
Under the veneer of polite society the instinct of feminine 
servitude is everywhere discernible. 

Thus it is easy to regard masochism in general as 
a pathological growth of specific feminine mental ele- 
ments, as an abnormal intensification of certain features 
of the psycho-sexual character of woman, and to seek its 
primary origin in that sex (v. infra, p. 199). It may, how- 
ever, be held to be established that, in woman, an inclina- 
tion to subordination to man (which may be regarded as 
an acquired, purposeful arrangement, a phenomenon of 
adaptation to social requirements) is to a certain extent a 
normal manifestation. 

The reason that, under such circumstances, the 
"poetry" of the symbolic act of subjection is not reached, 
lies partly in the fact that man has not the vanity of that 
weakling who would improve the opportunity by the dis- 
play of his power (as the ladies of the middle ages did 
towards the love-serving knights), but prefers to realise 
solid advantages. The barbarian has his wife plough for 
him, and the civilised lover speculates about her dowry; 
she willingly endures both. 

Cases of pathological increase of this instinct of sub- 
jection, in the sense of feminine masochism, are probably 

ing (cf. Schultze, "Das hofische Leben zur Zeit des Minnesangs," Bd. 
i., p. 163 et seq.). Yet, by the side of this, the paradoxical chivalry 
of the middle ages stands unexplained (v. infra, p. 198). 

2 Cf. Lady Milford's words in Schiller's " Kabale und Liebe": 
"We women can only ehoose between ruling and serving; but the 
highest pleasure power affords is but a miserable substitute, if the 
grater joy of being the slaves of a man we love is denied ua!" 
(Act II./ Scene I.). 



197 

enough, but custom represses their manifesta- 
ti-'ii. Manv Noting women like nothing better than to 
kii el U-t'oro their husbands or lovers. Among the lower 
classes of Slavs it is said that the wives feel hurt if they 
are not beaten by their husbands. A Hungarian official 
informs me that the peasant women of the Soinogyer 
Comitate do not think they are loved by their husbands 
until they have received the first box on the ear as a sign 
of love. 

It would probably be difficult for the physician to find 
cases of feminine masochism. 1 Intrinsic and extraneous 
restraints modesty and custom naturally constitute in 
woman insurmountable obstacles to the expression of per- 
verse sexual instinct. Thus it happens that, up to the 
present time, but two cases of masochism in woman have 
been scientifically established. 

Case 84. Miss X., twenty-one years of age; her 
mother was a morphia maniac and died some years ago 
from nervous disorders. Her uncle (mother's side) was also 
a morphia-eater. One brother of the girl was neurasthenic, 
another a masochist (wished to be beaten with a cane by 
proud, noble ladies). Miss X. had never had a severe ill- 
ness, but at times suffered from headaches. She considered 
If to ! be physically sound, but periodically insane, 
vix., when she was haunted by the fancies which she thus 
described : 

Since her earliest youth she fancied herself being 
whipped. She simply revelled in these ideas, and had the 
most intense desire to be severely punished with a rattan 
cane. 

This desire, she claimed, originated from the fact that 
at the age of five a friend of her father's took her for fun 

I 8eydel, " Vierteljahresschr. f. gor. Mcd.," 1893, vol. ii., quotes 
an an f iu:i-<><-|iism the patient of Dicffenbach, who repeat- 

edly and purposely dislocated her arm in order to experience lustful 
sensations when it was being reduced, anaesthetics not being known 

th.U. 



198 PSYCIIOPATHIA 8EXUALIS. 

across his knees, pretending to whip her. Since then she 
had longed for the opportunity of being caned, but to her 
great regret her wish was never realised. At these periods 
she imagined herself as absolutely helpless and fettered. 
The mere mention of the words "rattan cane" and "to 
whip" caused her intense excitement Only for the last 
two years she associated these ideas with the male sex. 
Previously she only thought of a severe school-mistress or 
simply a hand. 

Now she wished to be the slave of a man whom 
she loves; she would kiss his feet if he would only whip 
her. 

She did not understand that these manifestations were 
of a sexual nature. 

A few quotations from her letters are characteristic as 
bearing upon the masochistic character of this case: 

"In former years I seriously contemplated going into 
a lunatic asylum whenever these ideas worried me. I fell 
upon this idea whilst reading how the director of an 
insane asylum pulled a lady by the hair from her bed and 
beat her with a cane and a riding-whip. I longed to be 
treated in a similar manner at such an institute, and have 
therefore unconsciously associated my ideas with the male 
sex. I liked, however, best to think of brutal, uneducated 
female warders beating me mercilessly. 

"Lying (in fancy) before him, he puts one foot on my 
neck whilst I kiss the other. I revel in the idea of being 
whipped by him; but this changes often, and I fancy 
quite different scenes in which he beats me. At times I 
take the blows as so many tokens of love he is at first 
extremely kind and tender, and then, in the excess of his 
love, he beats me. I fancy that to beat me for love's sake 
gives him the highest pleasure. Often I have dreamed 
that I was his slave but, mind you, not his female slave ! 
For instance, I have imagined that he was Robinson- and 
I the savage that served him. I often look at the pictures 
in which Robinson puts his foot on the neck of the savage. 
1 now find an explanation of these strauee fancies : I look 



MASOCHISM. 199 

upon woman in general as low, far below man; but I am 
: \\i-e extremely proud and quite indomitable, whence 
it arises that I think as a man (who is by nature proud 
and superior). This renders my humiliation before the 
man I love the more intense. I have also fancied myself 
to be his female slave; but this does not suffice, for after 
all every woman can be the slave of her husband. 

Case 85. Miss v. X., aged thirty-five ; of greatly pre- 
disposed family. For some years she had been in the ini- 
tial stages of paranoia pcrsecutoria. This sprang from 
cerebro-spinal neurasthenia, the origin of which was found 
to be sexual hyperexcitation. With twenty-four she was 
given to masturbation. As a result of disappointment in 
an engagement, she began to practise masturbation and 
psychical onanism. Inclination toward persons of her own 
sex never occurred. The patient says: "At the age of 
six or eight I conceived a desire to be whipped. Since I 
had never been whipped, and had never been present when 
others were thus punished, I cannot understand how I came 
to have this strange desire. I can only think that it is 
congenital. With these ideas of being whipped I had a 
feeling of actual delight, and pictured in my fancy how 
fine it would be to be whipped by one of my female friends. 
I never had any thought of being whipped by a man. I 
revelled in the idea, and never attempted any actual reali- 
sation of my fancies, which disappeared after my tenth 
year. Only when I read "Rousseau's Confessions," at the 
age of thirty-four, did I understand what my longing for 
whippings meant, and that my abnormal ideas were like 
those of Rousseau. 

On account of its original character and the reference 
to Rousseau, this case may with certainty be called a case 
of masochism. The fact that it is a female friend who is 
conceived in imagination's whipping her, is explained by 
the circumstance that the masochistic desire was here 
present in the mind of a child before the psychical vita 
gexualis had developed and the instinct for the male had 



200 PSYCHOPATHIA SEXUALIS. 

been awakened. Antipathic sexual instinct . is here ex- 
pressly excluded. 

Case 86. A physician in the General Hospital of 
Vienna had his attention drawn to a girl who used to call 
on the medical assistants of the institution. When meet- 
ing one of them she would express great delight at meeting 
a medical man and ask him to at once undertake a gyneco- 
logical examination on her. She said she would make re- 
sistance, but he must take no notice of that, on the contrary 
ask her to be calm and proceed with the examination. If 
X. consented, the scene would be enacted as she desired. 
She would resist, and thus work herself up into a high state 
of sexual excitement. If the medical man refused to pro- 
ceed any further she would beg him not to desist. It was 
quite evident that the examination was only requested for 
the purpose of inducing the highest possible degree of 
orgasm. When the medical man refused coitus she felt 
deeply offended, but begged him to let her come again. 
Money she never accepted. 

It is apparent that orgasm was not induced by the mere 
palpation of the genitals, but the exciting cause undoubt- 
edly lay in the act of force, which was always demanded, 
and which became the equivalent of coitus. It is evidently 
a manifestation belonging in the province of masochism in 
woman. 

An Attempt to Explain Masochism. 

The facts of masochism are certainly among the most 
interesting in the domain of psychopathology. An attempt 
at explanation must first seek to distinguish in them the 
essential from the unessential. The distinguishing charac- 
teristic in masochism is certainly the unlimited subjection 
to the will of a person of the opposite sex (in sadism, on 
the contrary, the unlimited mastery of this person), witli 
the awakening and accompaniment of lustful sexual feel- 
ings to the degree of orgasm. From the foregoing it is 



MASOCHISM. 201 

that the particular manner in which this relation of 

subjection or domination is expressed (v. supra), whether 

!y in symbolic acts, or whether there is also a desire 

to suffer pain at the hands of a person of the opposite sex, 

is a subordinate matter. 

While sadism may be looked upon as a pathological 
intensification of the masculine sexual character in its 
psychical peculiarities, masochism rather represents a 
pathological degeneration of the distinctive psychical 
peculiarities of woman. But masculine masochism is un- 
doubtedly frequent; and it is this that comes most fre- 
quently under observation and almost exclusively makes 
u j> the series of observed cases. The reason for this has 
been previously stated. 

Two sources of masochism can be distinguished in the 
sphere of normal phenomena. The first is, that in the 
state of lustful excitement every impression made by the 
person giving rise to the sexual stimulus, independently of 
the nature of its action, is pleasing to the individual ex- 
cited. 

It is entirely physiological that playful taps and light 
blows should be taken for caresses, 1 

Like the lover's pinch, which hurts and is desired. 

Anthony and Cleopatra, v., 2. 

From here the step is not long to a state where the wish 
xperience a very intense impression at the hands of 
the consort leads to a desire for blows, etc., in cases of 
pathological intensification of lust; for pain is ever a 
r ;i'ly means for producing intense bodily impressions. 
Just as in sadism the sexual emotion leads to a state of 
exaltation in which the excessive motor excitement im- 
plicates neighbouring nervous tracts, so in masochism an 
ecstatic state arises, in which the rising flood of a single 

1 Analogous facts are found in the animal kingdom. Pulmonata 
Cuv., for instance, possess a small calcareous staff which lies hidden 
in a special pouch of the body, but is at the time of mating pro- 
jected and used as a means of sexual excitement, producing, beyond 
doubt, pain. 



202 PSYCHOPATHIA SEXUALI8. 

emotion ravenously devours and covers with lust every 
impression coming from the beloved person. 

The second and, indeed, the most important source of 
masochism is to be sought in a wide-spread phenomenon, 
which, though it is extraordinary and abnormal, yet, J)y 
no means lies within the domain of sexual perversion. 

I here refer to the very prevalent fact that in in- 
numerable instances, which occur in all varieties, one in- 
dividual becomes dependent on another of the opposite 
sex, in a very extraordinary and remarkable manner, 
even to the loss of all independent will-power; a depend- 
ence which forces the party in subjection to acts and 
suffering which greatly prejudice personal interest, and 
often enough lead to offences against both morality and 
law. 

This dependence, however, differs from. the manifesta- 
tions of normal life only in the intensity of the sexual 
feeling that here comes in play, and in the slight .degree 
of will-power necessary for the maintenance of its equili- 
brium. The difference is one of intensity, not of quality, 
as in masochistic manifestations. 

This dependence of one person upon another of the 
opposite sex abnormal but not perverse, a phenomenon 
possessing great interest when .regarded from a forensic 
standpoint I designate "sexual bondage"; 1 for the rela- 
tions and circumstances attending it have in all respects 
the character of bondage. The will of the ruling 2 indi- 

1 Cf. the author's article, " tiber geschlechtliche Horigkeit und 
Masochismus," in the " Psychiatrist-he Jahrbticher," Bd. x., p. 169 et 
teq., where this subject is treated in detail, and particularly from 
the forensic standpoint. 

* The expressions " slave " and " slavery," though often used 
metaphorically under such circumstances, are avoided here because 
they are the favourite expressions of masochism, from which this 
" bondage " must be strictly differentiated. 

The expression " bondage " is not to be construed to mean J. 8. 
Mill's " Bondage of Woman." What Mill designates with this 
expression are laws and customs, social and historical facts. Here, 
however, we always speak of facts having peculiar individual motives 
that even conflict with prevalent customs and laws. Besides it has 
reference to either sex. 



MASOCHISM. 203 

virtual dominates that of the person in subjection, just as 
the master's does that of bondsmen. 

This "sexual bondage," as has been said, is certainly 
an abnormal phenomenon. It hegins with the first devia- 
tion from the normal. The degree of dependence of one 
person upon another, or of two upon each other, resulting 
from individual peculiarity in the intensity of motives that 
in themselves are normal, constitutes the normal standard 
established by law and custom. Sexual bondage is not a 
perverse manifestation, however; the instinctive activities 
at work here are the same as those that set in motion 
even though it be with less violence the psychical vita 
sexualis which moves entirely within normal limits. 

Fear of losing the companion and the desire to keep 
him always content, amiable, and inclined to sexual inter- 
course, are here the motives of the individual in subjection. 
An extraordinary degree of love which, particularly in 
woman, does not always indicate an unusual degree of 
sensuality and a weak character are the simple elements 
of this extraordinary process. 1 

The motive of the dominant individual is egotism 
which finds unlimited room for action. 

The manifestations of sexual bondage are various in 
form, and the cases are very numerous. 2 At every step in 
life we find men that have fallen into sexual bondage. 

Among married men, hen-pecked husbands belong to this 
i 

1 Perhaps the moat important element is, that by the habit of 
submission a kind of mechanical obedience, without consciousness of 
its motives, which operates with automatic certainty, may be estab- 
lished, having no opposing motives to contend with, because it lies 
beyond the threshold of consciousness; and it may be used by the 
dominant individual like an inanimate instrument. 

1 Sexual bondage, of course, plays a rdle in all literature. 
Indeed, for the poet, the extraordinary manifestations of the sexual 
life that are not perverse form a rich and open field. The most 
celebrated description of masculine "bondage" is that by Albt 
Pr^vott, " Manon Lescault." An excellent description of feminine 
" bondage " is that of " Leone Leoni," by George Sand. But first of 
all comes Klcitt'a Kllthchen von Heilbronn," who himself called it 
the counterpart of (sadistic) " Penthesilea." Halm't "Griseldis'* 
and many other similar poema also belong here. 



204 PSYCHOPATHIA SEXUALIS. 

category, particularly elderly men who marry young wives 
and try to overcome the disparity of years and physical 
defects by unconditional submission to the wife's every 
whim; and unmarried men of ripe maturity, who seek to 
better their last chance of love by unlimited sacrifice, are 
also to be enumerated here. Here belong, also, men of 
any age, who, seized by hot passion for a woman, moot 
coldness and calculation, and have to capitulate on hard 
conditions; men of loving natures who allow themselves 
to be persuaded to marriage by notorious prostitutes ; men 
who, to run after adventuresses, leave everything and 
jeopardise their future; husbands and fathers who leave 
wife and child, to lay the income of a family at the feet 
of a harlot. 

But, numerous as the examples of masculine "bond- 
age" are, every observer of life who is at all unprejudiced 
must allow that they are far from equalling in number 
and importance the cases of feminine "bondage". This 
is easily explained. For a man, love is almost always 
only an episode, and he has many other and important 
interests; for a woman, on the other hand, love is the 
principal thing in life, and, until the birth of children, 
always her first interest. After this it is still oftener her 
first thought, but always takes at least the second place. 
But, what is still more important, man ruled by this 
impulse easily satisfies it in embraces for which he finds 
unlimited opportunities. Woman in the upper classes'of 
society, if she have a husband, is bound to him alone; 
and even in the lower classes there are still great obstacles 
to polyandry. Therefore, a woman's husband means for 
her the whole sex, and his importance to her becomes very 
great. It must also be considered that the normal relation 
established by law and custom between husband and wife 
is far from being one of equality. In itself it expresses 
a sufficient predominance of woman's dependence. The 
concessions she makes to her lover, to retain the love 
which it would be almost impossible for her to replace, 
only plunge her deeper in bondage ; and this increases the 



MASOCHISM. 205 

insatiable demands of husbands resolved to use their 
advantage and traffic in woman's readiness to sacrifice 
herself. 

Here may be placed the fortune-hunter, who for money 
allows himself to be enveloped in the easily created illu- 
sions of a maiden; the seducer, and the man who com- 
promises wives, calculating on blackmail ; the gilded army 
officer and the musician with the lion's mane, who know 
so well how to stammer "Thee or death!" as a means to 
pay debts and provide a life of ease. Here, too, belong 
the kitchen-soldier, whose love the cook returns with love 
plus means to satisfy a different appetite ; the drinker, who 
consumes the savings of the mistress he marries; and the 
man who with blows compels the prostitute on whom he 
lives to earn a certain sum for him daily. These are only 
a few of the innumerable forms of bondage into which 
woman is forced by her greater need of love and the diffi- 
culties of her position. 

It was necessary to give the subject of "sexual bond- 
age" here brief consideration, for in it may be clearly 
discerned the soil from which the main root of masochism 
springs. The relationship of these two phenomena of 
psychical sexual life is immediately apparent. Bondage 
and masochism both consist of the unconditional subjec- 
tion of the individual affected with this abnormality to a 
person of the opposite sex, and of domination of the former 
by the latter. 1 The two phenomena, however, must be 
strictly differentiated ; they are not different in degree, but 
in quality. 

Sexual bondage is not a perversion and not pathologi- 
cal ; the elements from which it arises love and weakness 
of will are not perverse; it is only their simultaneous 
activity that produces the abnormal result which is so 

1 Cases may occur in which the sexual bondage is expressed in 
the same acts that are common in masochism. When rough men 
beat their wives, and the latter suffer for love, without, however, 
having a desire for blows, we have a pseudo form of bondage that 
may simulate masochism, 



206 PSYCHOPATHIA SEXUALI8. 

opposed to self-interest, and often to custom and law. 
The motive, in obedience to which the subordinated indi- 
vidual acts and endures tyranny, is the normal instinct 
toward woman (or man), the satisfaction of which is the 
price of bondage. The acts of the person in subjection, 
by means of which the bondage is expressed, are per- 
formed at the command of the ruling individual, to sat- 
isfy selfishness, etc. For the subordinated individual 
they have no independent purpose; they are only the 
means to an end to obtain or retain possession of the 
ruling individual. Finally, bondage is a result of love 
for a particular person; it first appears when this love is 
awakened. 

In masochism, which is decidedly abnormal and a 
perversion, this is all very different. The motive under- 
lying the acts and suffering of the person in subjection is 
here the charm afforded by the tyranny in itself. There 
may, at the same time, be a desire for coitus with the 
dominant person, but the impulse is directed to the acts 
which serve to express the tyranny, as the immediate 
objects of gratification. These acts in which masochism 
is expressed are, for the individual in subjection, not 
means to an end, as in bondage, but the end in them- 
selves. Finally, in masochism the longing for subjection 
occurs a priori before the occurrence of an inclination to 
any particular object of love. 

The connection between bondage and masochism may 
be assumed by reason of the correspondence of the two 
phenomena in the objective condition of dependence, 
notwithstanding the difference in their motives; and the 
transformation of the abnormality into the perversion 
probably takes place in the following manner: Any one 
living for a long time in sexual bondage becomes disposed 
to acquire a slight degree of masochism. Love that 
willingly bears the tyranny of the loved one then becomes 
an immediate love of tyranny. When the idea of being 
tyrannised is for a long time closely associated with the 
Jwtful thought of the beloved person, the lustful emotion 



MASOCHISM. 207 

is finally transferred to the tyranny itself, and the trans- 
formation to perversion is completed. This is the manner 
in which masochism may be acquired by cultivation. 1 

Thus a mild degree of masochism may arise from 
"bondage" become acquired; but genuine, complete, 
deep-rooted masochism, with its feverish longing for sub- 
jection from the time of earliest youth, is congenital. 

The explanation of the origin of the perversion in- 
frequent though it be of fully developed masochism is 

1 It is highly interesting, and dependent upon the nature of 
bondage and masochism, which essentially correspond in external 
effects, that to illustrate the former certain playful, metaphorical 
expressions are in general use ; such as " slavery," " to bear chains," 
" bound," " to hold the whip over," " to harness to the triumphal 
car," " to lie at the feet," " henpecked," etc., all things which, 
literally carried out, form the objects of the masochist's desire. 
Such similes are frequently used in daily life and have become trite. 
They are derived from the language of poetry. Poetry has always 
recognized, within the general idea of the passion of love, the element 
of dependence in the lover, who practises self-sacrifice spontaneously 
or of necessity. The facts of " bondage " have also always presented 
themselves to the poetical imagination. When the poet chooses such 
expressions as those mentioned, to picture the dependence of the 
lover in striking similes, he proceeds exactly on the same lines at 
does the masochitt, viz., to intensify the idea of his dependence (his 
ultimate aim), he creates such situations in reality. In ancient 
poetry, the expression " domina " is used to signify the loved one, 
with a preference for the simile of " casting in chains " (e.g., Horace, 
Od. iv., 11). From antiquity through all the centuries to our own 
times ( cf. Grillparzer, " Ottokar," act v. : " To rule is sweet, almost 
as sweet as to obey") the poetry of love is filled with similar 
phrases nnd similes. The history of the word " mistress " is also 
interesting. But poetry reacts on life. It is probable that the 
courtly chivalry of the middle ages arose in this way. In its rever- 
ence for women as " mistresses " in society and in individual love- 
rolatinns; its transference of the relations of feudalism and vassalage 
to the relation between the knight and his lady ; its submission to all 
feminine whims; its love-tests and vows; its duty of obedience to 
every command of the lady in all this, chivalry appears as a sys- 
tematic, poetical development of the " bondage " of love. Certain 
extreme manifestations, like the deeds and sufferings of Vlrich von 
Lichtemtein or Pierre Vidal in the Rprviee of their ladies; or the 
practice of the fraternity of the " Galois " in France, whose members 
sought martyrdom in love and subjected themselves to all kinds of 
suffering these clearly have a masochistic character, and demon- 
strate the natural transformation of one phenomenon into the other. 



208 PSYCHOPATHIA SEXUALIS. 

most probably to be found in the assumption that it arises 
from the more frequent abnormality of "sexual bondage,'' 
through which, now and then, this abnormality is heredi- 
tarily transferred to a psychopathic individual in such a 
manner that it becomes transformed into a perversion. It 
has been previously shown how a slight displacement of 
the psychical elements under consideration may effect this 
transition. Whatever effects associating habits may have 
on possible cases of acquired masochism, the same effects 
are produced by the varying tricks of heredity upon orig- 
inal masochism. No new eleme'nt is thereby added to 
"bondage," but on the contrary the very element is deleted 
which cements love and dependence, and thereby distin- 
guishes "bondage" from masochism and abnormality from 
perversion. It is quite natural that only the instinctive 
element is transmitted. 

This transition from abnormality into perversion, 
through hereditary transference, takes place very easily 
where the psychopathic constitution of the descendant 
presents the other factor of masochism, i.e., what has 
been previously called its main root, the tendency of 
sexually hyperrcsthetic natures to assimilate all impres- 
sions coming from the beloved person with the sexual im- 
pression. 

From these two elements, from "sexual bondage" on 
the one hand and from the above-mentioned disposition 
to sexual ecstasy, which apperceives even maltreatment 
with lustful emotion, on the other, the roots of which 
may be traced back to the field of physiological facts, 
masochism arises from the basis of psychopathic predis- 
position, in so far as its sexual hypersesthesia intensifies 
first all the physiological accessories of the vita sexualis 
and, finallv, only its abnormal accompaniments, to the 
pathological degree of perversion. 1 

1 If it he considered that, as shown above, " sexual bondage " 
is a phenomenon observed much more frequently and in a more 
pronounced degree in the female sex than in the male, the thought 
arises that masochism (if not always, at least as a ruls-* is a* 



MASOCHISM. 209 



At any rate, masochism, as a ci.nircnital sexual per- 

itutes a functional sign of degeneration in 

(almost exclusively) hereditary taint ; and this clinical 

deduction is continual in my cases of masochism and 

-in. It is easy to demonstrate that the peculiar, 
hically anomalous direction of the vita sexualis 
resented in masochism is an original abnormality, and 
not, so to speak, cultivated in a predisposed individual 
by passive flagellation, through association of ideas, as 
Rousseau and Binet contend. This is shown by the 
numerous cases of masochism in fact, the majority in 
which flagellation never appears, in which the perverse 
impulse is directed exclusively to purely symbolic acts 
expressing subjection without any actual infliction of pain. 
This is demonstrated by the whole series of observations, 
from case 50, given here. 

The same result namely, that passive flagellation is 
not the nucleus around which all the rest is gathered is 
reached when closer study is given to the cases in which 
passive flagellation plays a role, as in cases 50 and 52. 
Case 58 is particularly instructive in relation to this; for 
in this instance there can be no thought of a sexually 
stimulating effect by punishment received in youth. More- 
over, in this case, connection with an early experience is 
not possible; for the situation constituting the object of 
principal sexual interest is absolutely incapable of being 
carried out by a child. 

Finally, the origin of masochism from purely psychical 
elements, on confronting it with sadism (v. infra), is con- 
vincingly demonstrated. That passive flagellation occurs 

inheritance of the " bondage " of feminine ancestry. Thus it comes 
into a relation though distant with antipathic sexual instinct, as 
a transference to the male of a perversion really belonging to the 
female. 

It must, however, be emphasised that " bondage " also plays no 
unimportant role in the masculine vita scxualis, and that masochism 
in man may also be explained without any such transference of 
feminine elements. It must also be remembered here that masochism, 
a well aa its counterpart, sadism, occurs in irregular combinatiog 
with antipathic sexual instinct. 

14 



210 rsYciiorATiiiA SEXUALIS. 

so frequently in masochism is explained simply by the 
fact that it is the most extreme means of expressing the 
relation of subjection. 

I repeat that the decisive points in the differentiation 
of simple passive flagellation from flagellation dependent 
upon masochistic desire are, that in the former the act is 
a means to render coitus, or at least ejaculation, possible ; 
and that in the latter it is a means of gratification of 
masochistic desires. 

As we have already seen, masochists subject themselves 
to all other kinds of maltreatment and suffering in which 
there can be no question of reflex excitation of lust. Since 
such cases are numerous, we must in these acts (as well 
as in flagellation in masochists, having like significance) 
seek to ascertain the relation in which pain and lust stand 
to each other. From the statement of a masochist it is 
as follows : 

The relation is not of such a nature that what causes 
physical pain is here simply perceived as physical pleas- 
ure; for the person in a state of masochistic ecstasy feels 
no pain, either because, by reason of his emotional state 
(like that of the soldier in battle), the physical effect on 
his cutaneous nerves is not apperceived, or because ( as with 
religious martyrs and enthusiasts), in the preoccupation 
of consciousness with lustful emotion, the idea of mal- 
treatment remains merely a symbol, without its quality of 
pain. 

To a certain extent there is overcompensation of 
physical pain in the psychical pleasure, and only the excess 
remains in consciousness as psychical lust. This also 
undergoes an increase, since, either through reflex spinal 
influence or through a peculiar colouring in the sensoriuiu 
of sensory impressions, a kind of hallucination of bodily 
pleasure takes place, with a vague localisation of the ob- 
jectively projected sensation. 

In the self-torture of religious enthusiasts (fakirs, 
howling dervishes, religious flagellants) there is an analo- 
gous state, only with a difference in the quality of pleas- 



MASOCHISM. 211 

uru!>lo frclin^. Ilm- the coiiccjition of martyrdom is 
apperccivcd without its pain; for consciousness is filial 
\\ith tin- plcasnrably colon PM! idea of serving God, atoning 
for sins, deserving heaven, etc., through martyrdom. 

In order to give masochism its proper place in the 
sphere of sexual perversion, we must proceed from the 
fact that it is a manifestation of psychical characteristics 
of the feminine type transcending into pathological con- 
ditions, in so far as its determining marks are suffering, 
subjection to the will of others, and to force. Among 
peoples of a lower class of culture the subjection of woman 
is extended even to brutality. This flagrant proof of de- 
pendence is felt by woman even with sensual pleasure and 
accepted as a token of love. It is probable that the woman 
of high civilisation looks upon the role of being over- 
shadowed by the male consort as an acceptable situation 
which forms a portion of the lustful feeling developed in 
the sexual act. The daring and self-confident demeanor 
of man undoubtedly exercises a sexual charm over woman. 
It cannot be doubted that the masochist considers himself 
in a passive, feminine role towards his mistress and that 
his sexual gratification is governed by the success his il- 
lusion experiences in the complete subjection to the will 
of the consort. The pleasurable feeling, call it lust, re- 
sulting from this act differs per se in no wise from the 
feeling which woman derives from the sexual act. 

The masochistically inclined individual seeks and finds 
an equivalent for his purpose in the fact that he endows 
in his imagination the consort with certain masculine psy- 
chical sexual characteristics i.e., in a perverse manner, 
in so far as the sadistic female partner constitutes his 
ideal. 

From this emanates the deduction that masochism is, 
properly speaking, only a rudimentary form of antipathic 
soxiial instinct. It is a partial effemination which has 
only apperceived the secondary sexual characteristics of 
the psychical vita sexualis. 

This assumption is supported by the fact that hetero- 



212 PSYCHOPATHIA SEXUALIS. 

sexual masochists consider themselves merely as individ- 
uals endowed with feminine feelings. 1 Observation shows 
that they really possess feminine traits of character. 2 This 
renders it intellfgible that the masochistic element is so fre- 
quently found in homosexual men. 3 

In the woman masochist also these relations to an- 
tipathic sexual instinct are to be found. Cf., case 84. 
Moll quotes a typical case of homosexuality in a woman 
afflicted with passive flagellantism and koprolagnia : 

Case 87. Miss X., age twenty-six. At the age of 
six cunnilingus mutuus; then up to seventeen deficiente 
occasione solitary masturbation. Since then cunnilingus 
with various female friends, at times playing the passive, 
at others the active role, always producing ejaculation in 
herself. For years koprolagnia. Maxime delectata fuit 
lambendo anum feminarum amatarum, lambendo san- 
guinem menstrualem amicae. The same effect had ver- 
bera amicae delectae nudae et robustae ad nates. The 
thought of performing koprolagnia in corpore viri was 
repulsive to her. Satisfaction in cunnilingus viri she only 
obtained when she imagined that the act was performed 
by a woman, not by a man. Coitus cum viro she dis- 
dained. Erotic dreams were always of a homosexual na- 
ture and were confined to active or passive cunnilingus. 
Inter osculationem mutuam maximam offert voluptatem 

*Cf. cases 57 and 58. 

a Cf. case 70 in Schrenck-Notzing; case 20 in F6r6, 1'instinct 
sexuell, p. 262. 

1 Cf. case 67 in Schrenck-Notzing; Atoll, Contr. Sexualempfindung, 
3rd edition, p. 265 (gentleman who pestered an officer with letters in 
which he begged him to be allowed to clean his boots) ; ibidem, p. 281 
(gentleman who was agitated by two wishes, viz.: (1) to be a woman 
that he might have coitus with the man he loved, (2) to be maltreated 
by the same) ; ibidem, case 17; ditto, p. 283 (man who finds satis- 
faction in the act with another man only when the latter rubs his 
back with a hard brush till the blood flows) ; p. 284 (koprolagnia) ; 
p. 317; v. Krafft, Psycop. sexual., 6th edit., case 43; 8th edit., cases 
46, 114, 115; item, Jahrb. f. Psychiatric, xii., pp. 339 and 351; 
item, "Arbeiten," iv., p. 134. 



MASOCHISM AND SADISM. 213 

raorsus consortis, by preference in the lobe of the ear, 
causing pain and subsequent swelling. 

X. always had leaning to male occupations, loved to 
be among moil as one of their own. From her tenth to 
her fifteenth year she worked in the brewery of a relative, 
if possible clad in trousers and a leather apron. She was 
bright, intelligent and good-natured, and felt quite happy 
in her perverse, homosexual existence. She smoked ami 
drank beer. Female larynx (Dr. Flatau), small, badly 
developed breasts, large hands and feet. (Dr. Moll, intern. 
(Vntralblatt f. Physiol. und Patholog. der Harn- und Sex- 
ual-organe. iv. 3). 

Masochism and Sadism. 

The perfect counterpart of masochism is sadism. 
While in the former there is a desire to suffer and bo 
subjected to violence, in the latter the wish is to inflict 
pain and use violence. 

The parallelism is perfect. All the acts and situations 
used by the sadist in the active role become the object of 
tin desire of the masochist in the passive role. In both 
perversions these acts advance from purely symbolic acts 
to severe maltreatment. Even murder, in which sadism 
reaches its acme, finds, as is shown in case 62, of 
course, only in fancy, its passive counterpart. Under 
favouring conditions, both perversions may occur with 
a normal vita sexualis; in both, the acts in which they 
express themselves are preparatory to coitus or substi- 
tutes for it. 1 

*Of course, both have to contend with opposing ethical and 
esthetic motives in foro intcrno. After these have been overcome, 
active sadism immediately conies in conflict with the law. This is 
not the case with ninsodrism, which accounts for the greater fre- 
quency of masochistic acts. But the instinct of self-preservation and 
fear of pain prevent the realisation of the latter. The practical 
significance of masochism lies only in its relations to psychical 
impotence; while that of sadism lies beyond this, and is principally 
forensic. 



214: P8YCHOPATHIA SEXUALIS. 

But the analogy does not exist-simply in external man- 
ifestations; it also extends to the intrinsic character of 
both perversions. Both are to be regarded as original 
psychopathies in mentally abnormal individuals, who, in 
particular, are affected with psychical hypercesthcsia sexu- 
alis, and, as a rule, also with other abnormalities ; and for 
each of these perversions two constituent elements may be 
demonstrated, which have their roots in psychical facts 
lying within physiological limits. In masochism, as shown 
above, these elements lie in the fact (1) that in the state 
of sexual emotion every impression produced by the con- 
sort, independently of the manner of its production, is, 
per se, attended with lustful pleasure, which, when accom- 
panied by hypercesthesia sexualis, may go so far as to 
overcompensate all painful sensation; and in the fact (2) 
that "sexual bondage," dependent on mental factors in 
themselves not perverse may, under pathological condi- 
tions, become a perverse, pleasurable desire for subjection 
to the opposite sex, which even if its inheritance from 
the female side need not be presupposed represents a 
pathological degeneration of the character (really belong- 
ing to woman) of the instinct of subordination, physiolo- 
gical in woman. 

In harmony with this, there are, likewise, two constit- 
uent elements explanatory of sadism, the origin of which 
may also be traced back within physiological limits. These 
are: the fact (1) that in sexual emotion, to a certain ex- 
tent as an accompanying psychical excitation, an impulse 
may arise to influence the object of desire in every possible 
way and with the greatest possible intensity, which, in in- 
dividuals sexually hypersesthetic, may degenerate into a 
craving to inflict pain; and the fact (2) that, under path- 
ological conditions, man's active role of winning woman 
may become an unlimited desire for subjugation. 

Thus masochism and sadism represent perfect counter- 
parts. It is also in harmony with this that the individuals 
affected with these perversions regard the opposite perver- 



MASOCHISM AND SADISM. 215 

sion in the other sex as their ideal, as shown by case 57, 
and also by "Rousseau's Confessions". 

But the contrast of masochism and sadism may also 
be used to invalidate the assumption that the former has 
its origin in the reflex effect of passive flagellation, and 
that all the rest is the product of association of related 
ideas, as Bintt, in his explanation of Rousseau's case, 
thinks, and as Rousseau himself believed. In the active 
maltreatment forming the object of the sadist's sexual 
desire there is, in fact, no irritation of his own sensory 
nerves by the act of maltreatment, so that there can be no 
doubt of the purely psychical character of the origin of this 
perversion. Sadism and masochism, however, are so re- 
lated to each other, and so correspond in all points with 
each other, that the one allows, by analogy, a conclusion 
for the other; and this is alone sufficient to establish the 
purely psychical character of masochism. 

According to the above-detailed contrast of all the ele- 
ments and phenomena of masochism and sadism, and as a 
resume of all observed cases, lust in the infliction of pain 
and lust in inflicted pain appear but as two different sides 
of the same psychical process, of which the primary and 
essential thing is the consciousness of active or passive 
subjection, in which the combination of cruelty and lustful 
pleasure has only a secondary psychological significance. 
Acts of cruelty serve to express this subjection ; first, be- 
cause they are the most extreme means for the expression 
of this relation; and, again, because they represent the 
most intense effect that one person, either with or without 
coitus, can exert on another. 

Sadism and masochism are the results of associations, 
just the same as all complicated manifestations of psychi- 
cal life are associations. For psychic life consists, after 
the production of the simplest elements of consciousness, 
simply of associations and disassociations of these ele- 
ments. 

The chief point gained by this analysis is that sadism 
and masochism are not merely the results of accidental 



216 PSYCHOPATIIIA SEXUALI8. 

associations, occasioned by chance.or an opportune coinci- 
dence, but results of associations springing from causes 
existing under normal circumstances, easily produced 
under certain conditions e.g., sexual hyperaesthesia. An 
abnormally intensified sexual instinct spreads in every 
direction. It reaches into adjacent spheres, and amalga- 
mates with their contents, thus producing the pathological 
associations which are the real essence of both these per- 
versions. 1 

Of course, this need not always be so, for there are 
cases of hyperaesthesia without perversion. But these 
cases of pure hypercesthesia sexualis at least, those of 
striking intensity seem to be of rarer occurrence than 
those of perversion. 

The cases in which sadism and masochism occur simul- 
taneously in one individual are interesting, but they pre- 

1 Schrenck-Notzing, who in his explanation of all perversions 
lays particular stress upon the " occasional momentum," gives prefer- 
ence to the theory of acquired perversions over the congenital, and 
allows the manifestations of sadism and masochism only a subordi- 
nate position. Although he admits that many cases can only be 
explained on the assumption of congenital predisposition, yet he 
contends that circumstances or a timely coincidence control their 
acquirement (op. cit. p. 170). 

His arguments are based upon observations. Quoting two cases 
of psychopathia sexualis (29 and 37 of the seventh edition) he con- 
tends that the accidental sight of a girl bleeding or a boy being 
whipped coinciding with a strong sexual emotion may be sufficient 
cause for continued pathological associations. 

Against this it may, however, be decisively held that in every 
hyperaesthetic individual early and strong sexual emotions have often 
coincided with numerous heterogeneous things, whilst the patho- 
logical associations are always coupled with but few definite (sadistic 
and masochistic) things. Numerous pupils indulge in sexual 
emotions or gratifications during lessons in grammar and mathe- 
matics in the class-room, as well as elsewhere, without thereby con- 
tracting perverse associations. 

From this clearly follows that the sight of a whipping or similar 
scenes may provoke pathological associations already present but 
latent, but that it cannot produce them. Moreover, the aroused 
sexual instinct is not associated with the numerous indifferent things 
that are ever present, but only with such as normally excite disgust. 
The same argument refers to the opinion of Binet, who also 
seeks to explain these manifestations by accidental associations. 



MASOCHISM AND SADISM. 217 

sent some difficulties of explanation. Such cases are, for 
instance, No. 47 of the seventh edition, also Nos. 57 and 
t the present, but especially No. 29 of the ninth edi- 
tion. Fnua the latter it is evident that it is especially 
the idea of subjection that, both actively and passively, 
forms the nucleus of the perverse desires. Traces of the 
same thing are also to bo observed, with more or less clear- 
ness, in many other cases. At any rate, one of the two 
perversions is always markedly predominant. 

Owing to this marked predominance of one perversion 
and the later appearance of the other in such cases, it 
may well be assumed that the predominating perversion 
is original, and that the other has been acquired in the 
course of time. The ideas of subjection and maltreat- 
ment, coloured with lustful pleasure, either in an active 
or passive sense, have become deeply imbedded in such 
an individual. Occasionally the imagination is tempted 
to try the same ideas in an inverted role. There may 
even be realisation of this inversion. Such attempts in 
imagination and in acts, are, however, usually soon aban- 
doned as inadequate for the original inclination. 

Masochism and sadism also occur in combination with 
antipathic sexual instinct, #nd, in fact, in association with 
all forms and degrees of this perversion. The individual 
of inverted sexuality may be a sadist as well as a masochist 
(cf. cases 55 of the present and 49 of the seventh edition 
and numerous cases in the subsequent series of cases of 
sexual inversion). 

Wherever a sexual perversion has developed on the 
basis of a neuropathic individuality, sexual hypersesthesia, 
which may always be assumed to be present, may induce 
the phenomena of masochism and sadism now of the 
one, now of both combined, one arising from the other. 
Thus masochism and sadism appear as the fundamental 
forms of psycho-sexual perversion, which may make their 



218 rSYCIIOPATIIIA SEXUALIS. 

appearance at any point in the dojnain of sexual aberra- 
tion. 1 

Fetichism. The Association of Lust with the Idea of 
Certain Portions of the Female Person, or with Cer- 
tain Articles of Female Attire. 

In the considerations concerning the psychology of the 
normal sexual life in the introduction to this work it was 
shown that, within physiological limits, the pronounced 
preference for a certain portion of the body of persons 
of the opposite sex, particularly for a certain form of 
this part, may attain great psycho-sexual importance. In- 

1 Every attempt to explain the facts of either sadism or maso- 
chism owing to the close connection of the two phenomena demon- 
strated here, must also be suited to explain the other perversion. 
An attempt to offer an explanation of sadism, by J. O. Kiernan 
(Chicago) (vide "Psychological Aspects of the Sexual Appetite," 
Alienist and Neurologist, St. Louis, April, 1891 ) meets this require- 
ment, and for this reason may be briefly mentioned here. Kiernan, 
who has several authorities in Anglo-American literature for his 
theory, starts from the assumption of several naturalists (Dallinger, 
Drysdale, Rolph, Cicnkowsky) which conceives the so-called con- 
jugation, a sexual act in certain low forms of animal life, to be 
cannibalism, a devouring of the partner in the act. He brings into 
immediate connection with this the well-known facts that at the 
time of sexual union crabs tear limbs from their bodies and spiders 
bite off the heads of the males, and other sadistic acts performed 
by rutting animals with their consorts. From this he passes to lust- 
murder and other lustful acts of cruelty in man, and assumes that 
hunger and the sexual appetite are, in their origin, identical ; that 
the sexual cannibalism of lower forms of animal life has an influence 
in higher forms and in man, and that sadism is an atavistic rebound. 

This explanation of sadism would, of course, also explain 
masochism; for if the origin of sexual intercourse is to be sought in 
cannibalistic process, then both the survival of one sex and the 
destruction of the other would fulfil the purpose of nature, and 
thus the instinctive desire to be the victim would be explained. 
But it must be stated in objection that the basis of this reasoning 
is insufficient. The extremely complicated process of conjugation in 
lower organisms, into which science has really penetrated only 
during the last few years, is by no means to be regarded as simply 
a devouring of one individual by another (cf. Weismann, "Die 
Bedeutung der sexuellcn Fortpflanzung fdr die Selectionstheorie," 
p. 51, Jena, 1886). 



FETICH ISM. 219 

deed, the especial power of attraction possessed by certain 
forms and peculiarities for many men in fact, the ma- 
jority may be regarded as the real principle of individ- 
ualism in love. 

This preference for certain particular physical char- 
acteristics in persons of the opposite sex by the side of 
which, likewise, a marked preference for certain psychical 
characteristics may be demonstrated following Binet 
("Du Fetischisme dans Famour," "Revue Philosophique," 
1887) and Lombroso (Introduction to the Italian edition 
of the second edition of this work), I have called "fetich- 
ism" ; because this enthusiasm for certain portions of the 
body (or even articles of attire) and the worship of them, 
in obedience to sexual impulses, frequently call to mind 
the reverence for relics, holy objects, etc., in religious cults. 
This physiological fetichism has already been described 
in detail. 

By the side of this physiological fetichism, however, 
there is, in the psycho-sexual sphere, an undoubted patho- 
logical, erotic fetichism, of which there is already a numer- 
ous series of cases presenting phenomena having great 
clinical and psychiatric interest, and, under certain cir- 
cumstances also, forensic importance. This pathological 
fetichism does not confine itself to certain parts of the 
body alone, but it is even extended to inanimate objects, 
which, however, are almost always articles of female 
wearing-apparel, and thus stand in close relation with the 
female person. 

This pathological iVtirliism is connected, through grad- 
ual transitions, with physiological fetich ism, so that (at 
least in body-fetichism) it is almost impossible to sharply 
define the beginning of the perversion. Moreover, the 
whole field of body-fetichism does not really extend beyond 
the limits of things which normally stimulate the sexual 
instinct. Here the abnormality consists only in the fact 
that the whole sexual interest is concentrated on the im- 
pression made ly a part of the person of the opposite sex, 
so that all other impressions fade and become more or less 



220. PSYCHOPATHIA SEXUALI8. 

indifferent. Therefore, the body-fetichist is not to be re- 
garded as a monstrum per excessum, like the sadist or 
masochist, but rather as a monstrum per defectum. What 
stimulates him is not abnormal, but rather what does not 
affect him, the limitation of sexual interest that has taken 
place in him. Of course, this limited sexual interest, 
within its narrower limits, is usually expressed with a 
correspondingly greater and abnormal intensity. 

It would seem reasonable to assume, as the distinguish- 
ing mark of pathological fetichism, the necessity for the 
presence of the fetich as a conditio sine qua non for the 
possibility of performance of coitus. But when the facts 
are more carefully studied, it is seen that this limitation 
is really only indefinite. There are numerous cases in 
which, even in the absence of the fetich, coitus is possible, 
but incomplete and forced (often with the help of fancies 
relating to the fetich), and particularly unsatisfying and 
exhausting; and, too, closer study of the distinctive sub- 
jective psychical conditions in these cases shows that there 
are transitional states, passing, on the one hand, to mere 
physiological preferences, and, on the other, to psychical 
impotence, in the absence of the fetich. 

It is therefore better, perhaps, to seek the pathological 
criterion of body-fetichism in purely subjective psychical 
states. The concentration of the sexual interest on a cer- 
tain portion of the body that has no direct relation to sex 
(as have the mammae and external genitals) a peculiarity 
to be emphasised often leads body-fetichists to such a 
condition that they do not regard coitus as the real means 
of sexual gratification, but rather some form of manipula- 
tion of that portion of the body that is effectual as a fetich. 
This perverse instinct of body-fetichists may be taken as 
the pathological criterion, no matter whether actual coitus 
is still possible or not. 

Fetichism of inanimate objects or articles of dress, how- 
ever, in all cases, may well be regarded as a pathological 
phenomenon, since its object, falls without the circle of 
normal sexual stimuli. But even here, in the phenomena, 



FETICHISM. 221 

there is a certain outward correspondence with processes of 
the normal psychical rita sexualis; the inner connection 
and meaning of pathological fetichism, however, are en- 
tirely different. In the ecstatic love of a man mentally 
normal, a handkerchief or shoe, a glove or letter, the flower 
"she gave," or a lock of hair, etc., may become the object 
of worship, but only because they represent a mnemonic 
symbol of the beloved person absent or dead whose 
whole personality is reproduced by them. The pathologi- 
cal fetichist has no such relations. The fetich constitutes 
the entire content of his idea. When he becomes aware 
of its presence, sexual excitement occurs, and the fetich 
makes itself felt. 1 

According to all observations thus far made, patho- 
logical fetichism seems to arise only on the basis of a 
psychopathic constitution that is for the most part heredi- 
tary, or on the basis of existent mental disease. 

Thus it happens that it not infrequently appears com- 
bined with the other (original) sexual perversions that 
arise on the same basis. Not infrequently fetichism occurs 
in the most various forms in combination with inverted 
sexuality, sadism, and masochism. Indeed, certain forms 
of body-fetichism (hand- and foot-fetichism) probably have 
a more or less distinct connection with the latter two per- 
versions (v. infra). 

But if fetichism also rests upon a congenital general 
psychopathic disposition, yet this perversion is not, like 
those previously considered, essentially of an original na- 
ture; it is not congenitally perfect, as we may well assume 
sadism and masochism to be. 

While in the sexual perversions described in the pre- 
ceding chapters we have met only cases of a congenital 
type, here we meet only acquired cases. Aside from the 
fact that often in fetichism the causative circumstance of 

iln Zola't "Th6rse Uaquin," where the lover repeatedly kisses his 
mistress's boot, the case is quite different from that of shoe- and boot- 
fi'tirhists, who, at the sight of every boot worn by a lady, or even 
.'!"iic, are thrown into sexual excitement, even to the extent of ejacu- 
lation. 



222 PSYCHOPATHIA 8EXUA1.IS. 

its acquirement is traced, yet the physiological conditions 
are wanting, which in sadism and masochism, by means of 
sexual hyperaesthesia, are intensified to perversions, and 
justify the assumption of congenital origin. In fetichism, 
every case requires an event which affords the ground for 
the perversion. 

As has been said, it is, of course, physiological in sexual 
life to be partial to one or another of woman's charms, 
and to be enthusiastic about it; but concentration of the 
entire sexual interest on such partial impression is here 
the essential thing; and for this concentration there must 
be a particular reason in every individual affected. There- 
fore, we may accept Binet's conclusion that in the life of 
every fetichist there may be assumed to have been some 
event which determined the association of lustful feeling 
with the single impression. This event must be sought for 
in the time of early youth, and, as a rule, occurs in connec- 
tion with the first awakening of the vita sexualis. This 
first awakening is associated with some partial sexual im- 
pression (since it is always a thing standing in some rela- 
tion to woman), 1 and stamps it for life as the principal 
object of sexual interest. The circumstances under which 
the association arises are usually forgotten; the result of 
the association alone is retained. The general predisposi- 
tion to psychopathic states and the sexual hypersesthesia of 
such individuals are all that is original here. 2 

1 Cf. " Arbeiten," iv., p. 172. Case of ring fetichism; p. 174, 
mourning crape fetichism in homosexual persons. 

'Though Binet (op. cit.)' declares that every sexual perversion, 
without exception, depends upon such an " accident acting on a 
predisposed subject " ( where, under predisposition, only hyper- 
rcsthesia in general is understood), yet such an assumption for other 
perversions than fetichism is neither necessary nor satisfactory. For 
example, it is not clear how the sight of another's chastisement 
could excite sexually even a very excitable individual, if the physio- 
logical relationship of lust and cruelty had not been developed into 
original sadism in an abnormally excitable individual. As the 
sadistic and masochistic associations are performed in the mind of 
the subject from homogeneous elements in adjacent spheres, in the 
same measure la the possibility of fetichistic associations prepared 



FETICHI8M. 223 

Like the other perversions thus far considered, erotic 
(pathological) fetichism may also express itself in strange, 
unnatural, and even criminal acts: gratification with the 
female person loco indcbito, theft and robbery of objects of 
fetichism, pollution of such objects, etc. Here, too, it only 
depends upon the intensity of the perverse impulse and 
the relative power of opposing ethical motives, whether 
and to what extent such acts are performed. 

These perverse acts of fetichists, like those of other 
sexually perverse individuals, may either alone constitute 
the entire external vita scxualis, or occur parallel with 
the normal sexual act. This depends upon the condition 
of physical and psychical sexual power, and the degree of 
excitability to normal stimuli that has been retained. 
Where excitability is diminished, not infrequently the 
sight or touch of the fetich serves as a necessary pre- 
paratory act 

The great practical importance which attaches to the 
facts of fetichism, in accordance with what has been said, 
lies in two factors. In the first place, pathological fetich- 
ism is not infrequently a cause of psychical impotence. 1 
Since the object upon which the sexual interest of the 
fetichist is concentrated stands, in itself, in no immediate 
relation to the normal sexual act, it often happens that 
the fetichist diminishes his excitability to normal stimuli 
by his perversion, or, at least, is capable of coitus only 

by the idiosyncrasies of the object and thus easier understood. In 
nearly every instance it is impressions of parts of the female form 
(including garments) that are in question. Fetichistic association 
which originated only by mere accident can only be traced in a few 
special cases. 

1 When young husbands who have associated much with prosti- 
tutes feel impotent in the face of the chastity of their young wives 
a thing of frequent occurrence the condition may be regarded as a 
kind of (psychical) fetichism in a wider sense. One of my patients 
was never potent with his beautiful and chaste young wife, because 
he was accustomed to the lascivious methods of prostitutes. When 
he now and then attempted coitus with puellis he was perfectly 
potent. Hammond (op. cit. pp. 48, 49) reports a very similar 
interesting case. Of course, in such cases, a bad conscience and 
hypochcadriacal fear of impotence play an important part. 



224 PSYCHOPATHIA SEXUALIS. 

by means of concentration of his "fancy upon his fetich. 
In this perversion, and in the difficulty of its adequate 
gratification, just as in the other perversions of the sexual 
instinct, lie conditions favouring psychical and physical 
onanisra, which again reacts deleteriously on the constitu- 
tion and sexual power. This is especially true in the case 
of youthful individuals, and particularly in the case of 
those who, on account of opposing ethical and aesthetic 
motives, shrink from the realisation of their perverse de- 
sires. 

Secondly, fetichism is of great forensic importance. 
Just as sadism may extend to murder and the infliction of 
bodily injury, fetichism may lead to theft and even to 
robbery for the possession of the desired articles. 

Erotic fetichism has for its object either a certain 
portion of the body of a person of the opposite sex, or 
a certain article or material of wearing apparel of the 
opposite sex. (Only cases of pathological fetichism in 
men have thus far been observed, and .therefore only 
portions of the female person and attire are spoken of 
here.) In accordance with this, fetichists fall into three 
groups. 

(a) The Fetich is a Part of the Female Body. 

Just as, in physiological fetichism, the eye, the hand, 
the foot and the hair of woman frequently become fetiches, 
so, in the pathological domain, the same portions of the 
body become the sole objects of sexual interest. This ex- 
clusive concentration of interest on these parts, by the 
side of which everything else feminine fades, and all other 
sexual value of woman may sink to nil, so that, instead of 
coitus, strange manipulations of the fetich become the 
object of desire, this it is that makes these cases patho- 
logical. 

Case 88. (Binet, op. cit.) X., aged thirty-four, 
teacher in a gymnasium. In childhood he suffered from 



FBTICHISM. 225 

convulsions. At the age of ten he began to masturbate, 
with lustful feelings, which were connected with very 
strange ideas. He was particularly partial to women's 
eyes ; but since he wished to imagine some form of coitus, 
and was absolutely innocent in sexual matters, to avoid 
too great a separation from the eyes, he evolved the idea 
of making the nostrils the seat of the female sexual organs. 
Then his vivid sexual desires revolved around this idea. 
He sketched drawings representing correct Greek profiles 
of female heads, but the nostrils were so large that 
immissio penis would have been possible. 

One day, in an omnibus, he saw a girl in whom he 
thought he recognised his ideal. He followed her to her 
home and immediately proposed to her. Shown the door, 
he returned again and again, until arrested. X. never had 
sexual intercourse. 

Nose fetichism is but seldomly met with. The follow- 
ing rare bit of poetry comes to me from England : 

"Oh! sweet and pretty little nose, so charming unto me; 
Oh, were I but the sweetest rose, I'd give my scent to thee. 
Oh, make it full with honey sweet, that I may suck it all; 
T'would be for me the greatest treat, a real festival. 
How sweet and how nutritious your darling nose does seem; 
It would be more delicious, than strawberries and cream." 

Hand-fetichists are very numerous. The following 
case is not really pathological. It is given here as a transi- 
tional one : 

Case 89. B., of neuropathic family, very sensual 
mentally intact. At the sight of the hand of a beautiful 
young lady he was always charmed and felt sexual excite- 
ment to the extent of erection. It was his delight to kiss 
and press such hands. As long as they were covered with 
gloves he felt unhappy. By pretexts he tried to get hold 
of such hands. He was indifferent to the foot. If the 
beautiful hands were ornamented with rings, his lust was 
increased. Only the living hand, not its image, caused 
him this lustful excitement. It was only when he was 

15 



226 rsYCHOPATiiiA SEXUALIS. 



exhausted sexually by frequent coitus that the hand 
lost its sexual charm. At first the memory-picture of 
female hands disturbed him even while at work (Binet.. op. 
cit.). 

Binet states that such cases of enthusiasm for the 
female hand are numerous. Here it may be recalled that, 
according to case 25, a man may be partial to the female 
hand as a result of sadistic impulses; and that, according 
to case 52, the same thing may be due to masochistic 
desires. Thus such cases have more than one meaning. 
But it docs by no means follow that all, or even a majority, 
of the cases of hand-fetichism allow or require a sadistic 
or masochistic explanation. 

The following interesting case, that has been studied 
in detail, shows that, in spite of the fact that at first a 
sadistic or masochistic element seems to have exercised 
an influence, at the time of the individual's maturity 
and the complete development of the perversion, the 
latter contained nothing of these elements. Of course, 
it is possible that, in the course of time, they disappeared; 
but here the assumption of the origin of the fetichism in 
an accidental association meets every requirement: 

Case 90. A case of hand-fetichism, communicated 
by Albert Moll. P. L., aged twenty-eight, a merchant in 
Westphalia. Aside from the fact that the patient's father 
was remarkably moody and somewhat quick-tempered, 
nothing of an hereditary nature could be proved in the 
family. At school the patient was not very diligent; he 
was never able to concentrate his attention on any one sub- 
ject for any length of time ; on the other hand, from child- 
hood he had a great inclination for music. His tem- 
perament was always nervous. 

In August, 1890, he came to me complaining of head- 
ache and abdominal pain, which in every way gave the 
impression of being neurasthenic. The patient also said 
he was destitute of energy. Only after accurately dim-to] 
questions did the patient make the following statements 






FETICHI8M. 227 

concerning his sexual life. As far as he could remember, 
tin- Ix-giiining of sexual excitement occurred in his seventh 
year. Whenever he saw a boy of his own age urinate and 
caught sight of his genitals, he became lustfully excited. 
L. states with certainty that this excitement was associated 
with strongly accentuated erections. Led astray by an- 
other boy, L. learned to masturbate at the age of seven or 
eight. "Being of a very excitable nature," said L., "I 
practised masturbation very frequently until my eighteenth 
year, without gaining any clear idea of the evil results or 
the meaning of the practice." He was particularly fond 
of practising mutual onanism with some of his school- 
friends, but it was by no means an indifferent matter who 
the other boy was ; on the contrary, only a few of his com- 
|i;iiiions could satisfy him in this respect. To the question 
as to what particularly caused him to prefer this or that 
boy, L. replied that a white, beautifully formed hand in his 
school-fellow impelled him to practise mutual onanism 
with him. L. further remembered that frequently, at the 
beginning of the gymnastic lesson, he would exercise by 
himself on a bar standing apart. He did this for the 
purpose of exciting himself as much as possible, and he 
was so successful that, without using his hand and without 
ejaculation L. was still too young he had lustful plea- 
sure. Another early event which L. remembered is inter- 
esting. One day his favourite companion, N., who prac- 
tised mutual onanism with him, proposed that L. should 
try to get hold of his (N.'s) penis, and he would do all 
he could to prevent it L. acquiesced. In this way onan- 
isra was directly combined with a struggle between both 
parties, in which N. was always conquered. The struggle 
was finally ended in N.'s being compelled to allow L. to 
practice onanisrn on him. L. assured me that this kind of 
masturbation had given him, as well as N., especial pleas- 
ure. In this way L. continued to practice masturbation 
very frequently until his eighteenth year. Warned by a 
friend, he then Ix-iran to struggle with all his might against 
this evil habit. He became more and more successful, and 



228 PSYCHOPATHIA SEXUALIS. 

finally, after the first performance of coitus, he stopped 
the practice of onanism entirely. But this was only ac- 
complished in his twenty-second year. It now seemed 
incomprehensible to the patient and he said he was filled 
with disgust at the thought how he could ever have found 
pleasure in performing masturbation with other boys. 
Now, nothing could induce him to touch another man's 
genitals, the sight of which was even unpleasant to him. 
He had lost all inclination for men, and felt attracted by 
women exclusively. 

It must be mentioned, however, that although L. had 
a decided inclination for the female sex, he presented an 
abnormal phenomenon. 

The essential thing in woman that excited him was the 
sight of her beautiful hands ; L. was far more impressed 
when he touched a beautiful female hand than he would 
have been had he seen its possessor in a state of complete 
nudity. The extent to which L.'s preference for beautiful 
female hands went is shown by the following incident: 

L. knew a beautiful young lady possessed of every 
charm, but her hands were quite large and not beautifully 
formed, and often they were not as clean as L. could wish. 
For this reason it was not only impossible for L. to con- 
ceive a deeper interest in the lady, but he was not able 
even to touch her. L. believed that there was nothing more 
disgusting to him than dirty finger-nails ; this alone would 
make it impossible for him to touch a woman who in all 
other respects was most beautiful. L. formerly, as a 
substitute for coitus, induced the puella to perform genital 
manipulation with her hand until ejaculation took place. 

To the question as to what there was about a woman's 
hand that attracted him in particular, whether he saw in 
it a symbol of power, and whether it gave him pleasure to 
be directly humiliated by a woman, the patient answered 
that only the beautiful form of the hand charmed him; 
that it afforded him no gratification to be humiliated by a 
woman ; and that he had never had any thought to regard 
the hand as the symbol or instrument of a woman's power. 



FETICH ISM. 

The preference for the hand was still so great that the 
patient had greater pleasure when his genitals were touched 
lv it thnt when he performed e<>itus in vaginam. Yet, the 
patient preferred to perform the latter, because it seen KM 1 
to him to be natural, while the former seemed abnormal. 
The touch of a beautiful female hand on his body imme- 
diately caused him to have erection; he thought that kiss- 
ing and other contacts do not exert nearly so strong an 
influence. It was only of late years that the patient had 
performed coitus frequently, but it had always been very 
difficult for him to determine to do it. Moreover, in coitus, 
he did not find the complete satisfaction he sought. How- 
ever, when he found himself near a woman whom he would 
like to possess, sometimes, at mere sight of her, his sexual 
excitement became so intense that ejaculation resulted. 
L. said expressly that during this process he did not in- 
tentionally touch or press his genitajs; ejaculation under 
such circumstances afforded him much more pleasure than 
he experienced in actual coitus. 1 

To go back, the patient's dreams were never about 
coitus. When he had pollutions at night, they were almost 
always associated with other thoughts than those that 
occur to the normal man. The patient's dreams were of 
events of his school-days, when, besides the mutual onan- 
ism described, he had ejaculations whenever he became 
anxiously excited. When, for example, the teacher dic- 
tated an extemporaneous exercise, and L. was unable to 
follow in translation, ejaculation often occurred. 1 The 
pollutions that now occurred occasionally, at night, were 

1 Great sexual hypertesthesia. 

'This is also seximl hypersesthesia. Any intense excitement 
affects the sexual sphere (Rinet'a " Dynamogeiiie g4nrale"). Con- 
cerning this Dr. Moll communicates the following case: " A similar 
thing is described by Mr. E., aged twenty-seven; merchant. While 
at school, and afterward, he often had ejaculation with pleasurable 
feeling when he was seized with a spell of intense anxiety. Besides, 
almost every other physical or mental pain exerted a similar 
influence. E., as he stated, had a normal sexual instinct, but suffered 
with nervous impotence." 



230 PSTCIIOPATHIA SEXUALIS. 

only accompanied by dreams that had the same or u similar 
subject i.e., the events at school just mentioned. On 
account of his unnatural feeling and sensibility the patient 
thought he was incapable of loving a woman permanently. 
Treatment of the patient's perversion was not possible. 

This case of hand-fetichism certainly does not depend 
on masochism or sadism, but is to be explained simply 
on the ground of early indulgence in mutual onanism. 
Neither is there antipathic sexual instinct. Before the 
sexual appetite was clearly conscious of its object, the 
hands of school-fellows were used. As soon as the instinct 
for the opposite sex became evident, the interest for the 
hand was transferred to that of woman. 

In hand fetichists, who according to Binet, are numer- 
ous, it is possible that other associations lead to the same 
result 

Next to the hand-fetichists, naturally come the foot- 
fetichists. While glove-fetichism, which belongs to the 
next group of object-fetichism, seldom takes the place of 
hand-fetichism, we find shoe- and boot-fetichism, of which 
there are innumerable cases occurring everywhere, taking 
the place of enthusiasm for the naked female foot. It is 
easy to see the reason for this. The female hand is 
usually seen uncovered; the foot, covered. Thus the 
early associations which determine the direction of the 
vita sexualis are naturally connected with the naked hand, 
but with the foot when covered. 

This assumption is certainly correct with regard to 
those who have grown up in large cities, and easily explains 
the scarcity of foot-fetichism, 1 which will be elucidated 
by the following cases. 

Case 91. Foot-fetichism. Acquired inverted sexuality. 

1 Exceptions are the cases of latent masochism in the form of 
Koprolagnia in which case the fetichistic stimulus is not to be 
found in the clean naked foot but e contra, cf. case 8G. 



FETICH ISM. 231 

Mr. X., civil servant, twmt v-nine years of age; mother 
neuropathic, father diabetic. 

Had good mental qualities, was of nervous disposition, 
but never suffered from nervous disease, showed no signs 
of degeneration. Patient distinctly recalled tiiat even at 
the age of six he became sexually excited when he saw 
the naked feet of women, and was impelled to follow them, 
or watch them when at work. 

At the age of fourteen he slipped one night into the 
room where his sister slept and kissed her foot. At the 
age of eight he began spontaneously to masturbate, think- 
ing all the while of the naked feet of women. 

\Vlien sixteen he often took shoes and stockings of 
servant girls to bed with him; and whilst fingering them 
excited himself into masturbation. 

At the age of eighteen he began sexual intercourse 
with persons of the opposite sex. He had full power, and 
coitus satisfied him without the aid of a fetich. For 
males he had not the slightest sexual inclination, neither 
had the feet of men any attraction for him. 

At the age of twenty-four a great change came over 
his sexual feelings and his physical condition. 

Patient became neurasthenic and began to experience 
sexual inclination to males. No doubt excessive mastur- 
bation brought about neurosis and inverted sexuality to 
which he was led by -libido nimia remaining unsated by 
coitus, and by the sight (accidental or otherwise) of female 

As neurasthenia (at first sexualis) increased, a rapid 
cessation of libido, power and gratification, with regard 
to women set in. Parallel with this, inclination towards 
his own sex developed and his fetichism was transferred 
to males. 

With the age of twenty-five he had coitus cum muliere 
but rarely, and without satisfaction. He had lost nearly 
all interest in the foot of woman. The craving to have 
sexual intercourse wfth men grew daily stronger. When 
he was transferred to a large city he found the long- 



232 PSYCHOPATIIIA SEXUALI8. 

wished-for opportunity and actually revelled with intense 
passion in this unnatural love. 

He ejaculated during these acts with the utmost volup- 
tuousness. By-and-by the sight of a sympathetic man, 
especially if he were barefooted, sufficed him. 

His nocturnal pollutions had now for their object 
intercourse with men, and, to be sure, in the fetichistic 
sense (feet). Shoes did not interest him. The naked foot 
was his charm. He often felt impelled to follow men in 
the street, hoping to find occasion for taking off their 
shoes. As a substitute he went barefooted himself. At 
times he was driven to walk along the street in his bare 
feet, thereby experiencing the most intense lustful feelings. 
If he resisted, agony, trembling, and palpitation of the 
heart set in. Often at nights he yielded to this impulse 
for hours, even in stormy, rainy weather, not minding the 
many risks and personal dangers to which he exposed 
himself by so doing. 

He would carry the shoes in his hand, became sexually 
excited, and only found satisfaction in spontaneous, or 
induced ejaculation. He felt envious of navvies and the 
poor who could go barefoot without attracting attention. 

His happiest moments were the time which he spent 
in an hydropathic establishment, a la Kneipp, where he 
was allowed to go barefoot with the other men under 
treatment. 

An awkward affair, the result of his perverse sexual 
practices sobered him. He sought safety from his un- 
natural sexual existence by consulting a physician who 
sent him to me. 

The patient did his utmost to abstain from masturba- 
tion and perverse connection with men. He underwent 
treatment for neurasthenia in an hydropathic institute, 
regained some interest in the gentle sex his foot-fetich- 
ism serving as a bridge had once, with a degree of plea- 
sure, coitus with a barefooted peasant girl who acceded 
to his wishes, and later on visited puellas a few times but 
without gratification. Then he turned again to persons 



FETICHISM. 233 

of his own sex, backslided totally, felt irresistibly drawn 
to tramps and farm labourers, whom he paid for the 
favour to kiss their feet. An attempt to rescue the unfor- 
tunate man by suggestive treatment was wrecked on the 
impossibility to remove an enervation which was beyond 
therapeutic aid. 

Case 92. Fool-fetichism with continued hetero-sex- 
uality. Mr. Y., fifty years of age, bachelor, belonged to 
high society. Consulted a physician on account of "ner- 
vous" troubles. Tainted, from childhood nervous, very 
sensitive to cold and heat, troubled with delusions which 
assumed the character of transient dementia persecutoria. 
For instance, when he sat in a restaurant he imagined 
that everybody stared at him, talked about, and made 
fun of him. As soon as he rose this feeling left him and 
he no longer believed his fancies. 

He never felt settled for any length of time, and 
moved about from one place to another. At times it 
happened that he engaged rooms at a hotel, but never 
went there on account of his peculiar delusions. 

He never had much libido. All his sentiments were 
heterosexual. Now and then he found gratification in 
coitus which he claimed to have been normal. 

Y. admitted that his sexual life was peculiar from early 
youth. Neither women nor men excited him sexually, 
but the sight of female feet, be they of children or grown- 
up women, would do so. All other parts of the female 
body had no attraction for him. 

If by chance he could see the naked feet of female 
gipsies or tramps he could gaze at them by the hour and 
was driven by a "terrible" impulse terere genitalia propria 
ad pedes illarum. Thus far he had successfully resisted 
this impulse. 

What annoyed him most was to see these feet covered 
with dirt He would like to see them well washed and 
clean. He could not say how this fetichism originated in 
him (from a communication of Professor Forel). 



234 PSYCHOPATHIA SEXUALIS. 

Moll in his recent researches in libido sexualis, p. 288, 
relates a most interesting case -x>f foot-fetichism which 
resembles case 91 above, in so far as the patient by force 
of the fetich became homosexual. 

Shoe-fetichism also finds its place in the following 
group of dress-fetich ism ; however, on account of its 
demonstrable masochistic character in the majority of 
cases, it has been, for the most part, described already 
above. 

Besides the eye, hand and foot, the mouth and ear often 
play the role of a fetich. Among others, Moll (op. cit.) 
mentions such cases. (Cf. Belot's romance, "La Bouche 
de Madame X.," which, B. states, rests upon actual ob- 
servation. ) 

The following remarkable case comes under my per- 
sonal observation : 

Case 93. A gentleman of very bad heredity con- 
sulted me concerning impotence that was driving him al- 
most to despair. While he was young, his fetich was 
women of plump form. He married such a lady, and was 
happy and potent with her. After a few months the lady 
fell very ill, and lost much flesh. When, one day, he tried 
to resume his marital duty, he was absolutely impotent, and 
remained so. If, however, he attempted coitus with plump 
women, he was perfectly potent. 

Even bodily defects become fetiches. 

Case 94. X., twenty-eight years of age; family 
heavily tainted ; neurasthenic ; want of self-confidence and 
frequent depression of mind, with fits of suicidal inten- 
tions, which he had great trouble to ward off. The smallest 
worries threw him out of temper, and filled him with 
despair. He was an engineer in a factory in Russian- 
Poland, a man of robust frame, without signs of degenera- 
tion. He complained of a peculiar mania, which caused 



FETICH ISM. 

him to doubt his sanity. Since his seventeenth year ho 
became sexually excited at the sight of physical defect* 
in women, especially lameness and disfigured feet. He was 
not conscious of the original associative connection be- 
tween his libido and these defects in women. 

Ever since puberty he had been under the bane of this 
fetichism, which was painful to himself. Normal women 
had no attraction for him. If a woman, however, was 
afflicted with lameness or with contorted or disfigured feet, 
she exercised a powerful sensual influence over him, no 
matter whether she was otherwise pretty or ugly. 

In his dreams, accompanied by pollutions, the forms of 
halting women were ever before him. At times he could 
not resist the temptation to imitate their gait, which caused 
vehement orgasm, with lustful ejaculation. lie claimed to 
have strong libido, and suffered intensely when his sexual 
desire remained unsatisfied. Despite these facts, he had 
>ims for the first time when he was twenty-two years of 
age, and then but five times. He felt, however, not the 
slightest satisfaction in spite of complete ability. !! 
thought it would cause him intense pleasure if he had the 
chance to mate with a halting woman. At any rate, be 
could never marry any other than a lame woman. 

Since his twentieth year the patient manifested fetich- 
ism for garments. It often sufficed him to put on female 
stockings, shoes and drawers. He I* night such wearing 
apparel at times and, putting it on secretly, became lust- 
fully excited and ejaculated. Garments which had been 
worn by women had no attraction for him. He would 
fain prefer to wear female garb, so as to keep up sensual 
emotions, but had not yet dared to do so for fear of being 
detected. 

His i-lln SCJT nulls was reduced ;<> these practices. He 
was definite in asserting that In- nver was addicted to mas- 
turbation. Quite recently lie had been, in consequence of 
his neurasthenic afflictions, much troubled with pollutions. 

Case 95. Z., gentleman, family tainted. Even iu 



236 PSYCHOPATHIA SEXUALI8. 

early childhood always felt great ..sympathy with the lame 
and the halt. He used to limp about the room on two 
brooms in lieu of crutches, or when unobserved, go limping 
about the streets; but at that time no sexual significance 
was coupled with the idea. Gradually the thought super- 
vened that he would like "as a pretty lame child" to meet 
a pretty girl who would express sympathy with his afflic- 
tion. Sympathy from men he disdained. Z. was brought 
up in a rich man's house by a private tutor, and claimed 
that he was unaware of the difference in sexes up to his 
twentieth year. His feelings were confined to the idea of 
being pitied by a pretty girl for being lame, or extending 
the same sympathy himself to a lame girl. Gradually 
erotic emotions associated themselves with this fancy and 
at the age of twenty he succumbed to a temptation and 
masturbated for the first time. This act he practised 
henceforth very often. Neurasthenia sexualis supervened 
and an irritable weakness took hold of him to such an 
extent that the very sight of a girl with a halting gait 
induced ejaculation. When masturbating, or in his erotic 
dreams, the idea of the limping girl was always the con- 
trolling element. The personality of the halting girl was 
a matter of indifference to Z., his interest being solely 
centered in the limping foot. He never had coitus with 
a girl thus afflicted. He never felt an inclination for doing 
so and did not think he could be potent under the circum- 
stances. His perverse fancies only revolved around mas- 
turbation against the foot of a halting female. At times 
he anchored his hope on the thought that he might succeed 
in winning and marrying a chaste lame girl, that, on ac- 
count of his love for her, she would take pity on him and 
free him of his crime by "transferring his love from the 
soul of her foot to the foot of her soul." He sought de- 
liverance in this thought. His present existence was one 
of untold misery. 

Case 96. Mr. V., thirty years, civil servant ; parents 
neuropathic. Since his seventh year he had for a play- 
mate a lame girl of the same age. 



FETICH ISM. 237 

At the age of twelve, being of a nervous disposition and 
hyporsexually inclined, the boy began spontaneously to 
masturbate. At that period puberty set in, and it lies 
beyond doubt that the first sexual emotions towards the 
other sex were coincident with the sight of the lame girl. 

For ever after only halting women excited him sexu- 
ally. His fetich was a pretty lady who, like the companion 
of his childhood, limped with the left foot 

Always heterosexual but abnormally sensual he sought 
early relations with the opposite sex, but was absolutely 
impotent with women who were not lame. Virility and 
gratification were most strongly elicited if the puella 
limped with the left foot, but he was successful also if 
the lameness was in the right foot. As, in consequence 
of his fetichism the opportunities for coitus occurred but 
seldom, he resorted to masturbation, but found it a dis- 
gusting and miserable substitute. His sexual anomaly 
rendered him very unhappy, and he was often near com- 
mitting suicide, but regard for his parents prevented him. 

This moral affliction culminated in the desire for 
marriage with a sympathetic lame lady, but since he could 
not love the soul of such a wife, but only her defect of 
lameness, he considered such a union a profanation of 
matrimony and an unbearable, ignoble existence. On 
this account he had often thought of resignation and 
castration. 

When V. came to me for advice I obtained, in my 
examination of him, only negative results as regards signs 
of degeneration, nervous disease, etc. 

I enlightened the patient on the subject, and told him 
that it was difficult, if not absolutely impossible, for 
medical science to obliterate a fetichism so deeply rooted 
by old associations, but expressed the hope that if he 
made a limping maid happy in wedlock he himself would 
find happiness also. 

Descartes, who himself ("Traite des Passions," 
cxxxvi.) expresses some opinions concerning the origin of 



238 PSYCHOPATUIA SEXUALIS. 

peculiar affections in associations of ideas, was alwavA 
partial to cross-eyed women, because the object of his first 
love had such a defect (Binet, op. cit.). 

Lydston ("A Lecture on Sexual Perversion," Chicago, 
1890) reports the case of a man who had a love affair 
with a woman whose right lower extremity had been am- 
putated. After separation from her he searched for other 
women with a like defect A negative fetich! 

A peculiar variety of body fetichism may be found in 
the following case (strongly complicated with sadistic ele- 
ments), in which fine white virgin skin is the fetich, and 
sadism leads to lustful acts of cruelty (as an equivalent to 
coitus), even to anthropophagy (cf. p. 95 ei seq.), for 
which the deeply degenerated and probably epileptic pa- 
tient seeks to find a substitute in automutilation and auto- 
phagy. 

Case 97. L., labourer, was arrested because he had 
cut a large piece of skin from his left forearm with a pair 
of scissors in a public park. 

He confessed that for a long time he had been craving 
to eat a piece of the fine white skin of amaiden, and that 
for this purpose he had been lying in wait for such a vic- 
tim with a pair of scissors ; but, as he had been unsuccess- 
ful, he desisted from his purpose and instead had cut his 
own skin. 

His father was an epileptic, and his sister was an imbe- 
cile. Tip to his seventeenth year he suffered from enuresis 
nociuma, was dreaded by everybody on account of his 
rough and irascible nature, and dismissed from school 
because of his insubordination and viciousness. 

He began onanism at an early age, and read with 
preference pious books. His character showed traits of 
superstition, proneness to the mystic, and showy acts of 
devotion. 

When thirteen his lustful anomaly awoke at the sight 
of a beautiful young girl who had a fine white skin. The 
impulse to bite off a piece of that skin and eat it became 



ntnciiiBic. 239 

paramount with him. Xo other parts of the female body 
excited lam. He nrv< -r had any desire for sexual inter- 
course, and never attempted such. 

Hi hoped to achieve his end easier with the aid of 
scissors than with his teeth, for which reason he always 
carried a pair with him for years. On several occasions 
his efforts were nearly successful. Since the previous year 
he found it most difficult to bear his failures any longer, 
when he decided upon a substitute viz., each time when 
he had unsuccessfully pursued a girl he would cut a piece 
of skin from his own arm, thigh or abdomen and 'eat it. 
Imagining that it was a piece of the skin of the girl whom 
he had pursued, he would whilst masticating his own skin 
obtain orgasm and ejaculation. 

Many extensive and deep wounds and numerous scars 
were found on his body. 

During the act of self-mutilation, and for a long time 
afterwards, he suffered severe pains, but they were over- 
compensated by the lustful feelings which he experienced 
whilst eating the raw flesh, especially if the latter dripped 
with blood, and when he succeeded in his illusion that it 
was cutis virginis. The mere sight of a knife or scissors 
sufficed to provoke this perverse impulse, which threw 
him into a state of anxiety, accompanied by profuse per- 
spiration, vertigo, palpitation of the heart, craving for 
cutis femince. lie must, with scissors in hand, follow the 
woman that attracted him, but he did not lose conscious- 
ness or self-control, for at the acme of the crisis he took 
from his own what was denied him from the body of the 
girl. During the whole crisis he had erection and orgasm, 
and at the very moment when he began to chew the piece of 
his skin ejaculation set in. After that he felt greatly 
relieved and comforted. 

L. was quite conscious of the pathological aspect of his 
condition. Of course, this dangerous character was sent 
to an insane asylum, where he attempted suicide (Magnan 
"Psychiatrische Vorlesungen"). 

An interesting category is formed by the hair-fetich- 



240 PSYCHCWATHIA SEXUALIS. 

ists. The transition from "admirer of woman's hair" 
within physiological limits to pathological fetichism is 
easy. The beginning of the pathological series is formed 
by those cases in which the hair of a woman simply makes 
a sensual impression and incites to cohabitation. Then fol- 
low those in which virility is only possible with a woman 
who possesses this individual fetich. Possibly various 
senses (sight, smell, hearing, crepitant sounds, also touch 
as with velvet- and silk-fetichists, vide infra) are drawn 
into activity in this hair-fetichism as they receive lustful 
impulses. 

The end of the series is formed by those whom the hair 
of woman suffices even when severed from the body so 
to speak, no longer a part of the living body, but only 
matter, even a mercantile article to excite libido and 
sensual gratification by way of physical or psychical onan- 
ism, eventually under contact of the genitals with the 
fetich. 1 An interesting instance of a hair-fetichist belong- 
ing to the second category is related by Dr. Gemy, under 
the title of "Historic des peruques aphrodisiaques," in 
"La Medecine Internationale," September, 1894. 

Case 98. A lady told Dr. Gemy that in the bridal 
night and in the night following her husband contented 
himself with kissing her, and running his fingers through 
the wealth of her tresses. He then fell asleep. In the third 
night Mr. X. produced an immense wig, with enormously 
long hair, and begged his wife to put it on. As soon as she 
had done so, he richly compensated her for his neglected 
marital duties. In the morning he showed again extreme 
tenderness, whilst he caressed the wig. When Mrs. X. re- 
moved the wig she lost at once all charm for her husband. 

l Gamier ( Sadi-fetichism, Annal. d'hyg.) knew a degenerate 
whose fetich was the hair of the Mons Veneris. His greatest delight 
was to tear them out with his teeth. He collected specimens and used 
them for renewed sexual gratification by biting and chewing them. 
He bribed housemaids of hotels to let him search the beds in which 
ladies had slept for such hairs. Whilst searching for them he be- 
came erotically excited and trembled with happiness when he made 
a successful find. 



FETICIIIBM. 241 

Mrs. X. recognised this as a hobby, and readily yielded to 
the wishes of her husband, whom she loved dearly, and 
whose libido depended on the wearing of the wig. It was 
remarkable, however, that a wig had the desired effect only 
for a fortnight or three weeks at a time. It had to be made 
of thick, long hair, no matter of what colour. 

The result of this marriage was, after five years, two 
children, and a collection of seventy-two wigs. 

The following case, observed by Magnan and reported 
by Thoinot (op. cit. p. 419), is that of a man with anti- 
pathic sexual instinct, to whom the actual existence of the 
fetich was a conditio sine qua non of potency. 

Case 99. X., aged twenty, inverted sexually. Only 
loved men with a large bushy mustache. One day he 
met a man who answered his ideal. He invited him 
to his home, but was unspeakably disappointed when this 
man removed an artificial mustache. Only when the vis- 
itor put the ornament on the upper lip again, he exercised 
his charm over X. once more and restored him to the full 
possession of virility. 

In those cases in which the female hair as mere mat- 
ter possesses the properties of a fetich, it not uncom- 
monly happens that the fetichist seeks to possess himself 
of woman's hair by unlawful acts. These form the group 
of hair-deepoilers, of no slight importance from the foren- 
sic aspect. 1 

Case 100. A hair-despoiler. P., aged forty, artistic, 
locksmith, single. His father was temporarily insane, 
and his mother was very nervous. He was well de- 
veloped and intelligent, but was early affected with tic 
and delusions. He had never masturbated. He loved 

1 Moll (op. cit., p. 131) reports: "A man, X., becomes intensely 
excited sexually whenever he sees a woman with the hair in a braid; 
loose hair, no matter how beautiful, cannot produce this effect." 

Of course, it is not justifiable to consider all hair-despoilers 
Midlists, for in a few cases such acts are done for the purpose of 
gain i. e. t the stolen hair is not a fetich. 

16 



242 PSYCHOPATHIA SEXUAL1S. 

platonically, and often busied himself with matrimonial 
plans. He had coitus with prostitutes but rarely, and never 
felt satisfied with such intercourse rather, disgusted. 
Three years ago he was overtaken by misfortune (financial 
ruin), and besides, he had a febrile disease, with delirium. 
These things had a very bad effect on his hereditarily 
predisposed nervous system. On August 28, 1889, P. was 
arrested at the Trocadero, in Paris, in flagranti, as he forc- 
ibly cut off a young girl's hair. He was arrested with 
the hair in his hand and a pair of scissors in his pocket. 
He excused himself on the ground of momentary mental 
confusion and an unfortunate, irresistible passion; he 
confessed that he had ten times cut off hair, which he took 
great delight in keeping at home. On searching his home, 
sixty-five switches and tresses of hair were found, as- 
sorted in packets. P. had already been once arrested, 
on 15th December, 1886, under similar circumstances, 
but was released for lack of evidence. 

P. stated that, for the last three years, when he was 
alone in his room at night, he felt ill, anxious, excited 
and dizzy, and then was troubled by the impulse to touch 
female hair. When it happened that he could actually 
take a young girl's hair in his hand, he felt intensely 
excited sexually, and had erection and ejaculation without 
touching the girl in any other way. On reaching home, 
he would feel ashamed of what had taken place; but the 
wish to possess hair, always accompanied by great sexual 
pleasure, became more and more powerful in him. He 
wondered that previously, even in the most intimate inter- 
course with women, he had experienced no such feeling. 
One evening he could not resist the impulse to cut off a 
girl's hair. With the hair in his hand, at home, the 
sensuous process was repeated. He was forced to rub his 
body with the hair and envelop his genitals in it. Finally, 
quite exhausted, he grew ashamed, and could not trust 
himself to go out for several days. After months of rest 
he was again impelled to possess himself of female hair, 
indifferent as to whose it might be. If he attained his 



yracuisM. 243 

end, he felt himself possessed by a supernatural power 
and unable to give up his booty. If he could not attain 
tin- object of his desire, ho became greatly depressed, 
hurried IK .mo, and there revelled in his collection of hair. 
II*- combed and fondled it, and thus had intense orgasm, 
satisfying himself by masturbation. Hair exposed in tin; 
show-cases of hair-dressers made no impression on him; 
it required hair hanging down from a female head. 

At the height of his act, he was in such a state of ex* 
<-i i finent that he had only imperfect apperception and 
subsequent recollection of what he had done. When he 
touched the hair with the scissors he had erection, and, at 
the instant of cutting it off, ejaculation. Since his mis- 
fortune, about three years ago, he had weakness of mem- 
ory, was easily exhausted mentally, and troubled by sleep- 
lessness and night-terrors. P. deeply regretted his crime. 

Not only hair, but a number of hair-pins, ribbons and 
other articles of the feminine toilet, were found in his 
possession, which he had had presented to him. He had 
always had an actual mania for collecting such things, as 
well as newspapers, pieces of wood and other worthless 
trash, which he would never give up. He also had a 
strange, and, to him, inexplicable fear of passing a certain 
street ; if he ever tried it, it made him ill. 

The opinion (medico-legal) showed him to be heredi- 
tarily predisposed, and proved the imperative, impulsive 
and decidedly involuntary character of the criminal acts, 
which had the significance of an imperative act, induced 
by an imperative idea, with an accompaniment of over- 
powering abnormal sexual feeling. Pardon; asylum for 
insane (Voisin, Socquet, Motet, "Annales d'hygiene," 
April, 1890). 

Following this case is a similar one, which also de- 
serves attention, for it has been well studied, and may be 
called almost classical ; and it places also the fetich, as well 
as the original associative awakening of the idea, in a clear 
light 



244 PSYCHOPATHIA BEXUALIS. 

Case 101. A hair-despoilcr, E., aged twenty-five. 
Maternal aunt, epileptic; brother had convulsions. Was 
fairly healthy as a child, and learned quite easily. At 
the age of fifteen he had an erotic feeling of pleasure, 
with erection, at the sight of one of the village beauties 
combing her hair. Until that time persons of the oppo- 
site sex had made no impression on him. Two months 
later, in Paris, the sight of young girls with their hair 
flowing down over their shoulders ever excited him in- 
tensely. One day he could not resist an opportunity to 
twist a young girl's hair in his fingers. For this he was 
arrested and sentenced to imprisonment for three months. 
After that he served five years in the army. During this 
time hair was not dangerous for him, because not very 
accessible; but he dreamed sometimes of female heads 
with the hair braided or flowing. Occasional coitus with 
women, but without their hair being effective as a fetich. 
Once more in Paris, he again dreamed as beforej and 
became greatly excited by female hair. He never dreamed 
about the whole form of a woman, only of heads with 
braids of hair. His sexual excitement due to this fetich 
had become so intense of late that he had resorted to mas- 
turbation. The idea of touching female hair, or, better, 
of possessing it to masturbate while handling it, grew 
more and more powerful. Of late, when he had female 
hair in his fingers, ejaculation was induced. One day he 
succeeded in cutting hair, about twenty-five centimetres 
long, from three little girls in the street, and keeping it in 
his possession, when he was arrested in a fourth attempt. 
Deep regret and shame. He was not sentenced. After 
spending some time in the asylum, he improved so far 
that female hair no longer excited him. Set at liberty, ho 
thought of going to his native place, where the women 
wear their hair done up (Magnan, "Archiv. de 1'anthro- 
pol. criminelle," v., No. 28). 

A third case is the following, which is likewise suited 
to illustrate the psychopathic nature of such phenomena; 



FETICHI8M. 

and the remarkable means which induced a cure are 
worthy of note: 

Case 102. Hair-fetichism. Mr. X., between thirty 
and fortv \vars old; of the higher class of society; single. 
Came of a healthy family, but from childhood had been 
nervous, vacillating and peculiar; since his eighth year 
he had been powerfully attracted by female hair. This was 
particularly true in the case of young girls. When he was 
nine years old, a girl of thirteen seduced him. He did not 
understand it, and was not at all excited. A twelve-year- 
old sister of this girl also courted, kissed, and hugged him. 
lie allowed this quietly, because this girl's hair pleased him 
so well. When about ten years old, he began to have erotic 
feelings at the sight of female hair that pleased him. 
Gradually these feelings occurred spontaneously, and 
memory-pictures of girl's hair were always immediately 
associated with them. At the age of eleven he was taught 
to masturbate by school-mates. The associative connec- 
tion of sexual feelings and a fetichistic idea were already 
established, and always appeared when the patient in- 
dulged in evil practices with his companions. With ad- 
vancing years, the fetich grew more and more powerful. 
Even false hair began to excite him, but he always pre- 
ferred natural hair. When he could touch or kiss it, he 
was perfectly happy. He wrote essays and poems on the 
beauty of female hair ; he sketched heads of hair and mas- 
turbated. After his fourteenth year he became so power- 
fully excited by his fetich that he had violent erections. In 
contrast with his early taste while a boy, he was now 
charmed only by luxuriant, thick black hair. He ex- 
perienced intense desire to kiss such hair, particularly to 
suck it. To touch such hair afforded him but little sat- 
isfaction ; he obtained much more pleasure in looking 
at it, but particularly in kissing and sucking it. If this 
were impossible, he would become unhappy, even to the 
extent of toedium vitce. Then he would attempt to re- 
lieve himself, imagining fantastic "hair-adventures" and 



246 I'SYCliOPATIlIA SEXUALIS. 

masturbating. Not infrequently, in the street and in 
crowds, he could not keep from imprinting a kiss on 
ladies' heads, lie would then hurry home to masturbate. 
Sometimes he could resist this impulse; but it was then 
necessary for him, filled with feelings of fear, to run away 
as quickly as possible, in order to escape the domination 
of his fetich, lie was only once impelled to cut off a girl's 
hair in a crowd. In the act he was seized with fear, and 
was not successful with his pocket-knife; and, by flight, 
he narrowly escaped detection. 

When he became mature, he attempted to satisfy him- 
self in coitus with puellis. lie induced powerful erection 
by kissing their tresses, but could not induce ejaculation, 
and coitus did not satisfy him. At the same time, his 
favourite idea was coitus with kissing of hair; but even 
this did not satisfy him, because it did not induce ejacu- 
lation. Faute de mieux, he once stole the combings 
of a lady's hair, put it in his mouth, and masturbated 
while calling its owner up in imagination. In the dark a 
woman could not interest him, because he could not then 
see her hair. Flowing hair also had no charm for him; 
nor did the hair about the genitals. His erotic dreams 
were all about hair. Of late the patient had become 
so excited that he had a kind of satyriasis. He was 
incapable of business, and felt so unhappy that he sought 
to drown his sorrow in alcohol. He drank large quantities, 
had alcoholic delirium, an attack of alcoholic epilepsy, 
and required hospital treatment. After the intoxication 
had passed away, under appropriate treatment, the sexual 
excitement soon disappeared; and when the patient was 
discharged, he was freed from his fetichistic idea, save 
for its occasional occurrence in dreams. The physical 
examination showed normal genitals and no degenerative 
signs whatever. 

Such cases of hair-fetichism, which lead to attacks on 
female hair, seem to occur everywhere, from time to 
time. In November 1890, according to reports in Aineri- 



FETICH IBM. 2 1 7 

can new-papers, several cities in the United States were 
tr<>ul>lrj by such hair-despoilers. 

(b) The Fetich is an Article of Female Attire. 

The great importance of adornment, ornament and 
dress in the normal vita sexualis of man is very generally 
recognised. Culture and fashion have, to a certain extent, 
endowed woman with artificial sexual characteristics, the 
removal of which, when woman is seen unattired, in 
spite of the normal sexual effect of this sight, may exert 
an opposite influence. 1 It should not be overlooked that 
female dress often shows a tendency to emphasise and 
exaggerate certain sexual peculiarities, secondary sexual 
characteristics (bosom, waist, hips). In most individuals 
the sexual instinct awakes long before there is any possi- 
bility or opportunity of intimate intercourse, and the early 
desires of youth are concerned with the ordinary appear- 
ance of the attired female form. Thus it happens that not 
infrequently, at the beginning of the vita sexualis, ideas of 
the persons exerting sexual charms and ideas of their 
attire become associated. This association may be lasting 
the attired woman may be always preferred if the 
individuals dominated by this perversion do not in other 
rts attain to a normal ///</ scxualis, and find gratifi- 
cation in natural charms. 

In psychopathic individuals, sexually hypersesthetic, as 
a result of this, it actually happens that the dressed woman 
is always preferred to the nude female form. It may be 
recalled that in case 55 the woman was not to take off her 
chemise, and that it case 58, cquus eroticus, the woman 
was prrtVnvd dressed. Further on a similar case will be 
referred to. 

Dr. Moll (op. cit. second edition) mentions a patient 
who could not perform coitus with puella nuda; the woman 

l ('f. (;<M-tlic'.s remark* iilxmt his adventure in Geneva (" Brief e 

aus der S<-li\\ri/.," 1. AMln-il.. S.-MIISH). 



248 PSYCHOPATHIA 8EXUALIS. 

had to have on a chemise, at least. The same author (op. 
cit. t p. 16) mentions a man affected with inverted sex- 
uality, who is subject to the same dress-fetichism. 

The reason for this phenomenon is apparently to be 
found in the mental onanism of such individuals. In 
seeing innumerable clothed forms, they have set desires 
before seeing nudity. 1 

A more marked form of dress-fetichism is that in 
which, instead of the dressed woman in general, a certain 
kind of attire in particular becomes a fetich. One can 
understand how, with an intense and early sexual impres- 
sion, combined with the idea of a particular garment on 
the woman, in hypersesthetic individuals, a very intense 
interest in this garment might be developed. 

Hammond (op. cit., p. 46) reports the following case, 
taken from Roubaud ("Traite de Timpuissance," Paris, 
1876) : 

Case 103. X., son of a general. He was raised in 
the country. At the age of fourteen he was initiated into 
the pleasures of love by a young lady. This lady was a 
blonde, and wore her hair in ringlets; and, in order to 
avoid detection in sexual intercourse with her young lover, 
she always wore her usual clothing, gaiters, a corset, and 
a silk dress on such occasions. 

When his studies were completed, and he was sent to 
a garrison where he could enjoy freedom, he found that his 
sexual desire could be excited only under certain condi- 
tions. A brunette could not excite him in the least, and 
a woman in night-clothes would stifle every bit of love in 
him. In order to awaken his desire, a woman had to be 
a blonde, and wear gaiters, a corset and a silk dress, in 
short, she had to be dressed like the lady who had first 

lr The fact that the partly veiled form is often more charming 
than when it is perfectly nude, is, as far as object goes, similar, but 
quite different psychically. This depends upon the effect of contrast 
and expectation, which are common phenomena, and in no sense 
pathological. 



FETICHISM. 249 

awakened his sexual desire. He was always compelled 
to give up thoughts of matrimony, because he knew he 
would be unable to fulfil his marital duty with a woman 
in night-clothes. 

Hammond (p. 42) reports another case where coitus 
marital is could be performed only by the help of a certain 
costume; and Dr. Moll mentions several similar cases in 
individuals of hetero- and homo-sexuality. The cause 
may often be shown to be an early association, and such 
may always be assumed. It is only in this way that one 
can explain why a certain costume is irresistible to such 
individuals, no matter who the person is that wears the 
fetich. Thus one can understand why, as Coffignon (op. 
cit.) relates, men at brothels demand that the women with 
whom they are concerned put on certain costumes, such as 
that of a ballet-dancer, or a nun, etc. ; and why these houses 
are furnished with a complete wardrobe for such purposes. 

Binet (op. cit.) relates the case of a judge who was 
exclusively in love with Italian girls who came to Paris 
as artists' models, and their peculiar costume. The cause 
was here demonstrably an impression made at the time of 
the awakening of the sexual instinct. 

There is but a step from such cases to the complete 
absorption of the whole vita sexualis by the fetich, the 
possession and manipulation of which may suffice to pro- 
voke orgasm and even ejaculation where irritable weak- 
ness of the centrum ejaculationis prevails. 

Case 104. P., thirty-three years of age, business 
man, son of a mother who suffered from melancholia and 
committed suicide. He was tainted with several signs of 
anatomical degeneration, was looked upon by his neigh- 
bours as a "type," and had the nickname I'amoureux des 
nourrices et des bonnes d'enfants. 

He became a nuisance to these girls by his obtrusive 
behaviour, picked a quarrel with one of them who wore his 
fetich, and was arrested. 



250 PSYCHOPATHIA SEXUALIS. 

He claimed to have always been vehemently excited at 
the sight of wet-nurses and nurse-'maids, but not because 
they were of the female sex, but because they wore a cer- 
tain costume. Again, it was not certain portions, but the 
costume as a whole which attracted him. To be in the 
company of such persons was his greatest happiness. 
When he returned home from such interviews it was suf- 
ficient for him to recall the impressions just received, in 
order to produce oryasmus venereus. 

An analogous case is related by Motet. It refers to a 
young man, who became sexually excited only at the sight 
of a woman attired in bridal costume. The individuality 
of the woman was a matter of indifference to him. In 
order to gratify his fetichistic cravings, he spent a great 
deal of his time at the door of a restaurant where many 
weddings were celebrated (Gamier, "Les Fetichistes, 
p. 59). 

A third form of dress-fetichism, having a much higher 
degree of pathological significance, is by far the most fre- 
quent. In this form it is no longer the woman herself, 
dressed, or even dressed in a particular fashion, that 
constitutes the principal sexual stimulus, but the sexual 
interest is so concentrated on some particular article 
of female attire that the lustful idea of this object is 
entirely separated from the idea of woman, and thus 
obtains an independent value. This is the real domain 
of dress-fetichism, where an inanimate object an isolated 
article of wearing-apparel is alone used for the excitation 
and satisfaction of the sexual instinct. This third form 
of dress-fetichism is also the one which forensically is the 
most important. 

In a large number of these cases the fetiches are articles 
of female underwear, which, owing to their private use, 
are suited to occasion such associations. 

Case 105. K., aged forty-five, shoemaker, was re- 
ported to be without hereditary taint. He was peculiar, 



FETICHI8M. 251 

and had small mental endowment. lie was of masculine 
habits, and without signs of di generation. Previously 
blameless in conduct, on the evening of Mh 'July, 187G, 
he wafl detected removing stolen fi-male under-garmcnts 
from a place of concealment. There were found with him 
about 300 articles of the female toilet, among them, be- 
sides chemises and drawers, night . rters, and a 
female doll. When arrested he was wearing a chemise. 
Since his thirteenth year he had been a slave to an im- 
pulse to steal women's linen; but, after his first pun- 
ishment for it, he became very careful, and stole with 
refinement and success. When this longing came over 
him, lie would grow anxious, and his head would become 
heavy. Then he could not resist the impulse, cost what 
it might. It was a matter of indifference to him from 
whom he took the articles. At night, on going to bed, 
he would put on the stolen clothing and create beautiful 
women in imagination, thus inducing pleasurable feeling 
and ejaculation. This was apparently the motive of his 
thefts ; at least, he had never disposed of any of the articles, 
but had hidden them here and there. 

He declared that, earlier in his life, he had indulged in 
normal sexual intercourse with women. He denied onan- 
i^in, pederasty, and other sexual acts. He said he was 

.red at twenty-five, but the engagement was broken 
through no fault of his. lie was incapable of grasping the 
abnormality of his condition and the wrong of his acts. 
. Yierteljahrsschrift f. ger. Medic.," N. F. 
.\\viii., p. 61; Krauss, "Psychologic des Verbrechens," 
1884, p. 190). 

Case 106. J., a young butcher. When arrested he 
underneath his overcoat a bodice, a corset, a vest, a 
jacket, a collar, a jersey, and a chemise, also fine stockings 
and garters. 

Since he was eleven he was troubled by the desire to 
wear a chemise of his elder sister. Wheiie er he could do 
it unnoticed he indulged in this pleasure, and since the ago 



252 PSYCHOPATHIA SEXUALI8. 

of puberty the wearing of such a garment would bring on 
ejaculation. When he became independent he bought 
chemises and other articles of female toilet. In his room 
a complete outfit of female attire was found. To put 
on such garments was the great aim of his sexual instinct. 
This fetichism had financially ruined him. At the hos- 
pital he begged the attending physician to permit him 
to wear female attire. Inverted sexuality did not exist 
(Gamier, "Les Fetichistes," p. 62). 

Case 107. Z., thirty-six years of age, scholar; had 
never heretofore felt interested in woman, only in her 
attire, and never had sexual intercourse. Besides the 
elegance and smartness of the female toilet in general, 
certain underwear, chemises made of cambric and trimmed 
with lace, silk corsets, embroidered silk skirts and silk 
stockings formed his particular fetich. It caused him 
voluptuous feelings to inspect and finger such female gar- 
ments at the draper's. His ideal was the female form in 
bathing costume, with silk stockings and corset, and clad 
in a mourning-dress with a long train. ' 

He studied the costumes of the coureuses des rues, but 
found them tasteless. He found more pleasure in gazing 
at the shop windows, but felt annoyed because the exhibits 
therein were not changed often enough. He found partial 
satisfaction in holding and studying fashion magazines, 
and in buying now and then single garments of excep- 
tional beauty. It would be the height of pleasure for him 
if he had access to the toilet arts of the boudoir or the 
fitting rooms of the dressmaker, or if he could be the 
fcmme de chambre of some wealthy lady of the world, and 
could arrange the toilet for her. There were no traces of 
masochism or homosexual inclination to be found on this 
peculiar fetichist. He was of thoroughly manly presence 
(Gamier, "La folie a Paris," 1890). 

Hammond (op. cit.} reports a case of passionate inter- 
est in single articles of female wearing-apparel. Here, 



FETICHI8M. 253 

also, the patient's pleasure consisted in wearing a corset 
and other female garments (without any traces of anti- 
pathic sexual instinct). The pain of tight lacing, ex- 
perienced by himself or induced in women, was a delight 
to him, sadistic-masochistic element. 

A case probably belonging here is one reported by Diet 
("Der Selbstmord," 1838, p. 24), where a young man 
could not resist the impulse to tear female linen. While 
tearing it, he always had ejaculation. 

A combination of fetichism with an impulse to destroy 
the fetich (in a certain sense, sadism with inanimate ob- 
jects) seems to occur quite frequently (cf. case 120). 

An article of dress, which, though it has not really a 
private character, by its material and colour, as well as by 
the place where it is worn, might be suggestive of under- 
garments, and hence has sexual relations, is the apron (cf. 
also the metonymic use of the word "apron" for "petticoat" 
in the saying, "To chase every apron," etc.). This ex- 
plains the following case : 

^ 

Case 108. C., aged thirty-seven; of a badly tainted 
family; of small mental endowment; plagiocephalic. At 
fifteen his attention was attracted by an apron hung out 
to dry. He put it on and masturbated behind the fence. 
From that time he could not see aprons without repeating 
the act. If he met any one no matter whether man or 
woman with an apron on, he was compelled to run after 
the person. In order to free him from this constant steal- 
ing of aprons, he was sent as a marine in his sixteenth 
year. In this calling he saw no aprons, and had con- 
tinual rest. When, at nineteen, he returned home, he was 
again compelled to steal aprons, and, as a result, got into 
serious complications, and was several times locked up. 
He sought to free himself of his weakness by a sojourn of 
several years with the Trappists. When he left them, he 
was just as bad as before. As a result of a new theft, he 
underwent a medico-legal examination, and was committed 
to an asylum. He never stole anything but aprons, it 



254 PSYCUOPATIIIA 8EXUALIS. 

was a pleasure to him to revel in the memory of the first 
apron he ever stole. His dreams were filled with aprons. 
He occasionally used the memory of his thefts to make 
coitus possible, or for masturbation (Charcot-Maynan, 
"Arch, de neurolog.," 1882, No. 12). 

In a case reported by Lombroso ("Amori anomali pre- 
coci nei pazzi," "Arch, di psich.," 1883, p. 17), analogous 
to those of this series, a boy of very bad heredity, at the 
age of four, had erections and great sexual excitement at 
the sight of white garments, particularly underclothing. 
He was lustfully excited by handling and crumpling 
them. At the age of ten he began to masturbate at the 
sight of white, starched linen. He seemed to have been 
affected with moral insanity, and was executed for murder. 

The following case of petticoat- fetichism is coupled 
with peculiar circumstances : 

Case 109. Z., aged thirty-five; civil servant; the 
only child of a nervous mother and a healthy father. 
From childhood he was "nervous," and at the consul- 
tation his neuropathic eyes, delicate, slender body, fine 
features, very thin voice, and sparse growth of beard at- 
tracted attention. The patient presented nothing ab- 
normal except symptoms of slight neurasthenia. Genitals 
and sexual functions normal. Patient stated that he had 
only masturbated four or five times when he was very 
young. As early as at the age of thirteen, the patient 
was powerfully excited sexually by the sight of wet female 
dresses, while the same dresses, when dry, had no effect 
upon him. His greatest delight was to look at women 
with wet garments in the rain. If he met a woman having 
a pleasing face under such circumstances, he experienced 
an intense feeling of lustful pleasure, had erection and felt 
impelled to perform coitus. He stated that he had never 
had any desire to steal wet female dresses or to throw 
water on women. He could give no explanation of the 
origin of his peculiarity. 

It is possible that, in this case, the sexual instinct was 



FETIC1II8M. 255 



first awakened by UK- M^lit <>f a unman as she exposed 
In T charms by raiding her skirts in wet weather. The 
obscure instin.-t, not yet conscious of its object, then 
became directed to the wet garments, ' as in other 



Lovers of female handkerchiefs are frequent, and, 
therefore, important forensically. As to the frequency 
>f handkerchief -fetichism, it may be remarked that the 
handkerchief is the one article of feminine attire which, 
outside of intimate association, is most frequently dis- 
playi (!, and which, with its warmth from the person and 
specific odours, may by accident fall into the hands of 

rs. The frequency of early association of lustful feel- 
ings with the idea of a handkerchief, which may always 
be presumed to have occurred in such cases of fetichism, 
probably is due to this. 

Case 110. A baker's assistant, aged thirty-two, sin- 
^|f, previously of good repute, was discovered stealing a 
handkerchief from a lady. In sincere remorse, he con- 
fessed that he had stolen from eighty to ninety such hand- 
kerchiefs. He had cared only for handkerchiefs, and, 
indeed, only for those belonging to young women attractive 
to him. In his outward appearance the culprit presented 
nothing peculiar. He dressed himself with much taste. 
His conduct was peculiar, anxious, depressed and unman- 
ly, and lie often lapsed into whining and tears. Lack of 
self-reliance, weakness of comprehension, and slowness of 

ption and reflection were noticeable. One of his sis- 
ters was epileptic. He lived in good circumstances ; never 
had a severe 1 illness; was well developed. In relating his 
history, he showed weakness of memory and lack of clear- 
ness ; calculation was hard for him, though when young he 
learned and comprehended easily. His anxious, uncertain 
<>f mind gave rise to a suspicion of onanism. The 
culprit confessed that he had been given to this practice 

>sively since his nineteenth year. For some years, as 



256 PSYCHOPATHIA SEXUALIS. 

a result of his vice, he had suffered with depression, lassi- 
tude, trembling of the limbs, pain, in the back, and disincli- 
nation for work. Frequently a depressed, anxious state 
of mind came over him, in which he avoided people. He 
had exaggerated, fantastic notions about the results of sex- 
ual intercourse with women, and could not bring himself 
to indulge in it. Of late, however, he had thought of mar- 
riage. With great remorse and in a weak-minded way, he 
now confessed that six months ago, while in a crowd, he 
became violently excited sexually at the sight of a pretty 
young girl, and was compelled to crowd up against her. 
He felt an impulse to compensate himself for the want of 
a more complete satisfaction of his sexual excitement, by 
stealing her handkerchief. Thereafter, as soon as he came 
near attractive females, with violent sexual excitement, 
palpitation of the heart, erection and impetus cceundi, the 
impulse would seize him to crowd up against them and 
faute de mieux, steal their handkerchiefs. Although the 
consciousness of his criminal act never left him for a 
moment, he was unable to resist the impulse. During the 
act he was uneasy, which was in part due to his inordinate 
sexual impulse, and partly to the fear of detection. The 
medico-legal opinion rightly gave weight to the congenital 
mental enfeeblement and the pernicious influence of mas- 
turbation, and referred the abnormal impulses to a per- 
verse sexual impulse, calling attention to the presence of 
an interesting and well-known physiological connection 
between olfactory and sexual senses. The inability to 
resist the pathological impulse was recognised. X. was 
not punished (Zippe, "Wiener Med. Wochenschrift," 
1879, No. 23). 

I am indebted to the kindness of Dr. Fritsch, of 
Vienna, for further facts concerning this handkerchief- 
fetichist, who was again arrested in August, 1890, in the 
act of taking a handkerchief from a lady's pocket : 

On searching his house, 446 ladies' handkerchiefs 



FETICIII8M. 257 

were found. I !< stated that In- had avready burned two 
bundles of them. In the course of tin examination, it 
was further shown that X. had been punished with im- 
prisonment for fourteen days in 1883 for stealing twenty- 

D handkerchiefs, and aguin with imprisonment for 
three weeks in 1886 for a similar crime. Concerning his 
relatives, nothing more could be learned than that his 
father was subject to congestions and that a brother's 
daughter was an imbecile and constitutionally neuro- 
pathic. X. had married in 1879, and embarked in an 
independent business, and in 1881 he made an assign- 
ment Soon af ^er that his wife, who could not live with 
him, and with whom he did not perform his marital 
duty (denied by X.), demanded a divorce. Thereafter he 
lived as assistant baker to his brother. He complained 
bitterly of an impulse for ladies' handkerchiefs, but when 
opportunity offered, unfortunately, he could not resist it. 
In the act he experienced a feeling of delight, and felt as 
if some one were forcing him to it. Sometimes he could 
restrain himself, but when the lady was pleasing to him 
he yielded to the first impulse. He would be wet with 
sweat, partly from fear of detection, and partly on account 
of the impulse to perform the act. He said he had been 
sexually excited by the sight of handkerchiefs belonging 
to women since puberty. He could not recall the exact cir- 
cumstances of this fetichistic association. The sexual 
excitement occasioned by the sight of a lady with 
handkerchief hanging out of her pocket had constantly 
increased. This had repeatedly caused erection, but nevef 
ejaculation. After his twenty-first year, he said, he had 
inclination to normal sexual indulgence, and had coitus 
without difficulty without ideas of handkerchiefs. With 
increasing fetichism, the appropriation of handkerchiefs 
had afforded him much more satisfaction than coitus. The 
appropriation of the handkerchief of a lady attractive to 
him was the same to him as intercourse with her would 
been. In the act he had true orgasm. 

If he could not gain possession of the handkerchief he 

17 



258 PSYCIIOPATIIIA 8EXUALIS. 

desired, he would become painfully excited, tremble ant! 
sweat all over. He kept separate the handkerchiefs of 
ladies particularly pleasing to him, and revelled in tlr> 
sight of them, taking great pleasure in it. The odour of 
them also gave him great delight, though he states that it 
was really the odour peculiar .to the linen, and not the 
perfume, which excited him sensually. He had mastur- 
bated but very seldom. 

X. complained of no physical ailments except occa- 
sional headache and vertigo. He greatly regretted his 
misfortune, his abnormal impulse, the evil spirit that 
impelled him to such criminal acts. He had but one 
wish: that some one might help him. Objectively there 
were mild neurasthenic symptoms, anomalies of the distri- 
bution of blood, and unequal pupils. 

It was proved that X. had committed his crimes in 
obedience to an abnormal, irresistible impulse. Pardon. 

Case 111. Z. began *o masturbate at the age of 
twelve. From that time he could not see a woman's 
handkerchief without having orgasm and ejaculation. He 
was irresistibly compelled to possess himself of it. At 
that time he was a choir boy and used the handkerchiefs 
to masturbate with in the bell-tower close to the choir. 
But he chose only such handkerchiefs as had black and 
white borders or violet stripes running through them. At 
fifteen he had coitus. Later on he married. As a rule, 
he was only potent when he wound such a handkerchief 
around his penis. Often he preferred coitus inter femora 
femince where he had placed a handkerchief. Wherever 
he espied a handkerchief he did not rest until he came in 
possession of it. He always had a number of them in his 
pockets and around his genitals (Rayneau, annales medico- 
psychol., 1895). 

Such cases of handkerchief-fetichism, where an abnor- 
mal individual is driven to theft, are very numerous. They 
also occur in combination with inverted sexuality, as is 



FETICHI8M. 259 



proved l>y the following ca^c, which I borrow from page 
' of Dr. Moll's frequently citl work: * 

Case 112. Handkerchief- fclichism in a case of an- 
tijxiilii'- srj-iinl instinct. K., agod thirty-eight; mechanic; 
a powerfully built man. He made numerous com- 
plaints, weakness of the legs, pain in the back, headache, 
want of pleasure in work, etc. The complaints gave the 
decided impression of neurasthenia with tendency to 
hypochondria. Only after the patient had been under 
Dr. Moll's treatment for several months did he state that 
he was also abnormal sexually. 

K. had never had any inclination whatever for women ; 
but handsome men, on the other hand, had a peculiar 
charm for him. Patient had masturbated frequently until 
he came to Dr. Moll. He had never practised mutual 
onanism or pederasty. He did not think that he would 
have found satisfaction in this, because, in spite of his 
preference for men, an article of white linen was his chief 
charm, though the beauty of its owner played a role. The 
handkerchiefs of handsome men particularly excited him 
sexually. His greatest delight was to masturbate in men's 
handkerchiefs. For this reason he often took his friends* 
handkerchiefs. In order to save himself from detection, 
he always left one of his own handkerchiefs with his 
friends in place of the one he stole. In this way he sought 
to escape the suspicion of theft, by creating the appearance 
of a mistake. Other articles of men's linen also excited 
K. sexually, but not to the extent that handkerchiefs 
did. 

On page 1<J1 (op. cit.) Dr. Moll writes concerning Una impulse 
in hetero- sexual individuals : " The passion for handkerchiefs may 
go so far that the man is entirely under its control. A woman tells 
me: 'I know a certain gentleman, and when I see him at a distance 
I only need to draw out my handkerchief so that it peeps out of 
ray pocket, and I am certain that he will follow me as a dog follows 
its master. Go where I please, this gentleman will follow me. He 
may be riding in a carriage or engaged in important business, and 
yet, when he see* my handkerchief he drops everything in order to 
follow me, . e., my handkerchief.'" 



260 PSYCHOPATIIIA 8EXUALIS. 

K. had often performed coitus with women, having 
erection and ejaculation, but without lustful pleasure. 
There was also nothing which could stimulate the patient 
to the performance of coitus. Erection and ejaculation 
occurred only when, during the act, he thought of a man's 
handkerchief; and this was easier for the patient when 
he took a friend's handkerchief with him and had it in his 
hand during coitus. In accordance with his sexual per- 
version, in his nightly pollutions with lustful ideas, men's 
linen played the. principal role. 1 

Still far more frequent than the f etichism of linen gar- 
ments is that of women's shoes. These cases are, in fact, 
almost innumerable, and a great many of them have been 
scientifically studied. I have but a few reports at third 
hand of similar glove-fetichism ; not to speak of case 
122 (vide infra), in which glove-fetichism develops itself 
merely into "stuff-f etichism". (Concerning the reason for 
the relative infrequency of glove-fetichism, vide above a). 

In shoe-fetichism the close relationship of the object 
to the feminine person, which explains linen-f etichism, is 
absolutely wanting. For this reason, and because there is 
a large number of well-observed cases at hand, in which 
the fetichistic enthusiasm for the female shoe or boot con- 
sciously and undoubtedly arises from masochistic ideas, 
an origin of a masochistic nature, even when it is con- 
cealed, may always be assumed in shoe-fetichism when, 
in the concrete case, no other manner of origin is demon- 
strable. For this reason the majority of the cases of 

1 Another case of temporary, t. e., periodical handkerchief- 
fetichism, accompanied by anxiety and severe sweating, is related by 
Dr. M oil in the " Centralblatt f. d. Krankheiten der Harn- und 
Sexual-organe," v., 8. This might be a case of latent epilepsy. 
(Trauma capitis at the age of ten, imbecility, repeated fainting fits, 
later on partial amnesia for fetichistic conditions, accompanied by 
anxiety and sweating, etc.) In these attacks of morbid impulse to 
steal ladies' handkerchiefs, which set in after an attack of typhus 
at the age of thirty, the patient would wipe his face with the stolen 
article, which act produced erection, and at times also ejaculation. 
A physician whom he consulted had given him the advice never to 
wear linen shirts again, as his peculiar impulse was caused by them. 



FETIC1II8M. 261 

shoe- or -foot-fetichisra have been given under "Maso- 
cliism. There the constant masochistic character of 
form of erotic fetichism has been sufficiently de- 
monstrated by means of transitional conditions. This 
presumption of the masochistic character of shoe-fetichism 
is weakened and removed only where another accidental 
cause for an association between sexual excitation and the 
idea of women's shoes the occurrence of which is quite 
improbable a priori is capable of proof. In the two 
following cases, however, there is such a demonstrable 
connection : 

Case 11 3. Shoe-fetichism. Mr. v. P., of an old and 
honourable family, Pole, aged thirty-two, consulted me, 
in 1890, on account of "unnaturalness" of his vita sexualis. 
lie gave the assurance that he came of a perfectly healthy 
family. He had been nervous from childhood, and had 
suffered with chorea minor at the age of eleven. For ten 
years he had suffered with sleeplessness and various neu- 
rasthenic ailments. From his fifteenth year he had recog- 
nised the difference of the sexes and been capable of sex- 
ual excitation. At the age of seventeen he had been 
seduced by a French governess, but coitus was not per- 
mitted; so that intense mutual sexual excitement (mutual 
masturbation) was all that was possible. In this situation 
his attention was attracted by her very elegant boots. 
Tli<'v made a very deep impression. His intercourse with 
tli is lewd person lasted four months. During this associa- 
tion her shoes became a fetich for the unfortunate lx>y. 
He Ix-^jin to have an interest in ladies' shoes in general, 
and actually went about trying to catch sight of ladies 
wearing pretty boots. The shoe-fetichism gained great 
power over his mind. He had the governess touch his 
j en is witli her shoes, and thus ejaculation with great lust- 
ful feeling was immediately induced. After separation 
from the governess he went to puellas, whom he made 

rni the same manipulation. This was usually suffi- 
cient for satisfaction. Only seldom did he resort to coitus 



262 PSYCHOPATHIA SEXUALJS. 

as an auxiliary, and inclination for it grew less and less. 
His vita sexualis consisted of dream-pollutions, in which 
women's shoes played the exclusive role; and of gratifica- 
tion with women's shoes appositos ad mentulam, but this 
had to be done by the puella. In the society of the 
opposite sex the only thing that interested him was the 
shoe, and that only when it was elegant, of the French 
style, with heels, and of a brilliant black, like the original. 
In the course of time the following conditions became 
accessory: a prostitute's shoe that was elegant and chic; 
starched petticoats, and black hose, if possible. Nothing 
else in woman interested him. Pie was absolutely indiffer- 
ent to the naked foot. Women have not the slightest psy- 
chic charm for him. He had never had masochistic desires 
in the sense of being trod upon. In the course of years 
his fetichism had gained such power over him that when 
he saw a lady in the street, of a certain appearance and 
with certain shoes, he was so intensely excited that he had 
to masturbate. Slight pressure on the penis sufficed to 
induce ejaculation in this state of severe neurasthenia. 
Shoes displayed in shops, and, of late, even advertise- 
ments of shoes, sufficed to excite him intensely. In 
states of intense libido he made use of onanism if shoes 
were not at his immediate command. The patient quite 
early recognised the pain and danger of his condition, 
and, even when he was free from neurasthenic ailments, 
he was morally very much depressed. He sought help of 
various physicians. Cold-water cures and hypnotism were 
unsuccessful. The most celebrated physicians advised 
him to marry, and assured him that, as soon as he once 
really loved a girl, he would be free from his fetichism. 
The patient had no confidence in his future, but he fol- 
lowed the advice of the physicians. He was cruelly dis- 
appointed in the hope which the authority of the physi- 
cians had aroused in him, though he led to the altar a 
lady distinguished by both mental and physical charms. 
The wedding night was terrible; he felt like a criminal, 
and did not approach his wife. The next day he saw a 



FETIC1II8M. 263 

prostitute with the required chic. lie was weak enough 
to have intercourse with her in his way. Then he bought 
a pair of elegant ladies' boots and hid them in bed, and, 
by touching them, while in marital embrace, after a few 
days, he was able to perform his marital duty. He ejacu- 
lated tardily, for he had to force himself to coitus; and 
after a few weeks this artifice failed, because his imagina- 
tion failed. lie felt unspeakably miserable, and would 
have preferred to make an end of himself. lie could no 
longer satisfy his wife, who was sensual, and much excited 
by their previous intercourse; and he saw her suffering 
severely, both mentally and morally. lie could not, and 
would not, disclose his secret. He experienced disgust in 
marital intercourse ; he felt afraid of his wife, and feared 
the coming of night and being alone with her. He could 
no longer induce erection. 

He again made attempts with prostitutes, and satisfied 
himself by touching their shoes. Then the puella had to 
touch his penis, when he would have ejaculation; but, 
if this did not take place, he would attempt coitus with 
the lewd woman; without success, however, for ejacula- 
tion would occur immediately. In absolute despair, the 
patient came for consultation. He deeply regretted that, 
against his inner conviction, he had followed the un- 
fortunate advice of the physicians, and made a virtuous 
wife unhappy, having deeply injured her, both mentally 
and morally. Could he answer God for continuing such 
a marriage? Even if he were to discover himself to his 
wife, and she were to do everything for him, it would not 
help him ; for the familiar perfume of the demi-monde was 
also necessary. 

Aside from his mental pain, this unfortunate man pre- 
sented no remarkable symptoms*. Genitals perfectly nor- 
mal. Prostate somewhat large. He complained that 
he was so under the domination of his boot-ideas that he 
would even blush when boots were talked about. His 
whole imagination was criven up to such ideas. When he 
was on his estate, he often suddenly had to go a distance 



264 P8YCHOPATHIA SEXUALIS. 

of ten. miles to the city, to satisfy his fetichism at shoe- 
shops or with puellis. 

This pitiable man could not bring himself to take 
treatment; for his faith in physicians had been greatly 
shaken. An attempt to ascertain whether hypnosis and 
a removal of the fetichistic association by this means, 
were possible, proved abortive on account of the mental 
excitement of the unfortunate man, who was exclusively 
controlled by the thought that he had made his wife un- 
happy. 

Case 114. X., aged twenty-four, from a badly taint- 
ed family (mother's brother and grandfather insane, one 
sister epileptic, another sister subject to migraine, parents 
of excitable temperament). During dentition he had 
convulsions. At the age of seven he was taught to mas- 
turbate by a servant-girl. X. first experienced pleasure 
in these manipulations cum ilia puella fortuito pede calce- 
olo tecto penem tetigit. Thus, in the predisposed boy, an 
association was established, as a result of which, from that 
time on, merely the sight of a woman's shoes, and, finally, 
merely the idea of them, sufficed to induce sexual excite- 
ment and erection. He now masturbated while looking at 
women's shoes, or while calling them up in imagination. 
The shoes of the schoolmistress excited him intensely, and 
in general he was affected by shoes that were partly con- 
cealed by female garments. One day he could not keep 
from grasping the teacher's shoes an act that caused him 
great sexual excitement. In spite of punishment he could 
not keep from performing this act repeatedly. Finally, 
it was recognized that there must be an abnormal motive 
in play, and he was sent to a male teacher. He then 
revelled in the memory of shoe-scenes with his former 
school-mistress, and thus had erections, orgasms, and, after 
his fourteenth year, ejaculation. At the same time, he 
masturbated while thinking of a woman's shoe. One day 
the thought came to him to increase his pleasure by using 
such a shoe for masturbation. Thereafter he frequently 
took shoes secretly, and used them for that purpose. 



FETICH ISM. 205 

else in a woman could excite him; the thought 
itus filled him with horror. Men did not interest 
him in any way. At the age of eighteen he opened a shop, 
and, among other things, dealt in ladies' shoes. He was 
-.\rit <! M-xually by fitting shoes for his female patrons, 
or hy manipulating shoes that came for mending. One day 
while doin<j; this he had an epileptic attack, and, soon after, 
another while practising onanism in his customary way. 
Then he recognised for the first time the injury to health 
caused by his sexual practices. He tried to overcome his 
onanism, sold no more shoes, and strove to free himself 
from the abnormal association between women's shoes and 
the sexual function. Then frequent pollutions, with erotic 
dreams about shoes, occurred, and the epileptic attacks con- 
tinued. Though devoid of the slightest feeling for the 
female sex, he determined on marriage, which seemed to 
him to be the only remedy. 

He married a pretty young lady. In spite of lively 
erections when he thought of his wife's shoes, in attempts 
at cohabitation he was absolutely impotent, because his 
distaste for coitus and for close intercourse in general was 
far more powerful than the influence of the shoe-idea, 
which induced sexual excitement. On account of his im- 
potence, the patient applied to Dr. Hammond, who treated 
his epilepsy with bromides, and advised him to hang a shoe 
up over his bed, and look at it fixedly during coitus, at the 
same time imagining his wife to be a shoe. The patient 
became free from epileptic attacks, and potent so that he 
could have coitus about once a week. His sexual excita- 
tion by women's shoes also grew less and less (Hammond, 
"Sexual Impotence"). 

These two cases of shoe-fetichism, 1 which apparently 

1 Other cases of shoe-fetichiam without distant relations to 
masochism are given by Alzheimer, " A Congenital Criminal," 
" Archiv f. Psychiatric u. Nerven Krankheiten," Bd. 28, p. 350. This 
same case was declared by Kurella, "Fetischiamus oder Simulation," 
ibid., Bd. 28, p. 904, to be imulation; but the reasons given are 
trivial and easily refuted. Vide also Moil, " Untersuchungcn liber 
libido sexualia." case 32. 



266 PSYCHOPATHIA SEXUALI8. 

depend upon subjective accidental associations, as is the 
case in fetichism generally, do not offer anything startling 
with reference to their objective cause, because, in the 
former case, it is only a matter of partial impression of 
the general appearance of woman, and in the latter, a 
partial impression of the exciting manipulation. 

But there are cases up till now only two have been 
closely" observed in which the determining association 
has decidedly not been brought about by any connection 
of the nature of the object with the otherwise normally 
exciting cause. 

Case 115. Shoe-fetichism. Kurella, in his "Natur- 
geschichte des Verbrechers," p. 213, tried to prove that 
this man was an imposter who invented an interesting 
nervous disease as a pretense for making a living by fraud. 
The author arrived at a different result 

O., born in 1865, student of theology, was tried, before 
a magistrate as a fraud and mendicant. He came from 
a heavily tainted family, was afflicted with shoe-fetichism, 
had from his twenty-first year periodical episodes in which 
he was irresistibly forced to run away and give himself up 
to drinking-bouts, although by doing so he knowingly 
jeopardised his position and property. When in the army 
he repeatedly deserted and became a veritable degenerate, 
an enigma to his superiors, for at times his conduct was 
exemplary and beyond blemish. 

Examined before a commission of army medical men, 
he was declared to suffer from "periodical insanity," in- 
herited beyond doubt. In consequence this "congenital 
criminal" was dismissed from service. He sank deeper 
and deeper in the mire, became a tramp, lived on his wits, 
and was confined several times in an insane asylum. 

The author found a pronounced asymmetry of the 
skull, and also the right foot much larger than the left, 
etc. 

O. was able to trace his shoe-fetichism back to his 
eighth year. At that time he had frequently at school 



FETICUISM. 267 

let things fall on tin- ground so that he might have a cause 
for coming near to the lady teacher's foot. Periodically 
the image of a woman's shoe impressed him so greatly that 
uld not resist tin- impulse to run away. 

This same impulse had been tin- cause of his vagrancy. 
lit In-Ill himself responsible for any punishable acts ho 
was guilty of. The author tested him as to the existence 
of his shoe-fetich ism and found definite proof that tin- 
same was not simulated. Kurella had assumed that tin' 
shoc-fetichism of the patient was a mere invention, in fact, 
had derived the idea from reading the author's book, 
"Psychopathia Sexualis," as other critics have done on 
similar occasions. 

It became quite evident that O. had never seen or 
heard of the book. (Cf. the original report of Kurella, 
in which his reasons for stamping O. a criminal, are given 
in extenso.) , 

The scientific observations made by the author in this 
case were based upon the following points, viz. : hereditary 
taint, asymmetry of the skull and other signs of degenera- 
tion, sexual perversion with periodical psychical manifes- 
tations in which irresistible perverse impulses forced the 
patient to abnormal thoughts and acts. 

Even during his lucid intervals, O. should not be held 
responsible for his actions, since nervous disturbances and 
other psychical anomalies in the shape of normal defects 
formed part of his degenerative psychopathic constitution. 

O. suffered from an inherited degenerative mania, and 
was to be considered a danger to society (Alzheimer, 
Archiv. f. Psychiatric, xxviii., 2). 

Case 116. L., aged thirty-seven, clerk, from tainted 
family, had his first erection at five years, when he saw 
his bed-fellow an aged relative put on his night-cap. 
The same thing occurred later, when he saw an old servant 
put on her night-cap. Later, simply the idea of an old, 
ugly woman's head, covered with a night-cap, was sufficient 
to cause an erection. The sight of a cap or of a naked 



268 PSYCHOPATHIA SEXUALJ8. 

woman or man only made no impression, but the mere 
touch of a night-cap induced erection, and sometimes even 
ejaculation. L. was not a masturbator, and had never 
been sexually active until his thirty-second year, when he 
married a young girl with whom he had fallen in love. 
On his marriage-night he remained cold until, from neces- 
sity he brought to his aid the memory-picture of an ugly 
woman's head with a night-cap. Coitus was immediately 
successful. Thereafter it was always necessary for him 
to use this means. Since childhood he had been subject 
to occasional attacks of depression, with tendency to sui- 
cide, and now and then to frightful hallucinations at night. 
When looking out of a window, he became dizzy and anx- 
ious. He was a perverse, peculiar, and easily embarrassed 
man, of bad mental constitution (Charcot-Magnan, "Arch, 
de neurol.," 1882, No. 12). 

In this very peculiar case, the simultaneous coinci- 
dence of the first sexual citation and an absolutely hetero- 
geneous impression seems to have determined the associa- 
tion. 

Hammond (op. cit.} also mentions a case of accidental 
associative fetichism that is quite peculiar. A married 
man, aged thirty, who, in other respects, was healthy, 
physically and mentally, is said to have suddenly lost his 
sexual power after moving to another house, and to have 
regained it as soon as the furniture of the sleeping-room 
had been arranged as it was before. 

(c) The Fetich is Some Special Material. 

There is a third principal group of fetichists who have 
as a fetich neither a portion of the female body nor a part 
of female attire, but some particular material which is so 
used, not because it is a material for female garments, but 
because in itself it can arouse or increase sexual feelings. 
Such materials are furs, velvets and silks. 

These cases differ from the foregoing instances of erotic 



FBTICUI8M. 260 

dress-fetichism, in this, that these materials, unlike female 
linen, do not have any close relation to the female body; 
and, unlike shoes and gloves, they are not related to cer- 
tain parts of the person which have peculiar symbolic sig- 
nificance. Moreover, this fetichism cannot be due to an 
accidental association, like that in the cases of the night- 
caps and the arrangement of the sleeping-room; for these 
cases form an entire group having the same object. It 
must be presumed that certain tactile sensations (a kind 
of tickling irritation which stands in some distant relation 
to lustful sensations?), in hypersesthetic individuals, fur- 
nish the occasion for the origin of this fetichisni. 

The following is a personal observation of a man af- 
fected with this peculiar fetichism: 

Case 117. N. N., aged thirty-seven; of a neuro- 
pathic family; neuropathic constitution. He made the 
following statement: "From my earliest youth I have al- 
ways had a deeply rooted partiality for furs and velvets, 
in so far that these materials cause me sexual excitement, 
and the sight and touch of them give me lustful pleasure. 
I can recall no event that caused this peculiarity (such as 
the simultaneous occurrence of the first sexual excitation 
and an impression of these materials, i. e. f first excitation 
by a woman dressed in them) ; in fact, I cannot remember 
when this enthusiasm began. However, by this I would 
not exclude the possibility of such an event, of an acci- 
dental connection in a first impression and consequent 
association; but I think it very improbable that such a 
thing took place, because I believe such an occurrence 
would have deeply impressed me. All I know is, that 
even when a small child I had a lively desire to see and 
stroke furs, and thus had an obscure sexual pleasure. 
With the first occurrence of definite sexual ideas, i.e., the 
direction of sexual thoughts to woman, the peculiar pre- 
ference for women dressed in such materials was present 
$ince then, up to mature manhood, it has remained un- 



270 PSYCHOPATHIA 8EXUALIS. 

changed. A" woman wearing furs or velvet, or, even bet- 
ter, both, excites me much more quickly and intensely than 
one devoid of these auxiliaries. To be sure, these materials 
are not a conditio sine qua non of excitation; the desire 
occurs also without them in response to the usual stimuli ; 
but the sight and, particularly, the touch of these fetich- 
materials form for me a powerful aid to other normal 
stimuli and intensify erotic pleasure. Often merely the 
sight of only a passably pretty girl dressed in these ma- 
terials causes me vivid excitement, and overcomes me com- 
pletely. Even the sight of my fetich-materials gives me 
pleasure, but the touch of them much more. (To the 
penetrating odour of furs I am indifferent rather, it is 
unpleasant and it is endurable only by reason of the 
association with pleasing visual and tactile impressions.) 
I have an intense longing to touch these materials 
while on a woman's person, to stroke and kiss them, 
and bury my face in them. My greatest pleasure is, 
inter actum, to see and feel my fetich on the woman's 
shoulder. 

"Fur, or velvet alone, exerts on me the effect described, 
the former much more intensely than the latter. The 
combination of the two has the most intense effect. Again, 
female garments made of velvet and fur, seen and touched 
when off the wearer, cause me sexual excitement; indeed, 
though to a less extent, the same effect is exerted by furs 
or robes having no relation to female attire, and also by 
the velvet and plush of furniture and drapery. Merely 
pictures of costumes of furs and velvet are objects of erotic 
interest to me; indeed, the very word "fur" has a magic 
charm, and immediately calls up erotic ideas. 

"Fur is such an object of sexual interest to me that a 
man wearing fur that is effective (v. infra) makes a very 
unpleasant, repugnant, and disgusting impression on me, 
such as would be made on a normal person by a man in 
the costume and attitude of a ballet-dancer. Similarly 
repugnant to me is the sight of an old or ugly woman clad 



FETICHISM. 271 

in beautiful furs, because contradicting feelings are thus 
aroused. 

"This erotic delight in furs and velvet is something 
entirely different from simple esthetic pleasure. I have a 
very lively appreciation of beautiful female attire, and, at 
the same time, a particular partiality for point-lace; but 
this is purely of an aesthetic nature. A woman dressed in 
a point-lace toilette (or in other elegant, elaborate attire) is 
more beautiful than another ; but one dressed in my fetich- 
material is more charming. 

"Furs, however, exercise on me the effect described 
only when the fur has very thick, fine, smooth and rather 
long hair, that stands out like that of the so-called bearded 
furs. I have noticed that the effect depends upon this. I 
am entirely indifferent not only to the ordinary, coarse, 
bushy furs, but also to those that are commonly regarded 
as beautiful and precious, from which the long hair has 
been removed (seal, beaver), or of which the hair is natu- 
rally short (ermine) ; and likewise to those of which the 
hair is overlong and lies down (monkey, bear). The speci- 
fic effect is exerted only by the standing long hair of the 
sable, marten, skunk, etc. Now, velvet is made of thick, 
fine, standing hairs (fibres) ; and its effect may be due to 
this. The effect seems to depend upon a very definite im- 
pression of the points of thick, fine hair upon the terminals 
of the sensory nerves. 

"But how this peculiar impression on the tactile nerves 
is related to sexual instinct is a perfect enigma to me. The 
fact is, that this is the case with many men. I would also 
state expressly that beautiful female hair pleases me, but 
plays no more important part than the other charms ; and 
that while touching fur I have no thought of female hair 
(the tactile sensation, also, has not the least resemblance 
to that imparted by female hair). There is never associa- 
tion of any other idea. Fur, per se, arouses sensuality in 
me, how, I cannot explain. 

"The mere aesthetic effect, the beauty of costly furs, 
to which every one is more or less susceptible, and which, 



272 FSYCHOPATHIA SEXUALIS. 

since Raphael's Fornarina and Reuben's Helene Four- 
raent, has been used as the foil and frame of female beauty 
by innumerable painters; which also plays so important a 
role in fashion, the art and science of female dress, this 
aesthetic effect, as has been remarked, explains nothing 
here. Beautiful furs have the same aesthetic effect on 
me as on normal individuals, and affect me in the same 
way that flowers, ribbons, precious stones, and other orna- 
ments affect every one. Such things, when skilfully used 
enhance female beauty, and thus, under certain circum- 
stances, may have an indirect sensual effect. They never 
have a direct, powerful, sensual effect on me, as do the 
fetich-materials mentioned. 

"Though in me, and, in fact, in all 'fetichists,' the 
sensual and aesthetic effect must be strictly differentiated, 
nevertheless, that does not prevent me from demanding in 
my fetich a whole series of aesthetic qualities in form, style, 
colour, etc. I could give a lengthy description of these 
qualities demanded by my tastes ; but I omit it as not being 
essential to the real subject in hand. I would only call 
attention to the fact that erotic fetichism is complicated 
with purely aesthetic tastes. 

"The specific erotic effect of my fetich-materials can 
be explained no better by the association with the idea 
of the person of the female wearing them, than by their 
aesthetic impression. For, in the first place, as has been 
said, these materials, as such, affect me when entirely 
isolated from the body; and, in the second place, articles 
of clothing of a much more private nature, and which 
undoubtedly call up associations, exert a much weaker 
influence over me. Thus the fetich-materials have an 
independent sensual value for me. Why, is an enigma 
to me. 

"Feathers in women's hats, fans, etc., have the same 
erotic fetichistic effect on me as furs and velvet (similar 
tactile sensation of airy, peculiar tickling). Finally, the 
fetichistic effect, with much less intensity, is exerted by 



FETICH18M. 273 

other smooth materials (satin and silk) ; but rough goods 
(cloth, flannel) have a repelling effect. 

"In conclusion, I will mention that somewhere I read 
an article by Carl Vogt on microccphalic men, according 
to which these creatures, at the sight of furs, rushed for 
them and stroked them with every manifestation of de- 
light. I am far from any thought, on this ground, to see 
in widespread fur-fetich ism an atavistic retrogression to 
the taste of our hairy ancestors. Every cretin, with that 
simplicity belonging to its condition, touches anything 
that pleases him, and the act is not necessarily of a sexual 
nature; just as many normal men like to stroke a cat and 
the like, or even velvet furs, and are not thus excited 
sexually." 

In the literature of this subject, there are a few cases 
belonging here: 

Case 1 18. A boy, aged twelve, became powerfully 
excited sexually, when, by chance, he covered himself with 
a fox-skin. Prom that time on there was masturbation 
with the employment of furs, or by means of taking a 
furry dog to bed. Ejaculation would result, sometimes 
followed by an hysterical attack. His nocturnal pollu- 
tions were induced by dreaming that he lay entirely cov- 
ered up in a soft skin. He was absolutely insusceptible 
to stimuli coming from men or women. He was neu- 
rasthenic, suffered with delusions of being watched, and 
thought that every one noticed his sexual anomaly. He 
had toedium vitce on account of this, and finally became in- 
sane. He had marked taint ; his genitals were imperfectly 
formed, and he presented other signs of degeneration 
(Tarnowsky, op. cit., p. 22). 

Case 119. C., was an especial lover of velvet. He 
was attracted in a normal way by beautiful women, but it 
particularly excited him to have the person with whom 
he had sexual intercourse dressed in velvet In this, it 

18 



274 PSYCHOPATIIIA SEXUALIS. 

was remarkable that it was not so much the sight as the 
touch of the velvet that caused the excitation. C. told 
me that stroking a woman's velvet jacket would excite him 
sexually to an extent scarcely possible in any other way 
(Dr. Moll, op. c\i., p. 127). * 

A physician communicated to me the following 
case : 

In a brothel a man was known under the name of 
"Velvet". He would dress a sympathetic puella with a 
garment made of black velvet, and would excite and satisfy 
his sexual desires simply by stroking his face with a corner 
of her velvety dress, not touching any other part of the 
person at all. 

Another authority assures me that this weakness for 
furs, velvets and silks and feathers, is quite common among 
masochists (cf. case 50). * 

The following is a very peculiar case of material- 
fetichism. It is combined with the impulse to injure the 
fetich, which, in this case, represents an element of sadism 
toward the woman wearing the fetich, or impersonal 
sadism toward objects, which is of frequent occurrence 
in fetichists (cf. p. 253). This impulse to cause injury 
made this a remarkable criminal case: 

Case 120. In July, 1891, Alfred Bachman, aged 
twenty-five, locksmith, was brought before Judge N., in 
the second term of the criminal court, in Berlin. In 
April, 1891, the police had had numerous complaints, 
according to which some evil hand had cut women's 

lln the novels of Sacher-Masoch, fur plays an important rdle; 
in fact, it serves as a title in some of them. The explanation given 
is that fur (crmin) is the symbol of sovereignty, and therefore the 
fetich of the men described in these novels, seems unsatisfactory and 
far-fetched. 



FETICHISM. 275 

dresses with a very sharp instrument. In the evening of 
25th April, tlu-y were successful in arresting the perpe- 
trator in the person of the accused. A policeman noticed 
how the accused pressed, in a remarkable manner, against 
a lady in the company of a gentleman, while they were 
going through a passage. The officer requested the lady 
to examine her dress, while he held the man under 
suspicion. It was ascertained that the dress had received 
quite a long slit. The accused was taken to the station, 
where he was examined. Besides a sharp knife, which 
he confessed he used for cutting dresses, two silk sashes, 
such as ladies wear on their dresses, were found on him; 
he also confessed that he had taken these from dresses 
in crowds. Finally, the examination of his person brought 
to light a lady's silken neck-scarf. The accused said he had 
found this. Since his statement in this case could not be 
refuted, complaint was therefore made to rest on the result 
of the search; in two instances in which complaint was 
made by the injured parties his acts were designated as 
injury to property, and in two other instances as theft 
The accused, a man who had been often punished before, 
with a pale, expressionless face, before the judge, gave a 
strange explanation of his enigmatical action. A major's 
cook had once thrown him downstairs when he was 
begging of her, and since that time he had entertained 
great hatred of the whole female sex. There was a doubt 
about his responsibility, and he was therefore examined 
by a physician. The medical expert gave the opinion at 
the final trial that there was no reason to regard the 
accused as insane, though he was of low intelligence. 
The culprit defended himself in a peculiar manner. An 
irresistible impulse forced him to approach women wear- 
ing silk dresses. The touch of silk material gave him a 
feeling of delight, and this went so far that, while in 
prison for examination, he had been excited if a silk thread 
happened to pass through his fingers while ravelling rags. 
Judge Miiller considered the accused to be simply a dan- 
gerous, vicious man, who should be made harmless for a 



276 PSYCHOPATIIIA SEXDALJS. 

long time. He advised imprisonment for one year. The 
court sentenced him to six months' imprisonment, with 
loss of honour for a year. 

A classical case of material-fetichism (silk) is the 
following related by Dr. P. Gamier: 

Case 121. On 22nd September, 1881, V. was ar- 
rested in the streets of Paris whilst he interfered with 
the silk dresses of a lady in a manner which aroused the 
suspicion of his being a pick-pocket. At first he was very 
much confused, but finally, after many vain excuses, made 
a clean confession of his "mania". He was twenty-nine 
years of age, an assistant in a bookseller's shop ; his father 
was a drunkard and a religious zealot, his mother of ab- 
normal character. She wished to make a priest of him. 
Since his early youth he felt an instinctive impulse con- 
genital as he believes to touch silk. When at the age 
of twelve as a choir boy he was allowed to wear a silk 
sash, he could not often enough finger it. He could not 
describe the peculiar sensation which he experienced in 
doing so. Later on he became acquainted with a ten- 
year-old girl for whom he had a childish affection. When 
on Sundays he met this girl clad in a silk dress, he was 
impelled to lovingly put his arms around her and touch 
her silk dress. Later he found exceeding great pleasure 
in gazing at the silk gowns exposed in a dressmaker's 
shop and to feel them. 

When they gave him remnants of silk material, he 
would hasten to put them next to his body, which act im- 
mediately produced erection, orgasm and even ejaculation. 
These lustful desires made him uneasy, so that he doubted 
his vocation to the priesthood and obtained his discharge 
from the seminary. In consequence of habitual mastur- 
bation he was at that time very neurasthenic. His silk- 
fetichism swayed him as ever. Only when a woman wore 
a silk gown could she charm him. 

Even when a child, ladies with silk gowns played a 



FETICIIISM. 277 

j.r. 'iiiiiient part in his dreams; later on the latter were 
accompanied l>y pollutions On account of his natural 
shyne.-s lie did not resort to coitus until later in life, 
and then he could only succeed in it with a woman 
I in silk. He much preferred to mix with crowds in 
the street and there t<uch the silk gowns of ladies, which 
always produced ejaculation accompanied by powerful 
-in.- and intense lustful feelings. What gratified him 
more than Ix-ing with the prettiest woman was to put 
on a silk petticoat when going to bed. 

The forensic medical opinion declared him to be a 
heavily tainted subject who gave way to abnormal 
desires under the strain of morbid impulses. Pardon 
(Dr. Gamier, "Annales d'hygiene publique," 3 e serie, 
xxix., 5). 

The following case of kid-glove- fetichism is peculiarly 
adapted to show the origin of fetichistic associations as 
well as the enormous influence permanently exercised by 
such an association, although itself based upon a psychico- 
physical and morbid predisposition. 

Case 122. Mr. Z., an American, thirty-three years 
of age, manufacturer, for eight years enjoying a happy 
married life, blessed with offspring; consulted me for a 
peculiar troublesome glove-fetichism. He despised him- 
self on account of it, and said it brought him well nigh 
to the verge of despair and even insanity. 

He claimed to come of thoroughly sound parents, but 
since infancy had been neuropathic and very excitable. 
By nature he was very sensual, whilst his wife was very 
frigid. 

At the age of nine, he was seduced by schoolmates to 
practise masturbation, which gratified him immensely, 
and he yielded to it with passion. 

One day when sexually excited he found a small bag 
of chamois skin, lie stripped it over his membrum and 
experienced thereby great sensual pleasure. After that 



278 PSYCHOPATHIA SEXUALI8. 

he used it for onanistic manipulations, put it around his 
scrotum and carried it about with him day and night. 
This aroused in him an unusual interest for leather in 
general, but particularly for kid gloves. 

With puberty this centered entirely in ladies' kid 
gloves, which simply fascinated him. If he touched his 
penis with one such glove it produced erection and even 
ejaculation. 

Men's gloves did not excite him in the least, although 
he loved to wear them. 

In consequence, nothing about woman attracted him 
but her kid gloves. These were his fetich. They must 
be long, with many buttons, and if worn out, dirty and 
saturated with perspiration at the finger-tips, they were 
preferable. Women wearing such, even if ugly and old, 
had a particular charm for him. Ladies with silk, or 
cotton gloves did not attract him. He always looked at 
her gloves first when meeting a lady. As for the rest 
he took very little interest in the female sex. 

When he could shake hands with a lady gloved with 
kid, the contact with the soft, warm leather would cause 
erection and orgasm in him. 

Whenever he could get hold of such a glove he would 
at once retire to a lavatory, wrap it around his genitals 
and masturbate. 

Later on when visiting brothels he would beg the 
puella to put on long gloves provided by himself for that 
purpose, which act alone would excite him so much that 
ejaculation ensued forthwith. 

Z. became a collector of ladies' kid gloves. He would 
hide away hundreds of pairs in various places. These 
he would count and gloat over in his spare time, "as a 
miser would over his gold," place them over his genitals, 
bury his face in a pile of them, put one on his hand 
and then masturbate. This gave him more intense pleasure 
than coitus. 

He made covers for his penis of them, or suspensories, 
wearing them for days. He preferred black, soft leather^ 



FETICHISM. 279 

He would fasten ladies' kid gloves around his waist in 
such a fashion that they would, apron-like, hang down 
over his genitals. 

After marriage this fetichism grew worse. As a rule 
he was only virile when he put a pair of his wife's gloves 
during coitus by her head so that he could kiss them. 

The acme of pleasure was when he could persuade his 
wife to put on kid gloves and thus touch his genitals 
previous to cohabitation. 

Z. felt very unhappy on account of this fetichism, and 
made repeated but vain attempts to free himself of the 
curse. 

Whenever he came across the word, or the picture 
of a glove in novels, fashion-plates, advertisements, etc., 
he was simply fascinated. At the theatre his eyes were 
riveted on the hands of the actresses. He could scarcely 
tear himself away from the show-windows of glove-dealers. 
He often would stuff long gloves with wool or some 
such material to make them resemble arms and hands. 
Then he would make tritus membri inter brachia talia arti- 
ficialia, until he had achieved his object. 

It was his habit to take ladies' kid gloves to bed with 
him and wrap them around his penis until he could feel 
them like a large leathern priapus between his legs. 

In the larger towns he bought from the cleaners ladies* 
gloves which had not been called for, but preferred those 
most soiled and worn. Twice he admitted to have yielded 
to the temptation to steal such gloves, although in every 
other respect he was absolutely correct. When in a crowd 
he must touch ladies' hands whenever possible. At his 
office he allowed no opportunity to pass without shaking 
hands with ladies, in order to fool for "at least a second 
the soft, warm leather". His wife must wear as much as 
possible kid gloves or such made v <-^o.m<MA. with which 
he provided her lavishly. 

At his office he always had ladies' gloves lying on h>* 
desk. Not an hour passed in which he did not toucB 



280 PSYCHOPATHIA SEXUALI8. 

and stroke them. When especially excited (sexually) he 
put such a glove in his mouth and chewed it. 

Other articles of the female toilet, likewise other parts 
of the female body besides the hand, did not attract him. 
Z. felt much depressed about this anomaly. He felt 
ashamed to look into the innocent eyes of his children, 
and prayed God to protect them from this curse of their 
father. 

The object of fetichism may also be found in a thing 
which only by sheer accident stands in relation to the body 
of woman, as may be gathered from the following instance 
related by Moll. It proves, moreover, how by the merely 
accidental association of an apperception with a parallel 
sexual emotion based, of course, upon a special psychic 
process the object of such apperception may become a 
fetich which in its turn may some day disappear again. 

The theory of association in connection with original 
perverse manifestations (based on organo-psychical mo- 
tives) seems here quite acceptable. The same may be 
said of the data relating to masochism and sadism. 

Case 123. B., thirty years of age, apparently un- 
tainted, refined and sensitive ; great lover of flowers ; liked 
to kiss them, but without any sensual motive or sensual 
excitement ; rather of natura frigida; did not before twen- 
ty-one practise onanism, and subsequently only at periods. 
When twenty-one he was introduced to a young lady who 
wore some large roses on her bosom. Ever since then 
large roses dominated over his sexual feelings. He in- 
cessantly bought roses; kissing them would produce erec- 
tion. He took them to bed with him although he never 
touched his genitals with them. His pollutions henceforth 
were accompanied by dreams of roses. He would dream 
of roses of fairy-like beauty and, inhaling their fragrance, 
have ejaculation. 

He became secretly engaged to his "lady of roses," 
but the platonic relations grew colder, and when the 



.' III8M. 281 

engagement was broken off tlio rose-fetirlii.-m suddenly 
ami prniianrntly <li. -appeared. It never returned, even 
\\hfii he became again engaged after a long spell of 
melancholia (4. Moll, "Centralb. f. d. Krankheiten der 
1 1 urn- mid Sexual-organe," v., 3). 

(d) Beast-fctichism. 

In close relation to stuff-fetichism, certain cases must 
be considered in which 'beasts exercise an aphrodisical 
influence over human beings. One feels tempted to call 
it Zoophilia Erotica. 

This perversion seems to be rooted in a fetichism the 
object of which is the skin of the beast. 

The transmitting medium of this fetichism may, 
perhaps, be found in a peculiar idiosyncrasis of the 
tactile nerves which, by touching furs or animal skins, 
produces peculiar and lustful emotions (analogous to 
hair-, braid-, velvet-, and silk-fetichism). This may, 
perhaps, also explain that peculiar hobby for cats and 
dogs at times met with in sexually perverted persons 
(vide especially case 118). The following case, coming 
under my personal observation, seems to favour this as- 
sumption. 

Case 124. Zoophilia erotica, fetichism. Mr. N. N., 
twenty-one years of age, from a neuropathically tainted 
family, himself congenitally neuropathic. Even as a 
child he often felt impelled to perform at times quite in- 
different actions for fear of encountering some untoward 
event. lie learned easily, never had a severe illness, and 
early a great love for domestic animals, especially dogs 
and cats, because when petting them he experienced lustful 
emotions. For years he indulged in this play with ani- 
mals, which sensually stimulated him, although in an 
innocent fashion, as it were. When he arrived at the age 
of puberty he recognized the immorality of his acts and 
tried to free himself from the habit. lie succeeded in this, 



282 P8YC1IOPATHIA SEXUAL1S. 

but henceforth he was troubled in his dreams by such 
situations which produced pollutions. He then began 
onanism. At first he practised if by manipulation accom- 
panied by the idea that he was petting and stroking ani- 
mals. After some time he arrived at psychical onanism, 
produced by vividly imagining such situations, and ac- 
companied by orgasm and ejaculation. This made him 
neurasthenic. 

He claimed that sodomitic ideas never entered his 
mind, that the sexus bcstiarum never influenced his fancies 
or actions, in fact he had given it no thought. 

He never had homosexual instinct; but heterosexual 
desires were not foreign to him, though he had never 
indulged in coitus because of want of libido (ex masturba- 
tione et neurasthenia!) and from fear of infection. He was 
drawn only to women of lithe figure and with a proud 
gait. 

The usual symptoms of cerebro-spinal neurasthenia 
were present. Patient was of slight build and anaemic. He 
was greatly concerned to know whether his lost virility 
could be restored, as this would raise his waning self- 
esteem. 

Suggestions how to avoid psychic onanism, to remove 
neurasthenia, to strengthen the sexual centres, to satisfy 
the vita sexualis in the normal way as soon as this should 
be possible and successful. 

Epicrisis. No bestiality, but fetichism. Very likely 
the petting of domestic animals coupled with an abnormally 
premature vita sexualis coincided with a primary sexual 
emotion probably originating from tactile sensations 
and thus established an association between the two facts 
which by repetition became permanent ("Zeitschr. f. Psy- 
chiatric," Bd. 50). 

Antipathic Sexuality. 

After the attainment of complete sexual development, 
among the most constant elements of self-consciousness in 



ANTII'ATIIK 1 SEXUALITY. 283 

the individual are the knowledge of representing a definite 
sexual personality and the consciousness of desire, during 
tlu> period of physiological activity of the reproductive 
organs (production of semen and ova), to perform sexual 
acts corresponding with that sexual personality, acts 
which, consciously or unconsciously, have a procreative 
purpose. 

The sexual instinct and desire, save for indistinct 
feelings and impulses, remain latent until the period of 
development of the sexual organs. The child is generis 
neutrius; and though, during this latent period, when 
sexuality has not yet risen into clear consciousness, is but 
virtually present, and unconnected with powerful organic 
sensations, abnormally early excitation of the genitals 
may occur, either spontaneously or as a result of external 
influence, and find satisfaction in masturbation ; yet, 
notwithstanding this, the psychical relation to persons of 
the opposite sex is still absolutely wanting, and the sexual 
acts during this period exhibit more or less a reflex spinal 
character. 

The existence of innocence, or of sexual neutrality, is 
the more remarkable, since very early in education, employ- 
ment, dress, etc., the child undergoes a differentiation from 
children of the opposite sex. These impressions remain, 
however, devoid of psychical significance, because they 
apparently are stripped of sexual meaning ; for the central 
organ {cortex) of sexual emotions and ideas is not yet 
capable of activity, owing to its undeveloped condition. 

With the inception of anatomical and functional 
development of the generative organs, and the differen- 
tiation of form belonging to each sex, which goes hand 
in hand with it (in the boy as well as in the girl), rudi- 
Jments of a mental fppling ftf>r rp ?p nm ling with the sex 
jure developed ; jind in this of c"iir-e, education and 
external influences in p-neral have a powerful .-tTecr upon 
the individual, who now begins to observe. 

If the sexual development is normal and undisturbed, 
a definite character, corresponding with the sex, is devel- 



284 PSYCHOPATIIIA 8EXUALI8. 

oped. Certain well-defined inclinations and reactions in 
intercourse with persons of the opposite sex arise; and 
it is psychologically worthy of note with what relative 
rapidity each individual psychical type corresponding with 
the sex is evolved. 

While modesty, for instance, during childhood, is 
essentially but an uncomprehended and incomprehensible 
exaction of education and imitation, expressed but im- 
perfectly in the innocence and naivete of the child; in 
the youth and maiden it becomes an imperative require- 
ment of self-respect; and, if in any way it is offended, 
intense vaso-motor reaction (blushing) and psychical 
emotions are induced. 

If the original constitution is favourable and normal, 

and factors injurious to the psycho-sexual development 

exercise no adverse influence, then a psycho-sexual 

\ personality is developed which is so unchangeable and 

! corresponds so completely and harmoniously with the sex 

/ of the individual in question, that subsequent loss of the 

generative organs (as by castration), or the climacterium 

or senility, cannot essentially alter it. 

This, however, must not be taken as a declaration that 
the castrated man or woman, the youth and the aged 
man, the maiden and the matron, the impotent and the 
potent man, do not differ essentially from each other ill 
their psychical existence. 

An interesting and important question for what follows 

is, whether the peripheral influences of the generative 

fglands (testes and ovaries), or central cerebral conditions, 

! are the determining factors in psycho-sexual development. 

The fact that congenital deficiency of the generative? 

glands, or removal of them before puberty, have a great 

influence on physical and psycho-sexual development, so 

that the latter is stunted and assumes a type more closely 

resembling the opposite sex (eunuchs, certain viragoes, 

etc.), betokens their great importance in this respect. 

That the physical processes taking place in the genital 



ANTIPATHIC SEXUALITY. 285 

organs are only co-operative, and not the exclusive factors, 
in the process of development of the psycho-sexual char- 
acter, is shown by the fact that, notwithstanding a normal 
anatomical and physiological state of these organs, a sexual 
instinct may be developed which is the exact opposite of 
that characteristic of the sex to which the individual 
belongs. 

In this case, the cause is to be sought only in an anom- 
aly of central conditions, in an abnormal psycho-sexual 
constitution. This constitution, as far as its anatomical 
and functional foundation is concerned, is as yet unknown. 
Since, in nearly all such cases, the individual tainted with 
antipathic sexual instinct displays a neuropathic predispo- 
sition in several directions, and the latter may be brought 
into relation with hereditary degenerate conditions, this 
anomaly of psycho-sexual feeling may be called, clinically, 
a functional sign of degeneration. This inverted sexuality 
appears spontaneously, without external cause, with the 
development of sexual life, as an individual manifestation 
\of an abnormal form of the vita sexualis, having the force 
of a congenital phenomenon ; or it develops iipon a sexuality 
the beginning of which was normal, as a result of very 
definite injurious influences, and thus appears as an ac- 
quired anomaly. Upon what conditions this enigmatical 
phenomenon of acquired homo-sexual instinct depends, 
remains still unexplained, and is a mere matter of hypo- 
thesis. Careful examination of the so-called acquired 
cases makes it probable that the predisposition also 
present here consists of a latent. homo-sexuality, or, at 
any rate, bi-sexuality, which, for its manifestation, re- 
quires the influence of accidental exciting causes to rouse 
it from its dormant state. 

In so-called antipathic sexual instinct there are degrees 
of the phenomenon which quite correspond with the de- 
grees of predisposition of the individuals. Thus, in the 
milder cases, there is simple hermaphroditism ; in more 
pronounced cases, only homo-sexual feeling and instinct, 
but limited to the vita sexualis; in still more complete 



286 PSYCHOPATHIA SEXUAIIS. 

cases, the whole psychical personality, and even the bodily 
sensations, are transformed so as to correspond with the 
sexual inversion; and, in the complete cases, the physical 
form is correspondingly altered. 

The following division of the various phenomena of 
this psycho-sexual anomaly is made, therefore, in accord- 
ance with these clinical facts. 

A. Homo-sexual Feeling as an Acquired Manifestation in 
Both Sexes. 

The determining factor here is the demonstration of 
perverse feeling for the same sex; not the proof of sexual 
acts with the same sex. These two phenomena must not 
be confounded with each other; perversity must not be 
taken for perversion. 

Perverse sexual acts, without being dependent upon 
perversion, often come under observation. This is. espe- 
cially true with reference to sexual acts between persons 
of the same sex, particularly in pederasty. Here paroes- 
thesia sexualis is not necessarily at work; but hyperaes- 
thesia, with physical or psychical impossibility for natural 
sexual satisfaction. 

Thus we find homo - sexual intercourse in impotent 
masturbators or debauchees, or faute de mieux in sensual 
men and women under imprisonment, on ship-board, in 
garrisons, bagnios, boarding-schools, etc. 

There is an immediate return to normal sexual inter- 
course as soon as the obstacles to it are removed. Very 
frequently the cause of such temporary aberration is 
masturbation and its results in youthful individuals. 

Nothing is so prone to contaminate under certain 
circumstances, even to exhaust the source of all noble 
and ideal sentiments, which arise of themselves from a 
normally developing sexual instinct, as the practice of 
masturbation in early years. It despoils the unfolding bud 
of perfume and beauty, and leaves behind only the coarse, 
animal desire for sexual satisfaction. If an individual, 



HOMO-SEXUAL FEELING IN BOTH SEXES. 287 

thus (Irjirnvcd, reaches the age of maturity, there is 
wanting in liiiu that aesthetic, ideal, pure and free impulse 
which draws the opposite sexes together. The glow of 
sensual sensibility wanes, and the inclination toward the 
opposite sex is weakened. This defect influences the 
morals, the character, fancy, feeling and instinct of tho 
youthful masturbator, male or female, in an unfavourable 
manner, even causing, under certain circumstances, the 
desire for the opposite sex to sink to nil; so that masturba- 
tion is preferred to the natural mode of satisfaction. 

Sometimes the development of the nobler sexual feel- 
ings toward the opposite sex suffers, on account of hypo- 
chrondriacal fear of infection in sexual intercourse; or 
on account of an actual infection ; or as a result of a faulty 
education which points out such dangers and exaggerates 
them. Again (especially in females), fear of the result of 
coituj^Jj^regmmfiy), or abhorrence of men, by reason of 
physical or moral defects, may direct into perverse chan- 
inels an instinct that makes itself felt with abnormal in- 
tensity. On the other hand, premature and perverse 
sexual satisfaction injures not merely the mind, but also 
the body; inasmuch as it induces neuroses of the sexual 
apparatus (irritable weakness of the centres governing 
erection and ejaculation; defective pleasurable feeling in 
coitus, etc.), while, at the same time, it maintains imagin- 
ation and libido in continuous excitement. 

Almost every masturbator at last reaches a point 
\vhere, frightened on learning the results of the vice, or on 
experiencing them (neurasthenia), or led by example or 
seduction to the opposite sex, he wishes to free himself 
of the vice and re-instate his vita sexnalis. 

The moral and mental conditions are here the most 
unfavourable possible. The pure glow of sexual feeling is 
destroyed ; the fire of sexual instinct is wanting, and self- 
confidence is lost ; for every masturbator is more or less 
timid and cowardly. If the youthful sinner at last comes 
to make an attempt at coitus, he is either disappointed 
because enjoyment is wanting, on account of defective 



288 PSYCHOPATH 1 A SKXUALIS. 

eensual feeling, or he is lacking in the physical strength 
necessary to accomplish the act. This fiasco has a fatal 
effect, and leads to absolute psychical impotence. A bad 
conscience and the memory of past failures prevent suc- 
cess in any further attempts. The ever present libido 
sexualis, however, demands satisfaction, and this moral 
and mental perversion separates further and further from 
woman. 

For various reasons, however, (neurasthenic complaints, 
hypochondriacal fear of results, etc.), the individual is 
also kept from masturbation. At times, under such cir- 
cumstances, bestiality is resorted to. Intercourse with the 
same sex is then near at hand, as the result of seduction 
or of the feelings of friendship which, on the level of patho- 
logical sexuality, easily associate themselves with sexual 
feelings. 

Passive and mutual onanism now become the equivalent 
of the avoided act. If there is a seducer, which, un- 
fortunately often happens, then the cultivated pederast 
is produced, i.e., a man who performs quasi acts of onan- 
ism with persons of his own sex, and, at the same time, 
feels and prefers himself in an active role corresponding 
with his real sex; who is mentally indifferent not only to 
persons of the opposite sex, but also to those of his own. 

Sexual aberration reaches this degree in the normally 
constituted, untainted, mentally healthy individual. No 
case has yet been demonstrated in which perversity has 
been transformed into perversion i.e., into an inversion 
of the sexual instinct. 1 

1 Gamier ("Anomalies Sexuelles," Paris, pp. 508, 509) reports 
two cases (cases 222 and 223) that are apparently opposed to this 
assumption, particularly the first, in which despair about the unfaith- 
fulness of a lover led the individual to submit to the seductions of 
men. But the case itself clearly shows that this individual never 
found pleasure in homo-sexual acts. In case 223, the individual waa 
effeminated ab origine, or was at least a psychical hermaphrodite. 

Those who hold to the opinion that the origin of homo-sexual 
feelings and instinct is found to be exclusively in defective education 
and other psychological influences are entirely in error. 

An untainted male may be raised ever so much like a female, 



HOMO-SEXUAL FEELING 1 289 

With l<iint<d individuals, the matter is quite different 
The latent perverse sexuality is developed under the influ- 
ence of neurasthenia induced 1>\ ma.-turhation, abstinence, 
or other 

Gradually, in contact with persons of the same sex, 
sexual excitation by them is induced. Related ideas are 
coloured with lustful feelings, and awaken corresponding 
desires. This decidedly degenerate reaction is the begin- 
ning of a process, of physical and mental transformation, 
a description <>f which is attempted in what follows, and 
which is one of the most interesting psychological phenom- 
ena that have been observed. This metamorphosis pre- 
sents different stages, or degrees. 

1. Degree: Simple Reversal of Sexual Feeling. 

This degree is attained when a person exercises an 

\aphrodisiac effect over another person of the same sex 

'who reciprocates the sexual feeling. Character and in- 

Btinct, however, still correspond with the sex of the indi- 

and a female like a male, but they will not become homo-sexual. 

The natural disposition is the determining condition; not education 

nn>l oth-r mSndcntal circumstances, I :'.< m <lu<-ti',. T!i.-r- mu he no 

thought of antipathic sexual instinct save when the person of the 

same sex exerts a psycho-sexual influence over the individual, and 

thus brings About libido and orgasm,-^t!~c., has a psychical attrac- 

tion. Those cases are quite different in which, faute de micux, with 

I great sensuality and a defective aesthetic sense, the body of a person 

I of the same sex is used for an onanistic act (not for coitus in a 

(psychical sense). 

In his excellent monograph, Moll shows very clearly and con- 
vincingly the importance of original predisposition in contrast with 
exciting causes (cf. op. cit., pp. 212-231). He knows "many cases 
where early sexual intercourse with men was not capable of inducing 
perversion." Moll significantly says, further: "I know of such an 
epidemic (of mutual onanism) in a Berlin school, where a person, 
who is now an actor, shamelessly introduced mutual onanism. 
Though I now know the names of very many urnings in Berlin, yet 
I could not ascertain, even with anything like probability, that among 
all the pupils of that school at that time there was one that had 
become an urning; but, on the other hand, I have quite certain 
knowledge that many of those pupils are now normal sexuallv. in 
feeling and intercourse. 

19 



290 PSYCHOPATHIA SEXUALI8. 

vidual presenting the reversal of sexual feeling. He feels 
himself in the active role; he recognizes his impulse 
toward his own sex as an aberration, and finally seeks 
aid. 

With episodical improvement of the neurosis, at first 
even normal sexual feelings may reappear and assert 
themselves. The following case seems well suited to 
exemplify this stage of the psycho-sexual degeneration: 

Case 125. Acquired Antipathic Sexual Instinct. "I 
am an official, and, as far as I know, come from an un- 
tainted family. My father died of an acute disease; my 
mother, still living, is very nervous. A sister has been very 
intensely religious for some years. 

"I myself am tall, and, in speech, gait and manner, 
give a perfectly masculine impression. Measles is the 
only disease I have had; but since my thirteenth year I 
have suffered with so-called nervous headaches. 

"My sexual life began in my thirteenth year, when 
I became acquainted with a boy somewhat older than 
myself, quocum alter alterius genitalia tangendo delectdbar. 
I had the first ejaculation in my fourteenth year. Seduced 
to onanism by two older school-mates, I practised it partly 
with others and partly alone; in the latter case, however, 
always with the thought of persons of the female sex. My 
libido sexualis was very great, as it is to-day. Later, I 
tried to win a pretty, stout servant-girl who had very 
large mammae; id solum assecutus sum, ut me prsesente 
superiorem corporis sui partem enudaret mihique conce- 
deret os mammasque osculari, dum ipsa penem meum 
valde erectum in manum suam recepit eumque trivit. 

"Quamquam violentissime coitum rogarem hoc solum 
concessit, ut genitalia ejus tangerem. 

"After going to the university, I visited a brothel and 
succeeded without special effort. 

"Then an event occurred which brought about a change 
in me. One evening I accompanied a friend home, and 
in a mild state of intoxication I grasped him ad genitalia. 



HOMO-SEXUAL FEELING IN BOTH BETES. 201 

He made but slight opposition. I then went up to his 
room with him, and we practised mutual masturbation. 
From that time we indulged in it quite frequently; in 
fact, it came to immissio penis in os, with resultant ejacu- 
lations. But it is strange that I was not at all in love with 
this person, but passionately in love with another friend, 
near whom I never felt the slightest sexual excitement, and 
whom I never connected with sexual matters, even in 
thought. My visits to brothels, where I was gladly re- 
ceived, became more infrequent; in my friend I found 
a substitute, and did not desire sexual intercourse with 
women. 

"We never practised pederasty. That word was not 
even known between us. From the beginning of this rela- 
tion with my friend, I again masturbated more frequently, 
and naturally the thought of females receded more and 
more into the background, and I thought more and more 
about young, handsome, strong men with the largest pos- 
sible genitals. I preferred young fellows, from sixteen to 
twenty-five years old, without beards, but they had to 
be handsome and clean. Young labourers dressed in 
trousers of Manchester cloth or English leather, partic- 
ularly masons, especially excited me. 

"Persons in my own position had hardly any effect on 
me ; but, at the sight of one of those strapping fellows of 
the lower class, I experienced marked sexual excitement. 
It seems to me that the touch of such trousers, the open- 
ing of them and the grasping of the penis, as well as 
kissing the fellow, would be the greatest delight. My 
sensibility to female charms is somewhat dulled ; yet in 
sexual intercourse with a woman, particularly when she 
has well-developed mammce, I am always potent without 
the help of imagination. I have never attempted to make 
use of a young labourer, or the like, for the satisfaction of 
my. evil desires, and never shall ; but I often feel a longing 
to do it. I often impress on myself the mental image of 
such a man, and then masturbate at home. 

"I am absolutely devoid of taste for female work. I 



292 PSYCHOPATIIIA SEXUALI8. 

rather like to move in female society, but dancing is 
repugnant to me. I have a lively interest in the fine arts. 
That my sexual sense is partly reversed is, I believe, in 
part due to greater convenience, which keeps me from 
entering into a relation with a girl; as the latter is a 
matter of too much trouble. To be constantly visiting 
houses of prostitution is, for aesthetic reasons, repugnant 
to me ; and thus I am always returning to solitary onanism, 
vvhich is very difficult for me to avoid. 

"Hundreds of times I have said to myself that, in 
order to have a normal sexual sense, it would be neces- 
sary for me, first of all, to overcome my irresistible passion 
for onanism, a practice so repugnant to my aesthetic 
feeling. Again and again I have resolved with all my 
might to fight this passion; but I am still unsuccessful. 
When I felt the sexual impulse gaining strength, instead 
of seeking satisfaction in the natural manner, I preferred 
to masturbate, because I felt that I would thus have more 
enjoyment. 

"And yet experience has taught me that I am always 
potent with girls, and that, too, without trouble and with- 
out the vision of masculine genitals. In one case, how- 
ever, I did not attain ejaculation because the woman it 
was in a brothel was devoid of every charm. I cannot 
avoid the thought and severe self-accusation that, to a 
certain extent, my inverted sexuality is the result of 
excessive onanism; and this especially depresses me, be- 
cause I am compelled to acknowledge that I scarcely feel 
strong enough to overcome this vice by the force of my 
own will. 

"As a result of my relations for years with a fellow- 
student and pal, mentioned in this communication 
which, however, began while we were at the university, 
and after we had been friends for seven years the im- 
pulse to unnatural satisfaction of libido has grown much 
stronger. I trust you will permit the description of an 
incident which worried me for months : 

"In the summer of 1882, I made the acquaintance 



lloMCHSEXUAL FEELINO IN BOTH SEXES. 293 

of a companion six years younger than myself, who, with 
several others, had been introduced to me and my ac- 
quaintances. I very soon felt a deep interest in this 
handsome man, who was unusually well-proportioned, 
slim, and full of health. After a few weeks of associa- 
tion, this liking ripened into friendship, and at last into 
passionate love, with feelings of the most intense jealousy. 
I very soon noticed that in this love sexual excitation was 
also very marked ; and, notwithstanding my determina- 
tion, aside from all others, to keep myself in check in 
relation to this man, whom I respected so highly for his 
superior character, one night, after free indulgence in 
beer, as we were enjoying a bottle of champagne in my 
room, and drinking to good, true and lasting friendship, 
I yielded to the irresistible impulse to embrace him, etc. 
"When I saw him next day, I was so ashamed that 
I could not look him in the face. I felt the deepest regret 
for my action, and accused myself bitterly for having thus 
sullied this friendship, which was to be and remain so 
pure and precious. In order to prove to him that I had 
lost control of myself only momentarily, at the end of 
the semester I urged him to make an excursion with me; 
and after some reluctance, the reason of which was only 
too clear to me, he consented. Several nights we slept 
in the same room without any attempt on my part to 
repeat my action. I wished to talk with him about the 
event of that night, but I could not bring myself to it; 
even when, during the next semester, we were separated, 
I could not induce myself to write to him on the subject ; 
and when I visited him in March at X., it was the same. 
And yet I felt a great desire to clear up this dark point 
by an open statement. In October of the same year I 
was again in X., and this time found courage to speak 
without reserve; indeed, I asked him why he had not 
resisted me. He answered that, in part, it was because 
he wished to please me, and, in part, owing to the fact 
that he was somewhat apathetic as a result of being a 
little intoxicated. I explained to him my condition, and 



294 PSYCHOPATIIIA SEXUALJS. 

also gave him "Psychopathia Sexualis" to read, express- 
ing the hope that by the force .of my own will I should 
become fully and lastingly master of my unnatural im- 
pulse. Since this confession, the relation between this 
friend and me has been the most delightful and happy 
possible; there are the most friendly feelings on both 
sides, which are sincere and true; and it is to be hoped 
that they will endure. 

"If I should not improve my abnormal condition, I 
am determined to put myself under your treatment; the 
more because, after a careful study of your work, I can- 
not count myself as belonging to the category of so-called 
urnings; and also because I have the firm conviction, or 
hope, at least, that a strong will, assisted and combined 
with skilful treatment, could transform me into a man 
of normal feeling." 

Case 126. lima S., 1 aged twenty-nine; single, mer- 
chant's daughter; of a family having bad nervous taint. 
Father was a drinker and died by suicide, as also did the 
patient's brother and sister. A sister suffered with con- 
vulsive hysteria. Mother's father shot himself while in- 
sane. Mother was sickly, and paralysed after apoplexy. 
The patient never had any severe illness. She was bright, 
enthusiastic and dreamy. Menses at the age of eighteen 
without difficulty ; but thereafter they were very irregular. 
At fourteen, chlorosis and catalepsy from fright. Later, 
hysteria gravis and an attack of hysterical insanity. At 
eighteen, relations with a young man which were not pla- 
tonic. This man's love was passionately returned. From 
statements of the patient, it seemed that she was very 
sensual, and after separation from her lover practised 
masturbation. After this she led a romantic life. In order 
to earn a living, she put on male clothing, and became a 
tutor ; but she gave up her place because her mistress, 
not knowing her sex, fell in love with her and courted her. 

1 Cf. author's " Experimental Study in the Domain of Hyp- 
notism," third edition, 1893. 



lloMK-M \f.\l 111! ..Til SEXES 20.") 



she Iwvame a railway employee. In tin- eompa; 

rompani'-ns, in order to conceal 1 -he was com- 

pelled to visit hrothels with them, and hear the most vul- 
gar stories. This became so distasteful to her that she 
gave up her place, resumed the garments of a female, and 
again sought to earn her living. She was arrested for 
theft, and on account of severe hystero-epilepsy was sent 
to the hospital. There inclination and impulse toward the 
same sex were discovered. The patient became trouble- 
some on account of passionate love for female nurses and 
patients. 

Her sexual inversion was considered congenital. With 
regard to this, the patient made some interesting state- 
ments : 

"I am judged incorrectly, if it is thought that I feel 
myself a man toward the female sex. In my whole thought 
and feeling I am much more a woman. Did I not love 
my cousin as only a woman can love a man ? 

"The change of my feelings originated in this, that, in 
Pesth, dressed as a man, I had an opportunity to observe 
my cousin. I saw that I was wholly deceived in him. That 
gave me terrible heart-pangs. I knew that I could neve'r 
love another man; that I belonged to those who love but 
once. Of similar effect was the fact that, in the society 
of my companions at the railway, I was compelled to hear 
the most offensive language and visit the most disreputa- 
ble houses. As a result of the insight into men's motives, 
gained in this way, I took an unconquerable dislike to 
them. However, since I am of a very passionate nature 
and need to have some loving person on whom to depend, 
and to whom I can wholly surrender myself, I felt myself 
more and more powerfully drawn toward intelligent women 
and girls who were in sympathy with me." 

The antipathic sexual instinct of this patient, which 
< -learly acquired, expressed itself in a stormy and de- 
cidedly sensual way, and was further augmented by mas- 
turbation; because constant control in hospitals made sex- 
ual satisfaction with the same sex impossible. Character 



296 P8YCHOPATHIA SEXUALI8. 

and occupation remained feminine. There were no man- 
ifestations of viraginity. According to information lately 
received by the author, this patient, after two years of 
treatment in an asylum, was entirely freed from her neu- 
rosis and sexual inversion, and discharged cured. 

Case 127. Mr. X., aged thirty-five, single, civil 
servant; mother insane, brother hypochondriacal. 

Patient was healthy, strong, of lively sensual tempera- 
ment. He had manifested powerful sexual instinct abnor- 
mally early, and masturbated while yet a small boy. He 
had coitus the first time at the age of fourteen, with en- 
joyment and complete power. When fifteen years old, 
a man sought to seduce him, and performed manustupra- 
tion on him. X. experienced a feeling of repulsion, and 
freed himself from the disgusting situation. At maturity 
he committed excesses in libido, with coitus; in 1880 he 
became neurasthenic, being afflicted with weakness of erec- 
tion and ejaculatio prcecox. He thus became less and less 
potent, and no longer experienced pleasure in the sexual 
act. At this period of sexual decadence, for a long time 
he still had what was previously foreign to him, still 
incomprehensible to him, an inclination for sexual inter- 
course with immature girls of the age of twelve or thir- 
teen. His libido increased as virility diminished. 

Gradually he developed inclination for boys of thirteen 
or fourteen. He was impelled to approach them. 

Quodsi ei occasio data est ut tangere posset pueros qui 
ei placuere, penis vehementer se erexit turn maxime quum 
crura puerorum tangere potuisset. Abhinc feminas non 
cupivit. Nonnunquam feminas ad coitum coegit sed erectio 
debilis, ejaculatio prsematura erat sine ulla voluptate. 

Now only youths interested him. He dreamed about 
them and had pollutions. After 1882 he now and then 
had opportunity concwnbere cum juvenibus. This led to 
powerful sexual excitement, which he satisfied by mas- 
turbation. It was quite exceptional for him to venture 
touching his bed-fellow and indulging in mutual mas- 



BOMO-OKXUAL 1 IX BOTH SEXES. 297 

turbation. Ho shunned pederasty. For the most part, he 
was coiiiju 11. .1 to satisfy his sexual needs by means of 
solitary masturbation. In the act he called up the vision 
of pleasing boys. After sexual intercourse with such boys, 
he always felt strengthened and refreshed, but morally 
depressed; because there was consciousness of having 
performed a perverse, indecent and punishable act. He 
found it painful that his disgusting impulse was more 
powerful than his will. 

X. thought that his love for his own sex had resulted 
from great excess in natural sexual intercourse, and be- 
moaned his situation. On the occasion of a consultation, 
in December, 1889, he asked me whether there were any 
means to bring him back to a normal sexual condition, 
since he had no real horror femince, and would very gladly 
marry. 

This intelligent patient, free from degenerative signs, 
presented no abnormal symptoms except those of sexual 
and spinal neurasthenia in a moderate degree. 

//. Degree: Eviration and Defemination. 

If, in cases of antipathic sexual instinct thus developed, 
no restoration occurs, then deep and lasting transforma- 
tions of the psychical personality may occur. The process 
completing itself in this way may be briefly designated 
eviration (defemination in woman). The patient under- 
goes a deep change of character, particularly in his feelings 

and inclinations, which thus become those of a female. 

7 

; After this, he also feels himself to be a woman during the 
sexual act, has desire only for passive sexual indulgence, 
and, under certain circumstances, sinks to the level of a 
prostitute. In this condition of deep and more lasting 
psycho-sexual transformation, the individual is like unto 
the (congenital) urning of high grade. The possibility of a 
restoration of the previous mental and sexual personality 
teems in such a case, precluded. 



298 PSYCHOPATHIA SEXUALIS. 

The following case is a classical example of this variety 
of lasting acquired antipathic sexual instinct: 

Case 128. Sch., aged thirty, physician, one day told 
me the story of his life and malady, asking for explana- 
tion and advice concerning certain anomalies for his vita 
sexualis. The following description gives, for the most 
part verbatim, the details of the autobiography; only in 
some portions it is shortened : 

"My parents were healthy. As a child I was sickly; 
but with good care I thrived, and got on well in school. 
When eleven years old, I was taught to masturbate by my 
playmates, and gave myself up to it passionately. Until 
I was fifteen, I learned easily. On account of frequent 
pollutions, I became less capable, and did not get on well in 
school, and was uncertain and embarrassed when called 
on by the teacher. Frightened by my loss of capability, 
and recognising that the loss of semen was responsible for 
it, I gave up masturbation; but the pollutions became 
even more frequent, so that I often had two or three in a 
night. In despair, I now consulted one physician after 
another. None were able to help me. 

"Since I grew weaker and weaker, by reason of the 
loss of semen, with the sexual appetite growing more and 
more powerful, I sought houses of prostitution. But I was 
there unable to find satisfaction; for, even though the 
sight of a naked female pleased me, neither orgasm nor 
erection occurred ; and even manustupration by the puella 
was not capable of inducing erection. Scarcely would I 
leave the house, when the impulse would seize me again, 
and I would have violent erections. I grew ashamed 
before the girls, and ceased to visit such houses. Thus a 
couple of years passed. My sexual life consisted of pollu- 
tions. My inclination toward the opposite sex grew less 
and less. At nineteen I went to the university. The 
theatre had more attractions for me: I wished to become 
an actor. My parents were not willing. At the metro- 
polis I was compelled now and then to visit girls with my 



HOMO-SEXUAL FEELING IN BOTH SEXES. 299 

comrades. I feared such a situation; because I knew that 
coitus was impossible for me, and because my friends 
might discover my impotence. Then-fure, I avoided, as 
far as possible, the danger of becoming the butt of their 
jokes and ridicule. 

"One evening, in the opera-house, an old gentleman 
sat near me. He courted me. I laughed heartily at the 
foolish old man, and entered into his joke. Exinopinato | 
genitalia mea prehendit, quo facto statim penis meus se 
erexit. Frightened, I demanded of him what he meant. 
He said that he was in love with me. Having heard of 
hermaphrodites in the clinics, I thought I had one before 
me, and became curious to see his genitals. The old man 
was very willing, and went with me to the water closet. 
Sicuti penem maximum ejus erectum adspexi, perterritus 
effugi. 

"This man followed me, and made strange proposals 
which I did not understand, and repelled. He did not give 
me any rest. I learned the secrets of male love for males, 
and felt that my sexuality was excited by it. But I 
resisted the shameful passion (as I then regarded it) and, 
for the next three years, I remained free from it. During 
this time I repeatedly attempted coitus with girls in vain. 
My attempts to free myself of my impotence by means of 
medical treatment were also in vain. Once, when my 
libido scxualis was troubling me again, I recalled what 
the old man had told me : that male-loving men were accus- 
tomed to meet on the E. Promenade. 

After a hard struggle, and with beating heart, I went 
there, made the acquaintance of a blonde man, and allowed 
myself to be seduced. The first step was taken. This 
kind of sexual love was satisfactory to me. I always pre- 
ferred to be in the arms of a strong man. The satisfaction 
consisted of mutual manustupration ; occasionally in 
oscuhim ad penem alterius. I was then twenty-three years 
old. Sit ti MI;, together with my comrades, on the beds of 
patients in the clinic during the lectures, excited me so 
intensely that I could scarcely listen to the lectures, In, 



300 PSYCHOPATHIA SEXUALIS. 

the same year I entered into a formal love-relation with a 
merchant of thirty-four. We lived as man and wife. X. 
played the man, and fell more and more in love. I gave 
up to him, but now and then I had to play the man. After 
a time I grew tired of him, became unfaithful and he* 
grew jealous. There were terrible scenes, which led to 
temporary separation, and finally to actual rupture. (The 
merchant afterwards became insane, and died by suicide.) 

"I made many acquaintances, and loved the most or- 
dinary people. I preferred those having a full beard, 
who were tall and of middle age, and able to play the active 
role well. I developed a proctitis. The professor thought 
it was the result of sitting too much while preparing for 
examinations. I developed a fistula, and had to undergo 
an operation ; but this did not cure me of my desire to let 
myself be used passively. I became a physician and went 
to a provincial town, where I had to live like a nun. I 
developed a desire to move in ladies' society, and was 
gladly welcomed there; because it was found that I was 
not so one-sided as most men, and was interested in 
toilettes and such feminine things. However, I felt very 
unhappy and lonesome. Fortunately, in this town, I made 
the acquaintance of a man, a 'sister,' who felt like me. 
For some time I was taken care of by him. When he 
had to leave I had an attack of despair, with depression, 
which was accompanied by thoughts of suicide. 

"When it became impossible for me to longer endure 
the town, I became a military surgeon in the capital. 
There I began to live again, and often made two or three 
acquaintances in one day. I had never loved boys or 
young people ; only fully developed men. The thought of 
falling into the hands of the police was frightful. Thus 
far I have escaped the clutches of the blackmailer. At the 
same time, I could not keep myself from the gratification 
of my impulse. After some months I fell in love with an 
official of forty. I remained true to him for a year, and 
we lived like a pair of lovers. I was the wife and was 
formally courted by the lover. One day I was transferred 



IloMO-SEXUAL FEELING IN BOTH SEXES. 301 

to a small town. We were in despair. The last night was 
spent in e. -niinually kissing and caressing one another. 

"In T. 1 was nn.-peakably unhappy, in spite of some 
'sisters' whom I found. I could not forget my lover. In 
order to satisfy my sexual desire, whieli cried for satis- 
faction, I chose soldiers. Money obtained men ; but they 
remained cold, and I had no enjoyment with them. I 
was successful in being retransferred to the capital, where 
there was a new love relation, but much jealousy; because 
my lover liked to go into the society of 'sisters,' and was 
proud and coquettish. There was a rupture. I was very 
unhappy and very glad to be transferred from the capital. 
I now stayed in C., alone and in despair. Two infantry 
privates were brought into service, but with the same 
unsatisfactory results. When shall I ever find true love 
again ? 

"I am over medium height, well developed, and look 
somewhat aged; and, therefore, when I wish to make 
conquests I use the arts of the toilet. My manner, move- 
ments and face are masculine. Physically I feel as youth- 
ful as a boy of twenty. I love the theatre, and especially 
art. My interest in the stage is in the actresses, whose 
every movement and gesture I notice and criticise. 

"In the society of gentlemen I am silent and em- 
barrassed, while in the society of those like myself I am 
free, witty, and as fawning as a cat if a man is sympathetic. 
If I am without love, I become deeply melancholic; but 
the favours of the first handsome man dispel my depres- 
sion. In other ways I am frivolous and very ambitious. 
My profession is nothing to me. Masculine pursuits do 
not interest me. I prefer novels and going to the theatre. 
I am effeminate, sensitive, easily moved, easily injured 
and nervous. A sudden noise makes my whole body trem- 
ble, and I have to collect myself in order to keep from 
crying out." 

Remarks: The foregoing case is certainly one of ac- 
quired antipathic sexual instinct, since the sexual instinct 



302 P8YCHOPATHIA SEXUAI.IS. 

and impulse were originally directed toward the female 
sex. Sch. became neurasthenic through masturbation. 

As an accompanying manifestation of the neurasthenic 
neurosis, lessened impressionability of the erection-centre 
and consequent relative impotence developed. As a result 
of this, sexual sensibility toward the opposite sex de- 
creased, with simultaneous persistence of libido sexualis. 
The acquired antipathic sexual instinct must be abnormal, 
since the first touch by a person of the same sex is an 
adequate stimulus for the erection-centre. The perverse 
sexual feeling becomes complete. At first Sch. felt like a 
man in the sexual act; but more and more, as the change 
progressed, the feeling and desire of satisfaction changed 
to the form which, as a rule, characterises the (congenital) 
urning. 

This eviration induces a desire for the passive role, 
and, further, for (passive) pederasty. It makes a creeper 
impress on the character. The character becomes femi- 
nine, inasmuch as Sch. now prefers to move in the society 
of actual females, has an increasing desire for feminine 
occupations, and indeed makes use of the arts of the toilet 
in order to improve his fading charms and make "con- 
quests". 

The foregoing facts concerning acquired antipathic 
sexual instinct and effemination find an interesting con- 
firmation in the following ethnological data: 

Herodotus already describes a peculiar disease which 
frequently affected the Scythians. The disease consisted 
in this: that men became effeminate in character, put 
on female garments, did the work of women, and even 
became effeminate in appearance. As an explanation of 
this insanity of the Scythians, 1 Herodotus relates the myth 



l Cf. Sprengel, "Apologie des Hippokrates," Leipzig, 1792, p. 611; 
Friedreich, " Literargeschichte der psych. Krankheiten," 1830, p. 
31; Lallemand, "Des pertes s^minales," Paris, 1836, L, p. 581; Nysten, 
11 Dictlonn. de mfciecine," xi. edit., Paris, 1858, Art. " Eviration et 



HOMO-SEXUAL FEELING IN BOTH BEXE8. 303 

that the goddess Venus, angered by the plundering of the 
temple at Ascalon by the Scythians, had made women of 
these plunderers and their posterity. 

Hippocrates, not believing in supernatural diseases, re- 
cognised that impotence was here a causative factor, and 
explained it, though incorrectly, as due to the custom of 
the Scythians to have themselves bled behind the ears in 
order to cure disease superinduced by constant horse-back 
riding. He thought that these veins were of great import- 
ance in the preservation of the sexual powers, and that 
when they were severed, impotence was induced. Since 
the Scythians considered their impotence due to divine 
punishment and incurable, they put on the clothing of 
females, and lived as women among women. 

It is worthy of note that, according to Klaproth ("Reise 
in dem Kaukasus," Berlin, 1812, v., p. 285) and Chotom- 
ski, even at the present time impotence is very frequent 
among the Tartars, as a result of riding unsaddled horses. 
The same is observed among the Apaches and Navajos 
of the western continent who ride excessively, scarcely 
ever going on foot, and are remarkable for small genitals 
and mild libido and virility. Sprengel, Lallemand and 
Nysten recognise the fact that excessive riding may be 
injurious to the sexual organs. 

Hammond reports analogous observations of great in- 
terest concerning the Pueblo Indians of New Mexico. 
These descendants of the Aztecs cultivate so-called "mu- 
jerados," of which every Pueblo tribe requires one in the 
religious ceremonies (actual orgies in the spring), in which 
pederasty plays an important part In order to cultivate 
a "mujerado," a very powerful man is chosen, and he 
is made to masturbate excessively and ride constantly. 
Gradually such irritable weakness of the genital organs is 
engendered that, in riding, great loss of semen is induced. 
This condition of irritability passes into paralytic im- 

Maladie dps Scythes"; Marandon, " De la maladie des Scythe*"; 
" Animl. me<Hco-psychol.," 1877, Mars, p. 161 ; Hammond, "American 
Journal of Neurology and Psychiatry," August, 1882. 



304 PSYCHOPATHIA B&XUALIS. 

potence. Then atrophy of the testicles and penis sets in, 
the hair of the beard falls out, -the voice loses its depth 
and compass, and physical strength and energy decrease. 
Inclinations and disposition become feminine. The "mu- 
jerado" loses his position in society as a man. He takes 
on feminine manners and customs, and associates with 
women. Yet, for religious reasons, he is held in honour. 
It is probable that, at other times than during the festivals 
he is used by the chiefs for pederasty. Hammond had 
an opportunity to examine two "mujerados". One had be- 
come such seven years before, and was thirty-five years 
old at the time. Seven years previous, he was entirely 
masculine and potent. He had noticed gradual atrophy 
of the testicles and penis. At the same time he lost libido 
and the power of erection. He differed in nowise, in 
dress and manner, from the women among whom Ham- 
mond found him. The genital hair was wanting, the 
penis was shrunken, the scrotum lax and pendulous, and 
the testicles were very much atrophied and no longer 
sensitive to pressure. The "mujerado" had large mamma} 
like a pregnant woman, and asserted that he had nursed 
several children whose mothers had died. A second "mu- 
jerado," aged thirty-six, after he had been ten years in 
the condition, presented the same peculiarities, though 
with less development of mammae. Like the first, the 
voice was high and thin. The body was plump. 

///. Degree: Stage of Transition to Metamorphosis Sex- 
ualis Paranoia. 

A further degree of development is represented by 
those cases in which physical sensation is also transformed 
in the sense of a transmutatio sexus. In this respect the 
following case is unique : 

Case 129. Autobiography. "Born in Hungary in 
1844, for many years I was the only child of my parents; 
for the other children died for the most part of general 
weakness. A brother of later birth is still living. 



li "MO-SEX UAL 1 : : SEXES. 305 

"I come of a family in which nervous and mental 
diseases have 'been numerous. It is said that I was very 
pretty as a little child, with blonde locks and transparent 
skin ; very obedient, quiet and modest, so that I was taken 
\\here in the society of ladies without any offence on 
my part. 

"With a very active imagination my enemy through 
life my talents developed rapidly. I could read and write 
at the age of four; my memory reaches back to my third 
year. I played with everything that fell into my hands, 
with leaden soldiers, or stones, or ribbons from a toy-shop; 
but a machine for working in wood, that was given to me 
as a present, I did not like. I liked best to be at home 
with my mother, who was everything to me. I had two 
or three friends with whom I got on good-naturedly; but 
I liked to play with her sisters quite as well, who always 
treated me like a girl, which at first did not embarrass me. 
I must have already been on the road to become just like 
a girl; at least, I can still well remember how it was 
always said: 'He is not intended for a boy.' At this I 
tried to play the boy, imitated my companions in every- 
thing, and tried to surpass them in wildness. In this I 
succeeded. There was no tree or building too high for 
me to reach its top. I took great delight in soldiers. I 
avoided girls more, because I did not wish to play with 
their playthings ; and it always annoyed me that they 
treated me so much like one of themselves. 

"In the society of mature people, however, I .was 
always modest, and, also, always regarded with favour. 
Fantastic dreams about wild animals which once drove 
me out of bed without waking me frequently troubled 
me. I was always very simple but very elegantly dressed, 
and thus developed a taste for beautiful clothing. It seems 

liar to me that, from the time of my school-days, I 
had a partiality for ladies' gloves, which I put on secretly 
as often as I could. Thus, when once my mother was 
iilmut to give away a pair of gloves, I made great opposi- 
tion to it, and told her, when she asked why I acted so, 

20 



306 PSYCHOPATHIA SEXUALIS. 

that I wanted them myself. I was laughed at ; and from 
that time I took good care not to display my preference 
for female things. Yet my delight in them was very great. 
I took especial pleasure in masquerade costumes i.e., only 
in female attire. If I saw them, I envied their owners. 
What seemed to me the prettiest sight was: two young 
men, beautifully dressed as white ladies, with masks on; 
and yet I would not have shown myself to others as a girl 
for anything ; I was so afraid of being ridiculed. At school 
I worked very hard, and was always among the first. 
From childhood my parents taught me that duty came 
first; and they always set me an example. It was also a 
pleasure for me to attend school; for the teachers were 
kind, and the elder pupils did not plague the younger ones. 
We left my first home; for my father was compelled, on 
account of his business, which was dear to him, to sepa- 
rate from his family for a year. We moved to Germany. 
Here there was a stricter, rougher manner, partly in 
teachers and partly in pupils; and I was again ridiculed 
on account of my girlishness. My schoolmates went so 
far as to give a girl, who had exactly my features, my 
name, and me hers ; so that I hated the girl. But I later 
came to be on terms of friendship with her after her 
marriage. My mother tried to dress me elegantly; but 
this was repugnant to me, because it made me the 
object of taunting. So, finally, I was delighted when 1 
had correct trousers and coats. But with these came a 
new annoyance. They irritated my genitals, particularly 
when the cloth was rough; and the touch of tailors while 
measuring me, on account of their tickling, which almost 
convulsed me, was unendurable, particularly about the 
genitals. Then I had to practise gymnastics; and I 
simply could do nothing at all, or only indifferently the 
things that even girls can do easily. While bathing I was 
troubled by feeling ashamed to undress; but I liked to 
bathe. Until my twelfth year I had a great weakness in 
my back. I learned to swim late, but ultimately so well 
that I took long swims. At thirteen I had pubic hair, and 



HOMO-SEXUAL FEELING IN lioTII UXK8. 307 

was about six fWt tall; l>ut my face was feminine until 
my eighteenth year, when my beard came in abundance 
and gave me rest from resemblance to woman. An 
inguinal hernia that was acquired in my twelfth year, 
a ixl cured when I was twenty, gave me much trouble, 
particularly in gymnastics. Besides, from my twelfth 
year on, I had, after sitting long, and particularly while 
working at night, an itching, burning and twitching, 
extending from the penis to my back, which the acts of 
Mtting and standing increased, and which was made 
worse by catching cold. But I had no suspicion what- 
ever that this could be connected with the genitals. Since 
none of my friends suffered in this way, it seemed strange 
to me; and it required the greatest patience to endure it; 
the more owing to the fact that my abdomen troubled me. 
"In sexualibus I was still perfectly innocent ; but now, 
as at the age of twelve or thirteen, I had a definite feeling 
of preferring to be a young lady. A young lady's form 
was more pleasing to me; her quiet manner, her deport- 
ment, but particularly her attire, attracted me. But I was 
careful not to allow this to be noticed ; and yet I am sure 
that I should not have shrunk from the castration-knife, 
could I have thus attained my desire. If I had been asked 
to say why I preferred female attire, I could have said 
nothing more than that it attracted me powerfully; per- 
haps, also, I seemed to myself, on account of my uncom- 
monly white skin, more like that of a girl. The skin 
of my face and hands, particularly, was very sensitive. 
Girls liked my society; and, though I should have pre- 
ferred to have been with them constantly, I avoided them 
when I could ; for I had to exaggerate in order not to ap- 
pear feminine. In my heart I always envied them. I was 
particularly envious when one of my young girl friends got 
l"ii<: dresses and wore gloves and veils. When, at the age 
of fifteen, I was on a journey, a young lady, with whom I 
was boarding, proposed that I should mask as a lady and go 
out with her; but, owing to the fact that she was not alone, 
I did not acquiesce, much as I should have liked it. While 



308 PSYCHOPATHIA SEXUALIS. 

on this journey, I was pleased at seeing boys in one city 
wearing blouses with short sleeves, and the arms bare. A 
lady elaborately dressed was like a goddess to me; and if 
even her hand touched me coldly I was happy and envi- 
ous, and only too gladly would have put myself in her 
place in the beautiful garments and lovely form. Never- 
theless, I studied assiduously, and passed through the 
Realschule and the Gymnasium in nine years, passing a 
good final examination. I remember, when fifteen, to have 
first expressed to a friend the wish to be a girl. In answer 
to his question, I could not give the reason why. At 
seventeen I got into fast society; I drank beer, smoked, 
and tried to joke with waiter-girls. The latter liked my 
society, but they always treated me as if I wore petti- 
coats. I could not take dancing lessons, they repelled me 
so ; but if I could have gone as a mask, it would have been 
different. My friends loved me dearly; I hated only one, 
who seduced me into onanism. Shame on those days, 
which injured me for life ! I practised it quite frequently, 
but in it seemed to myself like a double man. I cannot 
describe the feeling; I think it was masculine, but mixed 
with feminine elements. I could not approach girls; I 
feared them, but they were not strange to me. They im- 
pressed me as being -more like myself; I envied them. I 
would have denied myself all pleasures if, after my classes, 
at home I could have been a girl and thus have gone out. 
Crinoline and a smoothly-fitting glove were my ideals. 
With every lady's gown I saw I fancied how I should feel 
in it, i.e., as a lady. I had no inclination toward men. 
But I remember that I was somewhat lovingly attached 
to a very handsome friend with a girl's face and dark hair, 
though I think I had no other wish than that we both 
might be girls. 

"At the high-school I finally once had coitus; hoc 
modo sensi, me libentius sub puella concubuisse et penem 
meum cum runno mutatum maluisse. To her astonish- 
ment, the girl had to treat me as a girl, and did it will- 
ingly; but she treated me as if I were she (she was still 



HOMO-SEXUAL FKELINO IN BOTII SEXES. 309 

quite inexperienced, and, therefore, did not laugh at 
me). 

"When a student at times I was wild, but I always 
felt that I assumed this wildness as a mask. I drank and 
duelled, but I could not take lessons in dancing, because 
I was afraid of betraying myself. My friendships were 
close, but without other thoughts. It pleased me most 
to have a friend masked as a lady, or to study the ladies' 
costumes at a ball. I understood such things perfectly. 
Gradually I began to feel like a girl. 

"On account of unhappy circumstances, I twice at- 
tempted suicide. Without any cause I once did not sleep 
for fourteen days, had many hallucinations (visual and 
auditory at the same time), and was with both the living 
and the dead. The latter habit of thought remains. I 
also had a friend (a lady) who knew my hobby and put 
on my gloves for me; but she always looked upon me 
as a girl. Thus I understood women better than other 
men did, and in what they differed from men; so I was 
always treated more feminarum as if they had found in 
me a female friend. On the whole, I could not endure 
obscenity, and indulged in it myself only out of bragga- 
docio when it was necessary. I soon overcame my aversion 
to foul odours and blood, and even liked them. Only some 
things I could not look at without nausea. I was want- 
ing in only one respect: I could not understand my own 
condition. I knew that 'I had feminine inclinations, but 
believed that I was a man. Yet I doubt whether, with 
the exception of the attempts at coitus, which never gave 
me pleasure (which I ascribe to onanism), I ever admired 
a woman without wishing I were she; or without asking 
myself whether I should not like to be the woman, or 
be in her attire. Obstetrics I learned with difficulty (I 
was ashamed for the exposed girls, and had a feeling 
of pity for them) ; and even now I have to overcome 
a feeling of fright in obstetrical cases; indeed, it has 
happened that I thought I felt the traction myself. 
After filling several positions successfully as a physician, 



310 PSYC1IOPAT11IA SEXUALIS. 

I went through a military campaign as a volunteer 
surgeon. Riding, which, while a -student, was painful to 
me, because in it the genitals had more of a feminine 
feeling, was difficult for me (it would have been easier 
in the female style). 

"Still, I always thought I was a man with obscure 
masculine feeling; and whenever I associated with ladies, 
I was still soon treated as an inexperienced lady. When 
I wore a uniform for the first time, I should have much 
preferred to have slipped into a lady's costume, with a 
veil ; I was disturbed when the stately uniform attracted 
attention. In private practice I was successful in the 
three principal branches. Then I made another military 
campaign; and during this I came to understand my 
nature; for I think that, since the first ass ever made, 
no beast of burden has ever had to endure with so much 
patience as I have. Decorations were not wanting, but 
I was indifferent to them. 

"Thus I went through life, such as it was, never satis- 
fied with myself, full of dissatisfaction with the world, 
and vacillating between sentimentality and a wildness 
that was for the most part affected. 

"My experience as a candidate for matrimony was 
very peculiar. I should have preferred not to marry, but 
family circumstances and practice forced me to it I 
married an energetic, amiable lady, of a family in which 
female government was rampant. I was in love with her 
as much as one of us can be in love i.e., what we love 
we love with our whole hearts, and live in it, even though 
we do not show it as much as a genuine man does. We 
love our brides with all the love of a woman, almost as 
a woman might love her bridegroom. But I cannot say 
this for myself; for I still believed that I was but a 
depressed man, who would come to himself, and find him- 
self out by marriage. But, even on my marriage night, I 
felt that I was only a woman in man's form; sub femina 
locum meum esse mihi visum est. On the whole, we 
lived contented and happy, and for t^vo yers were child- 



MO-SEXUAL FEELING IN BOTH SEXES. 311 

leas. After a difficult pregnancy, during which time I 
lay at the point of death in the enemy's own country, my 
wife gave birth to our first boy in a difficult labour, a 
boy still afflicted with a melancholy nature. Then came 
a second, who is very quiet; a third, full of peculiarities; 
a fourth, a fifth; and all have the predisposition to neuras- 
thenia. Since I always felt out of my own place, I went 
much in gay society; but I always worked as much as 
human strength would endure. I studied and operated; 
and I experimented with many drugs and methods of 
cure, always on myself. I left the regulation of the house 
t<> 1 1 iv \\ife, as she understood housekeeping very well. 
My marital duties I performed as well as I could, but 
without personal satisfaction. Since the first coitus, the 
masculine position in it has been repugnant, and also 
difficult for mo. I should have much preferred to have 
the other role. When I had to deliver my wife, it almost 
hroke my heart; for I knew how to appreciate her pain. 
Thus we lived long together, until severe gout drove me 
to various baths, and made me neurasthenic. At the 
same time, I became so anaemic that every few months I 
had to take iron for some time; otherwise I would be 
almost chlorotic or hysterical, or both. Stenocardia often 
troubled me; then came unilateral cramps of chin, nose, 
neck and larynx; hemicrania and cramps of the dia- 
phragm and chest muscles. For about three years I had 
a feeling as if the prostate were enlarged, a bearing-down 
feeling, as if giving birth to something; and also pain in 
the hips, con.-tant pain in the back, and the like. Yet, 
with the strength of despair, I fought against these com- 
plaints, which impressed me as being female or effeminate, 
until three years ago, when a severe attack of arthritis 
completely broke me down. 

"lint In-fore this terrible attack of gout occurred, in 

lir, to lessen the pain of gout, T had taken hot baths, 

;i> near the temperature of the Ixuly as possible. On one 

of tl i-ion< it happened that I suddenly changed, 

and seemed to be near death. I sprang with all my 



312 rSYCIIOPATHIA SEXUALIS. 

remaining strength out of the bath ; I had felt exactly like 
a woman with libido. This happened when the extract 
of Indian hemp came into vogue, and was highly prized. 
In a state of fear of a threatened attack of gout (feeling 
perfectly indifferent about life), I took three or four times 
the usual dose of it, and almost died of hashish poison- 
ing. Convulsive laughter, a feeling of unheard of strength 
and swiftness, a peculiar feeling in brain and eyes, millions 
of sparks streaming from the brain through the skin, all 
these feelings occurred. But I could not force myself to 
speak. All at once I saw myself a woman from my toes 
to my breast; I felt, as before while in the bath, that the 
genitals had shrunken, the pelvis broadened, the breasts 
swollen out; a feeling of unspeakable delight came over 
me. I closed my eyes, so that at least I did not see the 
face changed. My physician looked as if he had a gigantic 
potato instead of a head; my wife had the full moon on 
her thorax. And yet, I was strong enough to briefly 
record my will in my note-book when both left the room 
for a short time. 

"But who could describe my fright when, on the next 
morning, I awoke and found myself feeling as if com- 
pletely changed into a woman; and when, on standing 
and walking, I felt vulva and mammas I When at last I 
raised myself out of bed, I felt that a complete trans- 
formation had taken place in me. During my illness a 
visitor said: 'He is too patient for a man'. And the 
visitor gave me a plant in bloom, which seemed strange, 
but pleased me. From that time I was patient, and 
would do nothing in a hurry; but I became tenacious, 
like a cat, though, at the same time, mild, forgiving and 
no longer bearing enmity, in short, I had a woman's 
disposition. During the last sickness I had many visual 
and auditory hallucinations, spoke with the dead, etc. ; 
saw and heard familiar spirits ; felt like a double person ; 
but, while lying ill, I did not notice that the man in me had 
been extinguished. The change in my disposition was a 
piece of good fortune, for I had a stroke of paralysis which 



HOMO-SEXUAL FEELING IN BOTH SEXES. 313 

would certainly have killed me had I been of my fonnor 
disposition ; but now I was reconciled, for I no longer 
recognized myself. Owing to the fact that I still often 
confounded neurasthenic symptoms with the gout, I took 
many baths, until an itching of the skin, with the feeling 
of scabies, instead of being diminished, was so increased 
that I gave up all external treatment (I was made more 
and more anaemic by the baths), and hardened myself as- 
best I could. But the imperative female feeling remained, 
and became so strong that I wear only the mask of a man, 
and in everything else feel like a woman ; and gradually I 
have lost memory of the former individuality. What was 
left of me by the gout, influenza ruined entirely. 

"Present condition: I am tall, slightly bald, and the 
beard is growing gray. I begin to stoop. Since having 
influenza I have lost about one-fourth of my strength. 
Owing to a valvular lesion, my face looks somewhat red; 
full beard; chronic conjunctivitis; more muscular than 
fat. The left foot seems to be developing varicose veins, 
and it often goes to sleep; but it is not really thickened, 
though it seems to be. 

"The mammary region, though small, swells out per- 
ceptibly. The abdomen is feminine in form; the feet are 
placed like a woman's, and the calves, etc., are feminine; 
and it is the same with arms and hands. I can wear ladies' 
hose and gloves 7/^2 to 724 in size. I also wear a corset 
without annoyance. My weight varies between 168 and 
184 pounds. Urine without albumen or sugar, but it con- 
tains an excess of uric acid. But when there is not too 
much uric acid in it, it is clear, and almost as clear as water 
after any excitement. Bowels usually regular, but should 
they not be, then come all the symptoms of female consti- 
pation. Sleep is poor, for weeks at a time only of two 
or three hours' duration. Appetite quite good; but, on 
the whole, my stomach will not bear more than that of a 
strong woman, and reacts to irritating food with cutaneous 
eruption and burning in the urethra. The skin is white, 
and, for the most part, feels quite smooth ; there has been 



314 PSYCIIOrATHIA SEXUALIS. 

unbearable cutaneous itching for the last two years; but 
during the last few weeks this has diminished, and is now 
present only in the popliteal spaces and on the scrotum. 

"Tendency to perspire. Perspiration was previously 
as good as wanting, but now there are all the odious pecu- 
liarities of the female perspiration, particularly about 
the lower part of the body; so that I have to keep myself 
cleaner than a woman (I perfume my handkerchief, and 
use perfumed soap and eau-de-Cologne). 

"General feeling: I feel like a woman in a man's form ; 
and even though I often am sensible of the man's form, 
yet it is always in a feminine sense. Thus, for example, 
I feel the penis as clitoris; the urethra as urethra and 
vaginal orifice, which always feels a little wet, even when 
it is actually dry; the scrotum as labia majora; in short, I 
always feel the vulva. And all that that means one alone 
can know who feels or has felt so. But the skin all over 
my body feels feminine; it receives all impressions, 
whether of touch, of warmth, or whether unfriendly, as 
feminine, and I have the sensations of a woman. I cannot 
go with bare hands, as both heat and cold trouble me. 
When the time is past when we men are permitted to carry 
sun-umbrellas, I have to endure great sensitiveness of the 
skin of my face, until sun-umbrellas can again be used. 
On awakening in the morning, I am confused for a few 
moments, as if I were seeking for myself; then the impera- 
tive feeling of being a woman awakens. I feel the sense 
of the vulva (that one is there), and always greet the day 
with a soft or loud sigh ; for I have fear again of the play 
that must be carried on throughout the day. I had to 
learn everything anew; the knife apparatus, everything 
has felt different for the last three years ; and with the 
change of muscular sense I had to learn everything over 
again. I have been successful, and only the use of the saw 
and bone-chisel are difficult; it is almost as if my strength 
were not quite sufficient. On the other hand, I have a 
keener sense of touch in working with the curette in the 
soft parts. It is unpleasant that, in examining ladies, I 



IH>M<> srxi'Al I I I i.IWO IN BOTH SEXES. 3 1 r> 

. frd ill. ir sensations; l>ut this, indeed, does- not r 
them. The most unpl-a<anf thing I experience is foetal 
movement. For a h'ULT time several months I was 
tmubled by reading the thoughts of both sexes, and I still 
have to fight against it. I can endure it better with 
women; with men it is repugnant. Three years ago I 
had not yet consciously seen the world with a woman's 
eyes; this chango in the relation of the eyes to the brain 
came almost suddenly, witli violent headache. I was 
with a lady whose sexual feeling was reversed, when sud- 
denly I saw her changed in the sense I now feel myself, 
-he as man, and I felt myself a woman in contrast, 
with her; so that I left her with ill-concealed vexation. 
At that time she had not yet come to understand her own 
condition perfectly. 

"Since then, all my sensory impressions are as if they 
wen- feminine in form and relation. The cerebral system 
almost immediately adjusted itself to the vegetative; so 
that all my ailments were manifested in a feminine way. 
The sensitiveness of all nerves, particularly that of the 
auditory and olfactory and trigeminal, increased to a con- 
dition of nervousness. If only a window slammed, I was 
frightened inwardly ; for a man dare not tremble at such 
things. If food is not absolutely fresh, I perceive a cadav- 
erous odour. I could never depend on the trigeminus; 
for the pain would jump whimsically from one branch of 
it to another ; from a tooth to an eye. But, since my 
transformation, I bear toothache and migraine more easily, 
and have less feeling of fear with stenocardia. It seems 
to me a strange fact that I feel myself to be a fearful, 
weak hcinir, and yet, when danger threatens, I am rather 
<-o,,l aiul collected, and this is true in dangerous opera- 
tions. The stomach rebels against the slightest indiscre- 
tion (in female diet) that is committed without thought of 
the female nature, either by ructus or other symptoms; 
but particularly acainst alrnse of alcoholics. The indis- 
position after intoxication that a man who feels like a 
woman experiences is much \\.TSC thnn any a student 



316 PSYCHOPATHIA SEXUALI8. 

could get up. It seems to me almost as if one feeling 
like a woman were entirely controlled by the vegetative 
system. 

"Small as my nipples are, they demand room, and I 
feel as though the pelvis were female; and it is the same 
puberty the nipples swelled and pained. On this account, 
the white shirt, the waistcoat and the coat trouble me. I 
feel as though the pelvis were female; and it is the same 
with the anus and nates. At first the sense of a female 
abdomen was troublesome to me; for it cannot bear 
trousers, and it always possesses or induces the feminine 
feeling. I also have the imperative feeling of a waist. It 
is as if I were robbed of my own skin, and put in a woman's 
skin that fitted me perfectly, but which felt everything as if 
it covered a woman ; and whose sensations passed through 
the man's body, and exterminated the masculine element. 
The testes, even though not atrophied or degenerated, are 
still no longer testes, and often cause me pain, with the 
feeling that they belong in the abdomen, and should be 
fastened there ; and their mobility often bothers me. 

"Every four weeks, at the time of the full moon, I 
have the molimen of a woman for five days, physically and 
mentally, only I do not bleed ; but I have the feeling of a 
loss of fluid ; a feeling that the genitals and abdomen are 
(internally) swollen. A very pleasant period comes when, 
afterward and later in the interval of a day or two, the 
physiological desire for procreation comes, which with all 
power permeates the woman. My whole body is then filled 
with this sensation, as an immersed piece of sugar is filled 
with water, or as full as a soaked sponge. It is like this : 
first, a woman longing for love, and then, for a man ; and, 
in fact, the desire, as it seems to me, is more a longing to 
be possessed than a wish for coitus. The intense natural 
instinct or the feminine concupiscence overcomes the feel- 
ing of modesty, so that indirectly coitus is desired. I have 
never felt coitus in a masculine way more than three times 
in my life ; and even if it were so in general, I was always 
indifferent about it. But, during the last three years, I 



HOMOSEXUAL FEE I.I NO IN BOTH SEXES. 317 

have expcrii nrr.l it passively, like a woman; in fact, often- 
- with the feeling of feminine ejaculation; and I al- 
ways feel that I am impregnated. I am always fatigued 
as a woman is after it, and often feel ill, as a man never 
does. Sometimes it caused me such great pleasure that 
there is nothing with which I can compare it; it is the 
most blissful and powerful feeling in the world; at that 
moment the woman is simply a vulva that has devoured the 
whole person. 

"During the last three years I have never lost for an 
instant the feeling of being a woman, and now, owing to 
habit, this is no longer annoying to me, though during 
this period I have felt debased; for a man could endure 
to feel like a woman without a desire for enjoyment; but 
Nvlirn desires come, the happiness ceases! Then come 
the burning, the heat, the feeling of turgor of the genitals 
(when the penis is not in a state of erection the genitals 
do not play any part). In case of intense desire, the 
feeling of sucking in the vagina and vulva is really terrible 
a hellish pain of lust hardly to be endured. If I then 
have opportunity to perform coitus, it is better; but, 
owing to defective sense of being possessed by the other, 
it does not afford complete satisfaction ; the feeling of ster- 
ility comes with its weight of shame, added to the feeling 
of passive copulation and injured modesty. I seem al- 
most like a prostitute. Reason does not give any help; 
the imperative feeling of femininity dominates and rules 
thing. The difficulty in carrying on one's occupa- 
tion, under such circumstances, is easily appreciated; but 
it is possible to force one's self to it. Of course, it is 
almost impossible to sit, walk, or lie down ; at least, any 
one of these cannot be endured long; and with the constant 
touch of the trousers, etc., it is unendurable. 

"Marriage then, except during coitus, where the man 
has to feel himself a woman, is like two women living 
together, one of whom regards herself as in the mask of 
a man. If the periodical inoinnina fail to occur, then 
come the feelings of pregnancy or of sexual satiety, which 



318 PSYCHOPATHIA SEXUALI8. 

a man never experiences, but which take possession of the 
whole being, just as the feeling of femininity does, and are 
repugnant in themselves ; and, therefore, I gladly welcome 
the regular molimina again. When erotic dreams or ideas 
occur, I see myself in the form I have as a woman, and 
see erected organs presenting. Since the anus feels fem- 
inine, it would not be hard to become a passive pederast ; 
only positive religious command prevents it, as all other 
deterrent ideas would be overcome. Since such conditions 
are repugnant, as they would be to any one, I have a 
desire to be sexless, or to make myself sexless. If I had 
been single, I should long ago have taken leave of testes, 
scrotum and penis. 

4 "Of what use is female pleasure, when one does not 
conceive ? What good comes from excitation of female 
love, when one has only a wife for gratification, even 
though copulation is felt as though it were with a man? 
What a terrible feeling of shame is caused by the feminine 
perspiration! How the feeling for dress and ornament 
lowers a man! Even in his changed form, even when he 
can no longer recall the masculine sexual feeling, he would 
not wish to be forced to feel like a woman. He still 
knows very well that, heretofore, he did not constantly 
feel sexually; that he was merely a human being unin- 
fluenced by sex. Now, suddenly, he has to regard his 
former individuality as a mask, and constantly feel like 
a woman, only having a change when, every four weeks, 
he has his periodical sickness, and in the intervals his 
insatiable female desire. If he could but awake without 
immediately being forced to feel like a woman ! At last 
he longs for a moment in which he might raise his mask ; 
but that moment does not come. He can only find 
amelioration of his misery when he can put on some bit 
of female attire or finery, an under-garment, etc. ; for he 
dare not go about as a woman. To be compelled to fulfil 
all the duties of a calling with the feeling of being a 
woman costumed as a man. and to see no end of it, is 
no trifle. Religion alone saves from a great lapse ; but it 



HOMO-SEXUAL FEELING IX DOTH SEXES. 319 

does not prevent (ho pain when temptation affects the 
man who feels as a woman; and BO it must be felt and 
endured! When a respectable man who enjoys an un- 
usual degree of public confidence, and possesses authority, 
inii;-r go about with his vulva imaginary though it be; 
uli<-n one, leaving his arduous daily task, is compelled 
to examine the toilette of the first lady he meets, and criti- 
cise her with feminine eyes, and to read her thoughts in her 
face; when a journal of fashions possesses an interest 
equal to that of a scientific work (I felt this as a child) ; 
when one must conceal his condition from his wife, \\hose 
thoughts, the moment he feels like a woman, he can read 
in her face, while it becomes perfectly clear to her that 
he has changed in body and soul what must all this be? 
The misery caused by the feminine gentleness that must 
be overcome? Oftentimes, of course, when 'I am away 
alone, it is possible to live for a time more like a woman ; 
for example, to wear female attire, especially at night, to 
keep gloves on, or to wear a veil or a mask in my room, 
so that thus there is rest from excessive libido. But when 
the feminine feeling has once gained an entrance, it im- 
peratively demands recognition. It is often satisfied with 
a moderate concession, such as the wearing of a bracelet 
above the cuff; but it imperatively demands some con- 
cession. My only happiness is to see myself dressed 
as a woman without a feeling of shame; indeed, when 
my face is veiled or masked, I prefer it so, and thus think 
of myself. Like every one of Fashion's fools, I have a 
taste for the prevailing mode, so greatly am I trans- 
formed. To become accustomed to the thought of feeling 
only like a woman, and only to remember the previous 
manner of thought to a certain extent in contrast with 
it, and, at the same time, to express one's self as a 
man, requires a long time and an infinite amount of 

istence. 

' X- vertheless, in spite of everything, it will happen 
that I betray myself by some expression of feminine 
feeling, either in sexualibus, when I say that I feel so and 



320 PSYCIIOPATHIA SEXUALIS. 

so, expressing what a man without the female feeling 
cannot know; or when I accidentally betray that female 
attire is my talent. Before women, of course, this does 
not amount to anything; for a woman is greatly flattered 
when a man understands something of her matters; but 
this must not be displayed to my own wife. How fright- 
ened I once was when my wife said to a friend that I had 
great taste in ladies' dress! How. a haughty, stylish lady 
was astonished when, as she was about to make a great 
error in the education of her little daughter, I described 
to her in writing and verbally all the feminine feelings! 
To be sure, I lied to her, saying that my knowledge had 
been gleaned from letters. But her confidence in me is 
as great as ever; and the child, who was on the road to 
insanity, is rational and happy. She had confessed all the 
feminine inclinations as sins; now she knows what, as a 
girl, she must bear and control by will and religion; and 
she feels that she is human. Both ladies would laugh 
heartily if they knew that I had only drawn on my own 
sad experience. I must also add that I now have a finer 
sense of temperature, and, besides, a sense of the elasticity 
of the skin and tension of the intestines, etc., in patients, 
that was unknown to me before; that in operations and 
autopsies, poisonous fluids more readily penetrate my (un- 
injured) skin. Every autopsy causes me pain ; examina- 
tion of a prostitute, or a woman having a discharge, a 
cancerous odour, or the like, is actually repugnant to me. 
In all respects I am now under the influence of antipathy 
and sympathy, from the sense of colour to my judgment of 
a person. Women usually see in each other the periodical 
sexual disposition; and, therefore, a lady wears a veil, if 
she is not always accustomed to wear one, and usually 
she perfumes herself, even though it be only with handker- 
chief or gloves; for her olfactory sense in relation to her 
own sex is intense. Odours have an incredible effect on 
the female organism; thus, for example, the odours of 
violets and roses quiet me, while others disgust me; and 
with Ylang-Ylang I cannot contain myself for sexual ex- 



HOMO-SEXUAL FEELING IN BOTH SEXES. 321 

Contact with a woman seems homogeneous to 
me; coitus with my wife seems possible to me "because she 
is somewhat masculine, and has a firm skin ; and yet it is 
more an amor lesbicus. 

"Besides, I always feel passive. Often at night, when 
I cannot sleep for excitement, it is finally accomplished, 
si femora mca distensa habeo, sicti jnu/i< / rum viro con- 
cumbens, or if I lie on my side; but an arm or the bed- 
clothing must not touch the mammce, or there is no 
sleep; and there must be no pressure on the abdomen. 
I sleep best in a chemise and night-robe, and with gloves 
on ; for my hands easily get cold. I am also comfortable 
in female drawers and petticoats, because they do not 
touch the genitals. I liked female dresses best when 
crinolines were worn. Female dresses do not annoy the 
feminine-feeling man ; for he, like every woman, feels 
them as belonging to his person, and not as something 
foreign. 

"My dearest associate is a lady suffering with neuras- 
thenia, who, since her last confinement, feels like a man, 
but who, since I explained these feelings to her, coitu 
abstinet as much as possible, a thing I, as a husband, dare 
not do. She, by her example, helps me to endure my 
condition. She has a most perfect memory of the female 
feelings, and has often given me good advice. Were she 
a man and I a young girl I should seek to win her; for 
her I should be glad to endure the fate of a woman. But 
her present appearance is quite different from what it 
formerly was. She is a very elegantly dressed gentleman, 
notwithstanding bosom and hair; she also speaks quickly 
and concisely, and no longer takes pleasure in the things 
that please me. She has a kind of melancholy dissatis- 
faction with the world, but she bears her fate worthily 
and with resignation, finding her comfort only in religion 
and the fulfilment of her duty. At the time of the menses, 
she almost dies. She no longer likes female society and 
conversation, and has no liking for delicacies. 

"A youthful friend felt like a girl from the very first, 

21 



322 PSYCHOPATHIA SEXUALIS. 

and had inclinations towards the male sex. His sister 
had the opposite condition; an4 when the uterus demanded 
its right, and she saw herself as a loving woman in spite of 
her masculinity, she cut the matter short, and committed 
suicide by drowning. 

"Since complete effemination, the principal changes I 
have observed in myself are: 

"1. The constant feeling of being a woman from top 
to toe. 

"2. The constant feeling of having female genitals. 

"3. The periodicity of the monthly molimina. 

"4. The regular occurrence of female desire, though 
not directed to any particular man. 

"5. The passive female feeling in coitus. 

"6. After that, the feeling of impregnation. 

"7. The female feeling in thought of coitus. 

"8. At the sight of women, the feeling of being of 
their kind, and the feminine interest in them. 

"9. At the sight of men, the feminine interest in them. 

"10. At the sight of children, the same feeling. 

"11. The changed disposition and much greater pa- 
tience. 

"12. The final resignation to my fate, for which I have 
nothing to thank but positive religion ; without it I should 
have long ago committed suicide. 

"To be a man and to be compelled to feel that chaque 
femme est futuee ou elle desire d'etre is hard to endure." 

The foregoing autobiography, scientifically so import- 
ant, was accompanied by the following no less interesting 
letter: 

"SiR, I must next beg your indulgence for troubling 
you with my communication. I lost all control, and 
thought of myself only as a monster before which I myself 
shuddered. Then your work gave me courage again ; and 
I determined to go to the bottom of the matter, and 
examine my past life, let the result be what it might. It 



HOMO-SEXUAL FEELINO IN BOTH 8EXKS. 323 

seemed a duty of gratitude to you to tell you the result of 
my recollection and observation, since I had not seen any 
description by you of an analogous case; and, finally, I 
also thought it might perhaps interest you to learn, from 
the pen of a physician, how such a worthless human, or 
masculine, being thinks and feels under the weight of the 
imperative idea of being a woman. 

"It is not perfect; but I no longer have the strength 
to reflect more upon it, and have no desire to go into 
the matter more deeply. Much is repeated; but I beg 
you to remember that any mask may be allowed to fall off, 
particularly when it is not voluntarily worn, but enforced. 

"After reading your work, I hope that, if I fulfil my 
duties as physician, citizen, father and husband, I may 
still count myself among human beings who do not deserve 
merely to be despised. 

"Finally, I wished to lay the result of my recollection 
and reflection before you, in order to show that one think- 
ing and feeling like a woman can still be a physician. I 
consider it a great injustice to debar woman from Medi- 
cine. A woman, through her feeling, gets on the track of 
many ailments which, in spite of all skill in diagnosis, re- 
main obscure to a man ; at least, in the diseases of women 
and children. If I could have my way, I should have 
every physician live the life of a woman for three months; 
then he would have a better .understand ing and more con- 
sideration in matters affecting the half of humanity from 
which he comes; then he would learn to value the great- 
ness of woman, and appreciate the difficulty of her lot." 

Remarks: The badly tainted patient was originally psy- 
cho-sexually abnormal, in that, in character and in the 
sexual act, he felt as a female. The abnormal feeling 
remained purely a psychical anomaly until three years 
ago, when, owing to severe neurasthenia, it received over- 
mastering support in imperative bodily sensations of a 
transmutatio sexus, which now dominate consciousness. 
Then, to the patient's horror, he felt bodily like a woman; 
and, under the impulse of his imperative feminine sensa- 



\ 
324 PSYCHOPATHIA SEXUALIS. 

tions, he experienced a complete transformation of his 
former masculine feeling, thought and will ; in fact, of his 
whole vita sexualis, in the sense of eviration. At the same 
time, his "ego" was able to control these abnormal psycho- 
physical manifestations, and prevent descent to paranoia, 
a remarkable example of imperative feelings and ideas on 
the basis of neurotic taint, which is of great value for a 
comprehension of the manner in which the psycho-sexual 
transformation may be accomplished. In 1893 ; three 
years later, this unhappy colleague sent me a new account 
of his present state. This corresponded essentially with the 
former. His physical and psychical feelings were abso- 
lutely those of a woman ; but his intellectual powers were 
intact, and he was thus saved from paranoia (vide infra). 

A counterpart to this case, which is of clinical and 
psychological moment, is that of a lady as given in : 

Case 130. Mrs. X., daughter of a high official. Her 
mother died from nervous disease. The father was un- 
tainted, and died from pneumonia at a good old age. Her 
brothers and sisters had inferior psychopathic dispositions ; 
one brother was of abnormal character, and very neuras- 
thenic. 

As a girl Mrs. X. had decided inclinations for boys' 
sports. So long as she wore short dresses she used to rove 
about the fields and woods in the freest manner, and 
climbed the most dangerous rocks and cliffs. She had no 
taste for dresses and finery. Once, when they gave her a 
dress made in boys' fashion, she was highly delighted; 
and when at school they dressed her up in boys' clothes 
on the occasion of some theatrical performance, she was 
filled with bliss. 

Otherwise nothing betrayed her homo-sexual inclina- 
tions. Up to her marriage (at the age of twenty-one) she 
could not recall to mind a single instance in which she felt 
herself drawn to persons of her own sex. Men were 
equally indifferent to her. When matured she had many 



HOMO-SEXUAL FEELING IN BOTH SEXES. 325 

admirers. This flattered her greatly. However, she 
claimed that the difference of the sexes never entered her 
mind; she was only influenced by the difference in the 
dress. 

When attending the first and only ball she felt interest 
only in intellectual conversation, but not in dancing or the 
dancers. 

At the age of eighteen the menses set in without diffi- 
culty. She always looked upon menstruation as an un- 
necessary and bothersome function. Her engagement with 
a man who, though good and rich, yet possessed not the 
slightest knowledge of woman's nature, was a matter of 
utter indifference to her. She had neither sympathy for 
nor antipathy against matrimony. Her connubial duties 
were at first painful to her, later on simply loathsome. 
She never experienced sexual pleasure, but became tfce 
mother of six children. When her husband began to 
observe coitus irHerruptus, on account of the prolific conse- 
quences, her religious and moral sentiments were hurt. 
Mrs. X. grew more and more neurasthenic, peevish and 
unhappy. 

She suffered from descensus uteri, erosions on the 
portio vaginalis, and became anaemic. Gynecological treat- 
ment and visits to watering-places procured but slight im- 
provements. 

At the age of thirty-six she had an apoplectic stroke, 
which confined her to bed for two years, with heavy neu- 
rasthenic ailments (agrypnia, pressure in the head, palpi- 
tation of the heart, psychical depression, feelings of lost 
physical and mental power, bordering even on insanity, 
etc.). During this long illness a peculiar change of her 
psychical and physical feelings took place. 

The small talk of the ladies visiting her about love, 
toilet, finery, fashions, domestic and servants' affairs dis- 
gusted her. She felt mortified at being a woman. She 
could not even make up her mind again to look in the 
mirror. She loathed combing her hair and making her 
toilet. Much to the surprise of her own people her hither- 



326 PSYCHOPATHIA SEXUALIS. 

to soft and decidedly feminine features assumed a strongly 
masculine character, so much so that she gave the impres- 
sion of being a man clad in female garb. She complained 
to her trusted physician that her periods had stopped, 
in fact, she had nothing to do with such functions. When 
they recurred again she felt ill-tempered, and found the 
odour of the menstrual flow most nauseating, but definitely 
refused the use of perfumes, which affected her in a similar 
unpleasant manner. 

But in other ways she felt that a peculiar change had 
come over her entire being. She had athletic spells, and 
great desire for gymnastic exercises. At times she felt as 
if she were just twenty. She was startled, when her 
neurasthenic brain allowed of thought at all, at the flight 
and novelty of her thoughts, at her quick and precise 
method of arriving at conclusions and forming opinions, 
at the curt and short way of expressing herself, and her 
novel choice of words not always becoming a lady. Even 
an inclination to use curse words and oaths was noticeable 
in this otherwise so pious and correct woman. 

She reproached herself bitterly, and grieved because 
she had lost her femininity, and scandalised her friends by 
her thoughts, sentiments, and actions. 

She also perceived a change in her body. She was 
horrified to notice her breasts disappearing, that her pelvis 
grew smaller and narrower, the hones became more mass- 
ive, and her skin rougher and harder. 

She refused to wear any more a lady's night-dress or a 
lady's cap, and put away her bracelets, earrings and fans. 
Her maid and her dressmaker noticed a different odour 
coining from her person; her voice also grew deeper, 
rougher, and quite masculine. 

When the patient was finally able to leave her bed, the 
female gait had altered, feminine gestures and movements 
in her female attire were forced, and she could no longer 
bear to wear a veil over her face. Her former period of 
life spent as a woman seemed strange to her, as if it did 
not belong to her existence at all ; she could play no longer 



HOMO-SEXUAL FEELING IN BOTH SEXES. 327 

the role of woman. She assumed more and more the 
acter of a rnun. Slie experienced strange feelings in 
IHT abdomen; and complained to the physician attending 
her that she could fed no longer the internal organs of 
generation, that her body was closed up, the region of her 
genitals enlarged, and often had the sensation of possessing 
a penis and scrotum. She showed, also, unmistakable 
symptoms of male libido. All these observations affected 
her deeply, filled her with horror, and depressed her so 
much that an attack of insanity was apprehended. But 
by incessant efforts and kind advice the family physician 
finally succeeded in calming the patient and piloting her 
safely over this dangerous point. Little by little she gained 
her equilibrium in this novel, strange and morbid physico- 
psychical form. She took pains in performing her duties 
as housewife and mother. It was interesting to observe 
the truly manly firmness of will which she developed, but 
her former softness of character had vanished. She as- 
sumed the role of the man in her house, a circumstance 
which led to many dissensions and misunderstandings. 
She became an enigma which her husband was unable to 
solve. 

She complained to her physician that at times a 
"bestial masculine libido" threatened to overcome her, 
which made her despondent. Marital intercourse with 
the husband appeared to her most repulsive in fact, 
impossible. Periodically the patient experienced feminine 
emotions, but they became scarcer and weaker as time 
went by. At such periods she became conscious again of 
her female genitals and breasts, but these episodes affected 
IHT painfully, and she felt that such a "second trans- 
mutation" would be unbearable, and would drive her to 
insanity. 

She now became reconciled to her iransmutaiio sexus, 
brought about by her severe illness, and bore her fate with 
resignation, finding much support in her religious con- 
victions. 

What affected her most keenly was the fact that, like 



PSYCHOPATHIA SEXUALI8. 

an actress, she must move in a strange sphere i.e, in that 
of a woman (Status Prsesens," Sep^t, 1892). 

IV. Degree: Metamorphosis Sexualis Paranoica. 

A final possible stage in this disease-process is the de- 
lusion of a transformation of sex. It arises on the basis 
of sexual neurasthenia that has developed into neurasthe- 
nia universalis, resulting in a mental disease, paranoia. 

The following cases show the development of the inter- 
esting neuro-psychological process to its height : 

Case 131. K., aged thirty-six, male, single, servant, 
received at the clinic on 26th February, 1889, typical 
case of paranoia persecutoria, resulting from neurasthenia 
sexualis, with olfactory hallucinations, sensations, etc. 

He came of a predisposed family. Several brothers 
and sisters were psychopathic. Patient had a hydro- 
cephalic skull, depressed in the region of the right fon- 
tanelle; eyes neuropathic. He had always been very 
sensual ; began to masturbate at nineteen ; had coitus at 
twenty-three; begat three illegitimate children. He gave 
up further sexual intercourse on account of fear of 
begetting more children, and of being unable to provide 
for them. Abstinence proved very painful to him. He 
also gave up masturbation, and was then troubled with 
pollutions. A year and a half ago he became sexually 
neurasthenic, had diurnal pollutions, became thereafter ill 
and miserable, and, after a time, generally neurasthenic, 
finally developing paranoia. 

A year ago he began to have paraesthetic sensations, 
as if there were a great coil in the place of his genitals; 
and then he felt that his scrotum and penis were gone, and 
that his genitals were changed into those of a female. 

He felt the growth of his breasts; that his hair was 
that of a woman ; and that feminine garments were on his 
body. He thought himself a woman. The people in the 
street gave utterance, to corresponding remarks: "Look 



, HOMO-SEXUAL FEELING IN BOTH SEXES. 329 

at the woman! The old blowhard!" In a half-dreamy 
state, he had the feeling as if he played the part of a 
woman in coitus with a man, which caused him the most 
lively feelings of pleasure. During his stay at the clinic, 
a remission of the paranoia occurred, and, at the same 
time, a marked improvement of the neurasthenia. Then 
the feelings and ideas due to a developing metamorphosi* 
sexualis disappeared. 

A more advanced case of eviration, on the way to a 
transformatio sexus paranoica, is the following: 

Case 132. Franz St., aged thirty-three; school- 
teacher, single ; probably of tainted family ; always neuro- 
pathic ; emotional, timid, intolerant of alcohol ; began to 
masturbate at eighteen. At thirty there were manifesta- 
tions of neurasthenia sexualis (pollutions with consequent 
fatigue, soon beginning to occur during the day; pain in 
the region of the sacral plexus, etc.). Gradually, spinal 
irritation, pressure in the head, and cerebral neurasthenia 
were added. Since the beginning of 1885 the patient had 
given up coitus, in which he no longer experienced pleas- 
urable feeling. lie masturbated frequently. 

In 1888 he began to have delusions of suspicion. He 
noticed that he was avoided, and that he had unpleasant 
odours about him (olfactory hallucinations). In this way 
he explained the altered attitude of people, and their 
sneezing, coughing, etc. 

. He could smell corpses and foul urine. He recognised 
the cause of his bad smells in inward pollutions. He 
recognised these in a feeling he had as if a fluid flowed 
up from the symphysis toward the breast. Patient soon 
left the clinic. 

In 1889 he was again received in an advanced stage of 
paranoia masturbatoria persecutoria (delusions of physical 
persecution). 

In the beginning of May, 1889, the patient attracted 
notice, in that he was cross when he was addressed as 



330 rSYCHOI'ATHIA 8EXUALJ8. 

"mister". He protested against it because he was a 
woman. Voices told him this. Jle noticed that his 
breasts were growing. Some weeks before, others had 
touched him in a sensual manner. He heard it said that 
he was a whore. Of late, dreams of pregnancy. He 
dreamed that, as a woman, he indulged in coitus. He felt 
the immissio penis, and, during the hallucinatory act, also 
a feeling of ejaculation. 

Head straight; facial form long and narrow; parietal 
eminences prominent; genitals normally developed. 

The following case, observed in the asylum at Illenau, 
is a pertinent example of lasting delusional alteration of 
eexual consciousness : 

Case 133. Metamorphosis sexualis paranoica. N. 
aged twenty-three, single, pianist, was received in the asy- 
lum at Illenau in the last part of October, 1865. He came 
of a .family in which there was said to be no hereditary 
taint! but there was phthisis (father and brother died of 
pulmonary tuberculosis). Patient, as a child, was weakly 
and dull, though especially talented in music. He was al- 
ways of abnormal character ; silent, retiring, unsocial, and 
sullen. He practised masturbation after fifteen. After a 
few years neurasthenic symptoms (palpitation of the heart, 
lassitude, occasional pressure in the head, etc.) and also 
hypochondriacal symptoms were manifested. During the 
last year he had worked with great difficulty. For about 
six months neurasthenia had increased. He complained 
of palpitation of the heart, pressure in the head, and 
sleeplessness; was very irritable, and seemed to be sexually 
excited. He declared that he must marry for his health. 
He fell in love with an artiste, but almost at the same 
time (September,,! 8 G5), fell ill with paranoia persecutors 
(ideas of enemies, derision in the street, poison in food; 
obstacles were placed on the bridge to keep him from 
going to his inamorata). On account of increasing ex- 
citement and conflicts with those about him that he con- 



HOMO-SEXUAL FEELING IN BOTH SEXES. 331 

siden 1 inimical to him, ho was taken to the asylum. At 
first he presented the picture of a typical paranoia pcrse- 
rnlnrld with symptoms of sexual, and later general, neuras- 
thenia, though the delusions of persecution did not rest 
upon this neurotic foundation. It was only occasionally 
that the patient heard such sentences as this : "Now the 
semen will be drawn from him. Now the bladder will be 
cut out" 

In the course of the years 1866-68, the delusions of 
persecution became less and less apparent, and were for 
the most part replaced by erotic ideas. The somatic and 
mental basis was a lasting and powerful excitation of the 
sexual sphere. The patient fell in love with every woman 
he saw, heard voices which told him to approach her, and 
beg to be allowed to marry, declaring that, if he were 
not given a wife, he would waste away. With continu- 
ance of masturbation, in 1869, signs of future effemination 
made themselves manifest. "He would, if he should get 
a wife, love her only platonically." The patient grew 
more and more peculiar, lived in a circle of erotic ideas, 
saw prostitution practised in the asylum, and now and 
then heard voices which imputed immoral conduct with 
women to him. For this reason he avoided the society of 
women, and only associated with them for the sake of 
music when two witnesses were with him. 

In the course of the year 1872, the neurasthenic con- 
dition became markedly increased. Now paranoia perse- 
cutoria again came into the foreground, and took on a 
clinical colouring from the neurotic basis. Olfactory 
hallucinations occurred. Magnetic influences were at work 
on him "magnetic waves produced by striking an anvil" 
(false interpretation of sensations due to spinal asthenia). 
With continued and intense sexual excitement and excess 
in masturbation, the process of effemination constantly 
progressed. Only episodically was he a man and inclined 
toward a woman, complaining that the shameless prosti- 
tution of the men in the house made it impossible for a 
lady to come to him. He was dying of magnetically pois- 



332 PSYCHOPATHIA 8EXUALI8. 

oned air and unsatisfied love. Without love he could not 
live. He was poisoned by lewd poison that affected his 
sexual desire. The lady whom he l6ved was surrounded 
here by the lowest vice. The prostitutes in the house had 
fortune-chains ; that is, chains in which, without moving, 
a man can indulge in lustful pleasure. He was ready 
now to satisfy himself with prostitutes. He was possessed 
of a wonderful ray of thought that emanated from his eyes, 
which were worth 20,000,000. His compositions were 
worth 500,000 francs. With these indications of delusions 
of grandeur, there were also those of persecution the food 
was poisoned by venereal excrements; he tasted and 
smelled poison, heard infamous accusations, and asked for 
appliances to close his ears. 

From August, 1872, however, the signs of effemination 
became more and more frequent. He acted somewhat 
affectedly, declaring that he could no longer live among 
men that drink and smoke. He thought and felt like a 
woman. He must thenceforth be treated like a woman and 
transferred to a female ward. He asked for confections 
and delicate desserts. Occasionally, on account off tenes- 
mus and cystospasm, he asked to be transferred to a lying- 
in hospital and treated as a woman very ill in pregnancy. 
The abnormal magnetism of masculine attendants had an 
unfavourable effect on him. 

At times he still felt himself to be a man, but in a way 
which indicated his abnormally altered sexual feeling. He 
pleaded only for satisfaction by means of masturbation, 
or for marriage without coitus. Marriage was a sensual 
institution. The girl that he would take for a wife must 
be a masturbator. 

About the end of December, 1872, his personality be- 
came completely feminine. From that time he remained 
a woman. He had always been a woman, but in his baby- 
hood a French Quaker, an artist, had put masculine geni- 
tals on him, and by rubbing and distorting his thorax had 
prevented the development of his breasts. 

After this he demanded to be transferred to the female 



HOMO-SEXUAL FEELING IN BOTH SEXES. 333 

department, protection from men that wished to violate 
IUIM, and asked for female clothing. Eventually he also 
desired to be given employment in a toy-shop, with crochet- 
ing and embroidery work to do, or a place in a dressmaking 
establishment with female work. From the time of the 
transformatio sexus, the patient began a new reckoning of 
time. He conceived his previous personality in memory 
as that of a cousin. 

He always spoke of himself in the third person, and 
called himself the Countess V., the dearest friend of the 
Empress Eugenie; asked for perfumes, corsets, etc., He 
took the other men of the ward for girls, tried to raise a 
head of hair, and demanded "Oriental Hair-Remover," 
in order that no one may doubt his gender. He took de- 
light in praising onanism, for "she had been an onanist 
from fifteen, and had never desired any other kind of 
sexual satisfaction". Occasionally neurasthenic symptoms, 
olfactory hallucinations, and persecutory delusions were 
observed. All the events up to the time of December, 1872, 
belonged to the personality of the cousin. 

The patient's delusion that he was the Countess V. 
could no longer be corrected. She proved her identity by 
the fact- that the nurse had examined her, and found her to 
be a lady. The countess would not marry, because she hated 
men. Since he was not provided with female clothing and 
shoes, he spent the greatest part of the day in bed, acted 
like an invalid lady of position, affectedly and modestly, 
and asked for bon-bons and the like. His hair was done up 
in a knot as well as it allowed, and the beard was pulled 
out. Breasts were made of rolls of bread. 

In 1874 caries began in the left knee-joint, to which 
pulmonary tuberculosis was soon added. Death on 2nd 
December, 1874. Skull normal. Frontal lobes atrophic. 
Brain anaemic. Microscopical (Dr. Schille). In the su- 
perior layer of the frontal lobe, ganglion cells somewhat 
shrunken; in the adventitia of the vessels, numerous fat- 
corpuscles; ganglia unchanged; isolated pigment particles 
and colloid bodies. The lower layers of the cortex normal, 



334 PSYCHOPATHIA 8EXUALIS. 

Genitals very large; testicles small, lax, and showed no 
change microscopically on section. 

The delusion of sexual transformation, displayed in its 
conditions and phases of development in the foregoing 
case, is a manifestation remarkably infrequent in the 
pathology of the human mind. Besides the foregoing 
cases, personally observed, I have seen such a case, as an 
episodical phenomenon, in a lady having sexual inversion 
(case 118, of the seventh edition of this work), one in a girl 
affected with original paranoia, and another in a lady 
suffering with original paranoia. 

Save for a case briefly reported by Arndt 1 in his text- 
book, and one quite superficially described by Seriettx 
("Recherches Clinique," p. 33), and the two cases known 
to Esquirol* I cannot recall any cases of delusion of sexual 
transformation in literature. 

I have already mentioned the interesting relations ex- 
isting between the facts of delusional transformation of 
sex and the so-called insanity of the Scythians. 

Marandon ("Annales medico-psychologiques," 1877, p. 
161), like others, has erroneously presumed that with the 
ancient Scythians there was an actual delusion, and that 
the condition was not merely that of eviration. According 
to the law of empirical actuality, the delusion, so infre- 
quent to-day, must also have been very infrequent in an- 
cient times. Since it can only be conceived as arising on 
the basis of paranoia, there can be no thought of its en- 
demic occurrence ; it can only be regarded as a superstitious 
manifestation of eviration (the result of anger of the 
goddess), as is also evident from the statements of Hippo- 
crates. 

The facts of the so-called Scythian insanity, as well as 

1 An abstract of this may be found in case 103 of the ninth edition 
of this book. 

*Cf. Hid., cases 104 and 105. 



HOMO-8KXUAI <J AS ABNOBU I KESTATIOW. 335 

the facts lately learned about the Pueblo Indians, are also 
worthy of note anthropologically, in so far as atrophy of 
the testes and genitals in general, and approximation to 
the female type, physically and mentally, were observed. 
This is the more remarkable, since, in men who have lost 
their procreative organs, such a reversal of instinct is quito 
as unusual as in women, mutatis mutandis, after the nat- 
ural or artificial climacteric. 

B. Homo-Sexual Feeling as an Abnormal Congenital 
Manifestation. 1 

The essential feature of this strange manifestation of 
the sexiial life is the want of sexual sensibility for the 
opposite sex, even to the extent of horror, while sexual 
inclination and impulse toward the same sex are present 
At the same time, the genitals are normally developed, the 

1 Bibliography (besides works mentioned hereafter) : Tardieu, 
"Des attentats aux moeurs," 7 dit., 1878, p. 210. Bofmann, 
"Lehrb. d. ger. Med.," 6 Aufl., pp. 170, 887. Oley, "Revue philo- 
sophique," 1884, No. 1. Magnan, " Annal. med-paychol.," 1885, p. 
458. Khaw and Ferra, " Journal of Nervous and Mental Diseases," 
1883, April, No. 2. Bernhardi, " Der Uranismus," Berlin (Volka- 
buchhamllung), 1882. Chevalier, " De 1'inversion de 1'instinct - 
uel," Paris, 1885. Ritti, " Gaz. hebdom. de medecine et de chirurg.," 
1878, 4. Januar. Tamanaia, " Rivista sperim," 1878, ppl 97-117. 
Lombroto, " Archiv. di Psiehiatr.," 1881. Charcot et Magnan, 
" Archiv. de neurologic," 1882, Nr. 7, 12. Moll, " Die contrlre Sex- 
ualempfindung," Berlin, 3rd edit., 1899 (numerous bibliographic 
references). Chevalier, "Archives de 1'anthropologie criminelle," 
vol. v., No. 27; vol. vi., No. 31. Reu, "Aberrations du sens 
gnesique," " Annales d'hygiene publique," 1886. Saury, " Etude 
(Unique sur la folie hre<iitaire," 1886. Brouardel, "Gaz. des hop- 
itaux," 1880 and 1887. Tilier, " L'instinct sexucl che/. 1'honimc et 
chez les animaux," 1889. Carlier, " Les deux prostitutions^" 1887. 
Lacassagne, art. " Petterastie," in the " Diction. encyclopetlique." 
Vibert, art. " Pe<le>astie," in the " Diction, med. et de chirurgic." 
Coutagnc, " Lyon medical," 1880, Nos. 35, 36. Blunter, " Amcric. 
Journ. of Insanity," July, 1882. F. Krafft, " Zeitschr. f Psychiatric," 
No. 38. niumerutock, art. " Contrlre Sexualompfindung," " Realcn- 
cyclop. d. ge. Heilkunde," 2 Aufl. vi. Brouardel, " Gar. des 
hopiteaux," 1887. Krirtc, " Inaugural dissert.," WQrzburg, 1888. 
Wo/man, art. " Paederastie," " Realencyclop. d. ges. Heilkunde," 2 



336 PSYCHOPATHIA SEXUALI8. 

sexual glands perform their functions properly, and the 
sexual type is completely differentiated. 

Feeling, thought, will, and the whole character, in 

leases of the complete development of the anomaly, corre- 

spond with the peculiar sexual instinct, but not with the 

sex which the individual represents anatomically and 

physiologically. This abnormal mode of feeling may not 

infrequently be recognized in the manner, dress and 

calling of the individuals, who may go so far as to yield 

to an impulse to don the distinctive clothing corresponding 

with the sexual role in which they feel themselves to be. 

Anthropologically and clinically, this abnormal mani- 
festation presents various degrees of development : 

1. Traces of hetero-sexual, with predominating homo- 
sexual, instinct (psycho-sexual hermaphroditism). 

2. There exists inclination only toward the same sex 
(homo-sexuality) . 

3. The entire mental existence is altered to correspond 
with the abnormal sexual instinct (effemination and 
viraginity ) . 

4. The form of the body approaches that which 
corresponds to the abnormal sexual instinct. However 
actual transitions to hermaphrodites never occur, but, on 
the contrary, completely differentiated genitals; so that, 
just as in all pathological perversions of the sexual life, 

Aufl. xv. Tarnowsky, " Die krankhaften Ercheinungen des Ge- 
schlechtsinnes," Berlin, 1886. Magnan, " Stance de I'acadfimie de 
m&iecine du 13 Janvier," 1885, idem, "Annales medico psychol.," 1886 
( " Anomalies du sens genital " ; " Discussion sur la f olie h6r6d- 
itaire"). Scrieux, " Recherches cliniques sur les anomalies de 
1'instinct sexuel," Paris, 1886. Chevalier, " L'inversion sexuelle," 
Lyon, Paris, 1893. Ladame, " Revue de 1'hypnotisme," Sept., 1889. 
Peyer, ""Munch, med. Wochenschrift," 1890, No. 23. Lewin, 
" Neurolog. Centralblatt," 1891, No. 18. 7. Schrenck-Xotzing, " Die 
Suggestions-therapie," etc., Stuttgart. Eulenburg, op. cit., p. 66, 
" Homo-sexuelle Parerosie." Raffalovich, " Die Entwickelung der 
Homo-sexualitfit," Berlin, 1895, 4dem, " Uranisme et Unisexualite"," 
Paris, 1886. V. Schrenck-Notzing, " Klin. Zeit- und Streitfragen," 
ix. 1 (Wien, 1895). Laupts, "Perversion et perversity sexuelles," 
Paris, 1896. Legrain, " Des anomalies de 1'instinct sexuel," etc., 
Paris, 1896. 



HOMO-SEXUAL FEELING AS ABNORMAL MANIFESTATION. 337 

the cause must be sought in the brain (androgyny and 
gynandry). 

The first definite communications 1 concerning this 
enigmatical phenomenon of Nature are made by Casper 
("Ueber Nothzucht und Paderastie," Casper's "Viertel- 
jahrsschrift," 1852, i.), who, it is true, classes it with 
pederasty, but makes the pertinent remark that this 
anomaly is, in most cases, congenital, and, at the same 
time, to be regarded as a mental hermaphroditism. There 
exists here an actual disgust of sexual contact with women, 
while the imagination is filled with beautiful young men, 
and with statues and pictures of them. It did not escape 
Casper that in such cases emissio penis in anum (peder- 
asty) is not the rule, but that, by means of other sexual 
acts (mutual onanism), sexual satisfaction is sought and 
obtained. 

In his "Clinical Novels" (1863, p. 33) Casper gives 
the interesting confession of a man showing this perver- 
sion of the sexual instinct, and does not hesitate to assert 
that, aside from vicious imagination and vice, as a result of 
over-indulgence in normal sexual intercourse, there are 
numerous cases in which "pederasty" has its origin in 
a remarkable, obscure impulse, which is congenital and 
inexplicable. About the middle of the "sixties" a certain 
assessor, Ulrichs, himself subject to this perverse instinct, 
declared, in numerous articles, under the nom-de-plume 

1 Dr. Moll, of Berlin, called my attention to the fact that in 
Moritz'a " Magazin f. Erfahrungsseelenkunde," vol. viii., Berlin, 1791, 
references are made to antipathic sexual instinct in man. In fact, two 
biographies of men are there reported who manifested an enthusiastic 
love for persons of their own sex. In the second case, which is par- 
ticularly noteworthy, the patient himself explains his aberration by 
the fact that, as a child he was caressed only by grown persons, and 
as a boy of ten or twelve years only by his school-fellows. " This, 
and the want of association with persons of the opposite sex, in me 
caused the natural inclination toward the female sex to be entirely 
diverted to the male sex. I am still quite indifferent to women." 

It cannot be determined whether such a case is one of con- 
genital (psycho-sexual hermaphrodisia?) or acquired antipathic 
sexual instinct. 



338 PSYCHOPATHIA SKXl'ALIS. 

"Numa Numantius, 1 that the sexual mental life was not 
connected with the bodily sex; tha.t there were male in- 
dividuals that felt like women toward men (anima mulie- 
bris in corpore virili inclusa). lie called these people 
"urnings," and demanded nothing less than the legal 
and social recognition of this sexual love of the urnings 
as congenital and, therefore, as right; and the permission 
of marriage among them. Ulrichs failed, however, to 
prove that this certainly congenital and paradoxical sexual 
feeling was physiological, and not pathological. 

Griesinger ("Archiv f. Psychiatric," i., p. 651) threw 
the first ray of light on these facts, anthropologically and 
clinically by pointing out the marked hereditary taint 
of the individual in a case which came under his own 
observation. 

We owe thanks to Westphal ("Archiv f. Psychiatric," 
^ ii., p. 73) for the first systematic consideration of the 
manifestation in question, which he defined as "congenital 
reversal of the sexual feeling, with consciousness of the 
abnormality of the manifestation," and designated with 
the name, since generally accepted, of antipathic sexual 
instinct. At the same time, he began a series of cases, 
which up to this time has numbered about 200, those 
reported in this monograph not being included. 

Westplial leaves it undecided as to whether antipathic 
sexual feeling is a symptom of a neuropathic or of a 
psychopathic condition, or whether it may occur as an 
isolated manifestation. He holds fast to the opinion that 
the condition is congenital. 

From the cases published up to 1877 I have desig- 
nated this peculiar sexual feeling as a functional sign 
of degeneration, and as a partial manifestation of a 
neuro- (psycho-) pathic state, in most cases hereditary, a 
supposition which has found renewed confirmation in a 

1M Vindex, Inclusa, Vindicta, Formatrix, Ara spei, Gladius 
furena" (Leipzig, H. Matthes, 1864 and 1865); Ulrtchs, " Kritische 
Pfeile," 1879, in Commission, by H. Cronlein, Stuttgart, Augusten- 
strasse, 5. 



HOMOSEXUAL FEELING AS ABNORMAL MANIFESTATION. 339 

consideration of additional cases. The following pecu- 
liarities may bo given as the signs of this neuro- (psycho-) 
I>athic taint : 

1. The sexual life of individuals thus organized mani- 
fests itself, as a rule, abnormally early, and thereafter with 
abnormal power. Not infrequently still other perverse 
manifestations are presented besides the abnormal method 
of sexual satisfaction, which in itself is conditioned by the 
peculiar sexual feeling. 

2. The psychical love manifest in these men is, for 
the most part, exaggerated and exalted in the same way 
as their sexual instinct is manifested in consciousness, 
with a strange and even compelling force. 

3. By the side of the functional signs of degeneration 
attending antipathic sexual feeling are found other 
functional, and in many cases anatomical, evidences of 
degeneration. 

4. Neuroses (hysteria, neurasthenic, epileptoid states, 
etc.) co-exist. Almost invariably the existence of tem- 
porary or lasting neurasthenia may be proved. As a rule, 
this is constitutional, having its root in congenital condi- 
tions. It is awakened and maintained by masturbation or 
enforced abstinence. 

In male individuals, owing to these practices or to 
congenital disposition, there is finally neurasthenia sex- 
ualis, which manifests itself essentially in irritable weak- 
ness of the ejaculation centre. Thus it is explained that, 
in most of the cases, simply embracing and kissing, or even 
only the sight of the loved person, induce the act of ejacu- 
lation. Frequently this is accompanied by an abnormally 
powerful feeling of lustful pleasure, which may be so in- 
tense as to suggest a feeling of "magnetic" currents pass- 
ing through the body. 

5. In the majority of cases, psychical anomalies (bril- 
liant endowment, in art, especially music, poetry, etc., by 
the side of bad intellectual powers or original eccentricity) 
are present, which may extend to pronounced conditions 
of mental degeneration (imbecility, moral insanity). 



340 PSYCHOPATHIA SEXUALI8. 

In many urnings, either temporarily or permanently, 
insanity of a degenerative character (pathological emo- 
tional states, periodical insanity, paranoia, etc.) makes its 
appearance. 

6. In almost all cases where an examination of the 
physical and mental peculiarities of the ancestors ahd 
blood relations has been possible, neurosis, psychoses, 
degenerative signs, etc., have been found in the families. 1 

The depth of congenital antipathic sexual feeling is 
shown by the fact that the lustful dream of the male-loving 
urning has for its content only male individuals; that of 
the female-loving woman, only female individuals, with 
corresponding situations. 

The observation of Westphal, that the consciousness of 
one congeni tally defective in sexual desires toward the 
opposite sex is painfully affected by the impulse toward 
the same sex, is true in only a number of cases. Indeed, 
in many instances, the consciousness of the abnormality 
of the condition is wanting. The majority of urnings are 
happy in their perverse sexual feeling and impulse, and 
unhappy only in so far as social and legal barriers stand 
in the way of the satisfaction of their instinct toward 
/ their own sex. 

The study of antipathic sexual feeling points directly 
to anomalies of the cerebral organisation of the affected 
individuals. The very fact that in these cases, with few 
exceptions, the sexual glands are found quite normal, 
anatomically and functionally, seems to favour this 
assumption. 

This enigmatical manifestation in the nature of man 
has led to many attempts of explanation. 

Among lay persons, it is called vice; in the language 

1 Tarnowsky (op. cit., p. 34) records a case which shows that 
antipathic sexual feeling, as a concomitant manifestation with 
neurotic degeneration, may also affect the descendants of parents 
having no neurotic taint. In this instance, lues of the parents played 
a part, as in a similar case of Scholz (" Vierteljahrsschr. f. ger. 
Mod." ) , in which the perversion of the sexual desires stood in causal 
relation with an arrest of psychical development, caused by 
traumatism. 



HOMO-SEXUAL FEELING AS ABNORMAL MANIFESTATION. 

..f the law, crime. Those tainted with it, although recog- 
nising it as an abnormality, claim for it the same rights 
and privileges that are accorded to normal (hetero-sexual) 
love, on account of its being based upon a freak of nature. 
From Plato down to Ulrichs, in antipathic sexual circles, 
this standpoint is maintained. Plato's "Banquet," chap- 
ters viii. and ix., are quoted for that purpose, viz.: "There 
is no Aphrodites without an Eros. But there are two 
goddesses. The older Aphrodites came into existence 
without a mother; being the daughter of Uranos she is 
called Urania. The younger Aphrodites is the daughter 
of Zeus and Diana and is called Pandemos. The Eros 
of the former must, therefore, be Uranos, that of the 
latter Pandemos. With the love of Eros Pandemos the 
ordinary human beings love; Eros Uranos did not choose 
a female but a male; this is the love for boys. Whoever 
is inspired with this love turns to the male sex." From 
many other places in the classics the impression may be 
won that Uranic love attained a higher position even 
than her sister. More recent explanations of the homo- 
sexual instinct have emanated from philosophers, psycho- 
logists and natural scientists. 

One of the most peculiar explanations is advanced by 
Schopenhauer ("Die Welt als Wille und Vorstellung"), 
who seriously contends that nature seeks to prevent old 
men (i.e., over fifty years of age) from begetting children, 
since experience teaches that these never turn out good. 
For this purpose nature in her wisdom has turned the 
sexual instinct in old men toward their own sex! The 
great philosopher and thinker evidently was not aware 
that sexual inversion, as a rule, exists ab origine, and that 
pederasty, occurring in the senium, is only sexual per- 
versity, but by no means proves the presence of perversion. 

Binet attempts to explain these peculiar manifestations 
from a psychological standpoint, thinking (with Condillac) 
to reduce them together with other bizarre psychical 
phenomena to the law of association of ideas (i.e., 
association of ideas with sentiments in statu nascendi). 



342 PSYCHOPATHIA SEXUALIS. 

This clever psychologist assumes that the instinct not 
as yet sexually differentiated is determined by the coin- 
cidence of a vivid sexual emotion with the simultaneous 
sight or contact of a person of the opposite sex. In 
this manner a mighty association is created, which takes 
root by repeating itself, whilst the original associative 
process is forgotten or becomes latent. Even to-day v. 
Schrenck-Notzing and others lean to this opinion, in their 
efforts to explain the inverted sexual instinct (chiefly 
when acquired; ; but it cannot withstand serious criticism. 
Psychological forces are insufficient to explain manifesta- 
tions of so thoroughly degenerated a character (vide infra). 

Chevalier ("Inversion Sexuelle," Paris, 1893) rightly 
demurs against Binet that these attempts at psychological 
explanations explain neither the precocity of homo-sexual 
impulses, i.e., such as have existed long before sexual 
feelings were associated with imagination, nor the aver- 
sion towards the opposite sex, nor early appearance of 
secondary psychico-sexual manifestations. Nevertheless, 
Binet's subtle remark that the lasting presence of such 
associations is only possible in predisposed (tainted) indi- 
viduals is worthy of note. 

Neither do the explanations attempted by physicians 
and naturalists prove anything to satisfaction. Gley 
("Revue philosophique," January, 1884) maintains that 
those afflicted with inverted sexual instinct have a female 
brain ( !) but masculine sexual glands, and that an existing 
morbid condition of the brain determines the sexual life, 
whilst e contra and normally the sexual glands influence 
the sexual cerebral functions. Magnan ("Annales med. 
psychol.," 1885, p. 458) also speaks of a female brain in 
the body of a man and vice versa. Ulrichs ("Memnon," 
1868) comes closer to the point when he speaks of an 
anima muliebris virili corpori innati, and thus seeks to 
explain congenital effeminatio. According to Mantegazza 
(op. cit. 1886, p. 106), anatomical anomalies exist in such 
persons in so far as the natural plextts of the genital nerves 
terminates in the rectum, thus misdirecting thither all 



0-8EXUAI >i;\!\[ l-ATION. 343 

s. But surelv nadir is guilty of such 

errors or "sallux". NYiiln-r does slit- burden a masculine 
body with a female brain. The author of this hypothesis, 
otherwise so acute, quite overlooks the fact that the 
individuals given to sexual inversion, as a rule, abhor 
the use of the anus viz., pederasty. Mantegazza, reverts, 
as a support for his hypothesis, to the communications 
which he received from a well-known prominent author, 
who assured him that he was not as yet satisfied in his 
own mind whether he derived greater pleasure from coitus 
than from defalcation. Even if we admit the correctness 
of this statement, it would only prove that its author was 
sexually abnormal, and that he derived but a minimum of 
pleasure from coitus. Moreover, one would come to the 
conclusion that the mucous membrane of his rectum was, 
in some abnormal manner, erogenous. 

Bernhardi ("Der Uranismus," Berlin, 1882) casually 
found in five effeminati ("Pathici") absence of spermato- 
zoa, in four cases not even sperm crystals, and thought to 
find the solution of this "enigma of many thousand years" 
in the assumption that the pathicux was a "monster of 
the feminine sex, having nothing else in common with 
the male than the male genitals, which in some cases are 
even only imperfectly developed". This author could not 
even base his contention upon an autopsy, which, no doubt, 
would have eventually established a case of hermaphrodit- 
ism. 

Those practising active viraginity and gynandry he 
styles as "monsters of masculine gender in opposition to 
which the passive tribade is as perfect a woman as the 
active paedicator is a perfect man". 

The author of this book has made an attempt to utilise 
facts of heredity for an explanation of this anomaly. 
Proceeding from the experience that manifestations of 
sexual perversion are frequently found in the parents, he 
suspects that the various grades of congenital sexual 
inversion represent various grades of sexual anomaly 
inherited by birth, acquired by ascendency, or otherwise 



344 PSYCHOPATH IA SEXUALI8. 

developed. In this connection, the law of progressive 
heredity must also be considered.^ 

All attempts at explanation made hitherto on the 
ground of natural philosophy or psychology, or those of 
a merely speculative character are insufficient. 

Later researches, however, proceeding on embryo- 
logical (onto- and phylogenetic) and anthropological lines 
seem to promise good results. 

Emanating from Frank Lydston ("Philadelphia Med. 
and Surg. Recorder," September, 1888,) and Kiernan 
("Medical Standard," November, 1888), they are based 
(1) on the fact that bisexual organisation is still found in 
the lower animal kingdom, and (2) on the supposition that 
mono-sexuality gradually developed from bisexuality. 
Kiernan assumes in trying to subordinate sexual inversion 
to the category of hermaphroditism that in individuals thus 
affected retrogression into the earlier hermaphrodisic 
forms of the animal kingdom may take place at least 
functionally. These are his own words: "The original 
bisexuality of the ancestors of the race, shown in the 
rudimentary female organs of the male, could not fail to 
occasion functional, if not organic reversions, when mental 
or physical manifestations were interfered with by disease 
or congenital defect. It seems certain that a feminily 
functionating brain can occupy a male body and vice versa. 

Chevalier (op. cit., p. 408) proceeds from the original 
bisexual life in the animal kingdom, and the original 
bisexual predisposition in the human foetus. 

According to him the difference in the gender, with 
marked physical and psychical sexual character, is only 
the result of endless processes of evolution. The psycho- 
physical sexual difference runs parallel with the high level 
of the evolving process. The individual being must 
also itself pass through these grades of evolution; it is 
originally bisexual, but in the struggle between the male 
and female elements either one or the other is conquered, 
and a monosexual being is evolved which corresponds with 
the type of the present stage of evolution. But traces of 



HOMO-SEXUAL FEELING AS ABNORMAL MANIFESTATION. 345 

the conquered srxualitv remain. Under certain circum- 
stances, these caracteres sexuels latcnts may gain Darwin's 
signification, i.e., they may provoke manifestations of 

i-tecl sexuality. Chevalier does not, however, look 
upon such processes as a retrogression (atavism), in the 
sense of Lombroso's opinion and that of others, but rather 
considers them with Lacassagne as disturbances in the 
present stage of evolution. 

If the structure of this opinion is continued, the fol- 
lowing anthropological and historical facts may be 
evolved : 

1. The sexual apparatus consists of (a) the sexual 
glands and the organs of reproduction; (6) the spinal 
centres, which act either as a check or a stimulus upon 
(a) ; (c) the cerebral regions, in which the psychical 
processes of the vita sexualis are enacted. 

Since the original predisposition of (a) is of a bisexual 
character, the same must be claimed for (6) and (c). 

2. The tendency of nature in the present stage of 
evolution is the reproduction of monosexual individuals, 
and the law of experience teaches that that cerebral centre 
is normally developed which corresponds with the sexual 
glands ("Law of the Sexual Homologous Development"). 

3. This destruction of antipathic sexuality is at present 
not yet completed. In the same manner in which the 
processus vermiformis in the intestinal tube points to 
former stages of organisation, so may also be found in 
the sexual apparatus in the male as well as in the 
female residua, which point to the original onto- and 
phylogenetic bisexuality, not to speak of hormaphrodisic 
malformations, which may be looked upon merely as 
partial excesses of development, or disturbances in the 
formation of the sexual organisation, and especially of 
the external genitals. 

The residua referred to are, in the male, the utriculus 
masculinus (remnants of the "Miillersche Gange") and 
the nipple, fn woman the paroophoron (remnants of the 
or i /r ;u<tl renal portions of the Wolffian bodies), and the 



346 PSYCHOPATHIA SEXUALIS. 

epoophoron (remnants of Wolff's ganglia, and analogous 
with the epididjrmifl in the male).\Bet^e^ Klebs, Fiirst and 
others have found in the human female suggestions of the 
Wolffian bodies in the shape of the so-called Gartnerian 
canals, which in the female ruminants are regularly present 
in the lateral wall of the uterus. 

4. Besides, a long line of clinical and anthropological 
facts favour this assumption. 

I will only call attention to the not infrequent cases 
of individuals with characters of mixed or (in the 
sense of sexual inversion) predominating physical and 
psychical sexuality ("female men and male women"), to 
the appearance of the female character (psychically and 
physically) in men, consequent upon castration (eunuclis)j 
and of the male character in woman after the removal of 
the ovaries in early youth, also to the manifestations of 
viraginity in climax prcecox, and even to the development 
of a second gender. 

Professor Kalteribach gives a remarkable instance of 
such a second (antipathic) vita sexualis, developed upon 
climax praecox. 

On the 17th of February, 1892, he consulted me about 
"a woman, thirty years of age, married two years, who 
formerly had irregular menstruations." 

Since June, 1891, a sudden series of manifestations 
which corresponded with the process of masculine puberty, 
viz., full beard, hair of the head much darker, eyebrows 
and pubis strongly developed, chest and abdomen covered 
with hair as in man. 

Increased activity of the sudoriparous and sabaceous 
glands. Upon chest, back and face strong miliary and 
acne developments, whilst formerly the tint was classically 
white and smooth. Change of voice formerly rich 
soprano, now a "lieutenant's voice". The entire facial 
expression changed. Complete change o f carriage: chest 
broad, waist gone, abdomen prominent with adipose tissue, 
short thick-set neck, masculine all over. l*/wer part 
of face broad, breasts flat and masculine. 



HOMO-SEXUAL FEELINO AS ABNORMAL MANIFESTATION. 347 

changes: formerly mild and tractable, now enrrgetic, 
hard to control, even aggressive. From the beginning 
of marriage no adequate sexual desire, but no traces of 
inversion. 

In the sexual organs also highly interesting changes 
may be found. "Thus this young woman has changed 
into a man, to all intents and purposes." 

My explanation of the case : 

"Climax prcecox, loss of former feminine sexuality. 
Physical and psychical development of male sexuality, 
hitherto latent. Interesting illustration of the bi-sexual 
predisposition, and of the possibility of continued existence 
of a second sexuality in a latent state, under conditions 
hitherto unknown." 

Unfortunately, I could obtain no further information 
about the subsequent metamorphosis of this case, or the 
presence of probable hereditary taint. 

Vide also cases 129 and 130. In these severe neuras- 
thenia was the causating element of transmutatio sexus, 
based upon heavy taint; the change, however, being only 
psychical, and not affecting the physical sexual character. 

5. These manifestations of inverted sexuality are 
evidently found only in persons with organic taint. 1 In 
normal constitutions the law of mono-sexual development, 
homologous with the sexual glands, remains intact. That 
the cerebral centre is developed under other conditions, 
quite independent from the peripheral sexual organs (in- 
cluding the sexual glands), is evident from the cases of 
hermaphroditism (at least, so far as pseudo-hermaphrodi- 
tism is concerned), in which the law referred to above re- 
mains intact in the sense of mono-sexual development, 

"The researches in zoology, by Klaus ("Zoology," 1891, p. 490) 
show that, in the lower grades of the animal world, not only 
hermaphroditism exists, but that also ( physiological T ) sexual ex- 
change in one and the same individual may take place. Klaus states 
that the cymothoidea" (classified under Crustacea) perform in the 
first part of their life the functions of the male, and in the second 
part under many, even secondary, changes of the sexual character 
iLc=e ot the female. 



348 PSYCHOPATHIA SEXUALIS. 

analogous to the sexual glands. In hermaproditismus 
verus, however, physically as well as psychically, a mutual 
influence of both centres obtains, and thus also a neutral- 
isation of the vita amoris, assuming even a state of asex- 
uality, and a tendency to physically and psychically com- 
bine and put into operation both these sexual characters. 

But hermaphroditism and sexual inversion stand in no 
relation to each other. This is clear from the fact that 
the hermaphrodite (or, practically speaking, the pseudo- 
hermaphrodite) follows the law of evolution quoted above, 
and does not offer inverted sexuality, whilst, on the 
other hand, hermaphroditism has never been anatomically 
observed in cases of antipathic sexual instinct. This 
follows, without further argument, from the difference of 
the conditions under which they originate, for in sexual 
inversion we must look for the cause in central (cerebral) 
defects, and in hermaphroditism in the anomalies affecting 
the peripheral sexual apparatus. 

The facts quoted seem to support an attempt of an 
historical and anthropological explanation of sexual inver- 



sion. 



It is a disturbance of the law of the development of 
the cerebral centre, homologous to the sexual glands 
(homo -sexuality), and eventually also of the law of 
the mono-sexual formation of the individual (psychical 
"hermaphroditism"). In the former case it is the centre 
of bi-sexual predisposition, antagonistic to the gender 
represented by the sexual gland, which in a paradoxical 
manner conquers that originally intended to be superior; 
yet the law of mono-sexual development obtains. 1 

In the other case victory lies with neither centre; yet 
an indication of the tendency of mono-sexual development 

*A mono-sexual psychic apparatus of generation, in a mono- 
sexual body which belongs to the opposite sex, does, of course, not 
mean a " feminine soul in a masculine brain," or vice versa this 
would simply contradict all monistic and scientific thought; neither 
a feminine brain in a masculine body this contradicts erery 
anatomical fact but only a feminine psycho-sexual centre in a 
masculine brain, and vice versa. 



HOMO-SEXUAL FEELING AS ABNORMAL MANIFESTATION. 349 

remains, in so far that one is predominant, as a rule the 
opposite. This is the more remarkable since it has not 
the support of a corresponding sexual gland in fact, not 
even a peripheral sexual apparatus, another proof that the 
cerebral centre is autonomous, and in its development 
independent of the sexual glands. 

In the first case it must be assumed that the centre 
which by right should have conquered was too weak. 
This fact may be recognized in the subsequently weak 
libido in the sexual character, but feebly marked in the 
physical and psychical conditions. 

In the second case both centres were too weak to 
obtain victory and superiority. 

This defect of the natural laws must, from the anthro- 
pological and clinical standpoint, be considered as a man- 
ifestation of degeneration. In fact, in all cases of 
sexual inversion a taint of a hereditary character may 
be established. What causes produce this factor of taint 
and its activity is a question which cannot be well 
answered by science in its present stage. 1 

There are plenty of analogous cases to be found in 
tainted individuals. For the symptoms of influences 
disturbing physical and psychical evolution, and plainly 
to be found in the germ of procreation, exhibit themselves 
in many other manifestations of a defective or perverse 
character (signs of anatomical, functional, somatic and 
psychical degeneration). 

The antipathic sexual instinct is only the strongest 

1 Joseph MUller, in a clever brochure ("Ueber Gamophagy," 
Stuttgart, 1892) offers an inducement for further research in this 
direction. He advances the opinion that by a certain law, established 
by necessity, and transcending in normal fashion, a union of the 
organs and their qualities is effected. This union would explain how, 
in the struggle of the development of mono- and bi-sexuality, those 
organs and their qualities suffer the common fate of conquest or 
defeat which belong together as a whole with regard to their 
functional capacity. The defect of the elements connecting the 
organs during the struggle for superiority in beings subject to 
organic taint could only be explained as a negative result of this 
hypothetical law. 



350 PSYCHOPATHIA SEXUALIS. 

mark left by a whole series of exhibitions of the partial 
development of psychical and physical inverted sexual 
characters (vide supra), and one may be easily permitted 
to say: The more indistinct the psychical and physical 
sexual characters appear in the individual, the deeper it 
is below the present level of perfect homologous mono- 
sexuality obtained in the evolution of manifold thousands 
of years. 

The cerebral centre mediates the psychical and, in- 
directly, also the physical sexual characters. The various 
grades of congenital antipathic sexuality will be found to 
correspond with the intensity of various grades of taint. 

The same holds good with regard to "acquired" sexual 
inversion, which exhibits itself only later in life. Un- 
tainted man will never become sexually inverted through 
onanism or seduction by persons of the same sex; for, as 
soon as the extrinsic influences cease, he returns to normal 
sexual functions. The tainted individual, however, whose 
psycho-sexual centre is originally weak, is in a different 
position. All possible psychical and physical deficiencies, 
especially neurasthenic, are able to impair his weakened 
sexuality, homologous though it may have been hitherto 
to the sexual glands. These evil influences may render 
him furthermost psychically bi-sexual, then invertedly 
mono-sexual, and eventually may effect even eviratio (de- 
feminatio), by way of producing physical and psychical 
characters of sexuality, in the sense of predominating 
antipathic, or the destruction of original, centres. On 
page 286, etc., I have tried to show in how far neurasthenia 
may give the impulse for the development of antipathic 
sexuality. 

Congenital Antipathic Sexual Instinct in Man. 

The sexual acts by means of which male urnings seek 
and find satisfaction are multifarious. There are indi- 
viduals of fine feeling and strength of will who sometimes 
satisfy themselves with platonic love, with the risk how- 



CONGEM1 A: I II 1C' 8EXUAI I IN MAN. 351 

<.f Ixvoiiiing nervous (neurasthenic) and insane as a 
result of this enforced ahstinence. In other in>taiices, fr 
the same reasons \\hieh may lead normal individuals to 
avoid coitus, onanism, fautc de mieux, is indulged in. 

In urnings with nervous systems congenitally irritable, 
or injured by onauism (irritable weakness of the ejacu- 
lation centre), simple embraces or caresses, with or without 
contact of the genitals, are sufficient to induce ejaculation 
and consequent satisfaction. In less irritable individuals, 
the sexual act consists of manustupration by the loved 
person, or mutual onanism, or imitation of coitus between 
the thighs. In urnings morally perverse and potent, quoad 
ereciionem, the sexual desire is satisfied by pederasty, an 
act, however, which is repugnant to perverted individuals 
that are not defective morally, much in the same way as 
it is to normal men. The statement of urnings is remark- 
able, that the adequate sexual act with persons of the 
same sex gives them a feeling of great satisfaction and 
accession of strength, while satisfaction by solitary onan- 
ism, or by enforced coitus with a woman, affects them in 
an unfavourable way, making them miserable and increas- 
ing their neurasthenic symptoms. 

As to the frequency 1 of the occurrence of the anomaly, 
it is difficult to reach a just conclusion, since those affected 
with it not often break from their reserve; and in criminal 
cases the urning with perversion of sexual instinct is usual- 
ly classed with the person given to pederasty for simply 
vicious reasons. According to Casper's and Tardieu's, as 
well as my own, experience, this anomaly is much more 
frequent than reported cases would lead us to presume. 

'That inversion of the sexual instinct is not uncommon is 
proved, among other things, by the circumstances that it is frequently 
the subject in novels. The neuropathic foundation of this sexual 
perversion does not escape tlie writers. This theme is treated in 
m literature in " Fridolin's hcimliche Eho," by Wilbrand; in 
" Brick-a-Braek odcr Lie-lit im Schatton," by Emcrich Graf Stadion; 
also by Raldtiin Grnllrr, " Prinz Klotz." The oldest urning romance 
is probably that publish***! by 1'etroniut at Rome, under the Empire. 
under the title " Satyricon." 



352 PSYCHOPATH I A SEXUALIS. 

Ulrichs ("Kritische Pfeilc," p. 2, 1880) declares that, 
on an average, there is one person affected with antipathic 
sexual instinct to every 200 mature men, or to every 800 of 
the population; and that the percentage among the Mag- 
yars and South Slavs is still greater, statements which 
may be regarded as untrustworthy. The subject of one 
of my cases knows personally, at his home (13,000 inhab- 
itants), fourteen urnings. He further declares that he is 
acquainted with at least eighty in a city of 60,000 inhabi- 
tants. It is to be presumed that this man, otherwise 
worthy of belief, makes no distinction between the congen- 
ital and the acquired anomaly. 

I. Psychical Hermaphroditism. 1 

The characteristic mark of this degree of inversion of 
the sexual instinct is that, by the side of the pronounced 
sexual instinct and desire for the same sex, a desire toward 
the opposite sex is present; but the latter is much weaker 
and is manifested episodically only, while homo-sexuality 
is primary, and, in time and intensity, forms the most strik- 
ing feature of the vita sexualis. 

The hetero-sexual instinct may be but rudimentary, 
manifesting itself simply in unconscious (dream) life; or 
(episodically, at least) it may be powerfully exhibited. 

The sexual instinct toward the opposite sex may be 
strengthened by the exercise of will and self-control; by 
moral treatment, and possibly by hypnotic suggestion; by 
improvement of the constitution and the removal of 
neuroses (neurasthenia) ; but especially by abstinence from 
masturbation. 

However, there is always the danger that homo-sexual 
feelings, in that they are the most powerful, may become 
permanent, and lead to enduring and exclusive antipathic 



1 Cf. author's work, " Ueber psychosexuales Zwitterthum," in 
the " Internationales Centralblatt f. d. Physiologic u. Pathologic der 
Harn- und Sexualorgane," Bd. i., Heft 2. 



PSYCHICAL !I1:>1>1TI8M. 353 

sexual instinct. This is especially to be feared as a result 
of the influences of masturbation (JIM a- in ac<|iiired in- 
version of tin- sexual in.-iinct) and its neurasthenia and 
conseqm-nt exacerbations; and, further, it is to be found 
as a consequence of unfavourable experiences in sexual 
intercourse with persons of the opposite sex (defective feel- 
ing of pleasure in coitus, failure in coitus on account of 
\\( akness of erection and premature ejaculation, infection). 

On the other hand, it is possible that aesthetic and 
ethical sympathy with persons of the opposite sex may 
favour the development of hetero-sexual desires. Thus 
it happens that the individual, according to the predomi- 
nance of favourable or unfavourable influences, experiences 
now hetero-sexual, now homo-sexual, feeling. 

It seems to me probable that such hermaphrodites 
from constitutional taint are rather numerous. 1 Since they 
attract very little attention socially, and since such secrets 
of married life are only exceptionally brought to the knowl- 
edge of the physician, it is at once apparent why this in- 
teresting and practically important transitional group to 
the group of absolute inverted sexuality has thus far 
escaped scientific investigation. 

Many cases of frigiditas uxoris and marili may possibly 
depend upon this anomaly. Sexual intercourse with the 
opposite sex is, in itself, possible. At any rate, in cases 
of this degree, no horror sexus alterius exists. Here is a 
fertile field for the application of medical and moral thera- 
peutics (v. infra). 

The differential diagnosis from acquired antipathic 
sexual instinct may present difficulties; for, in such cases, 
so long as the vestiges of a normal sexual instinct are not 
absolutely lost, the actual symptoms are the same (v. 
infra) . 

In the first degree, the sexual satisfaction of homo- 

1 This idea ia supported by the statement* of an unmarried 
urning, which Dr. Moll, of Berlin, kindly communicated to me. He 
could report a number of cases of his acquaintance, in which married 
men had also " relations " with men. 

23 



354 PSYCHOPATH I A SEXUALIS. 

sexual impulses consists in passive and mutual onanism and 
coitus inter femora. 

Case 134. Antipathic sexual instinct with sexual sat- 
isfaction in hetero-sexual intercourse. Mr. Z., aged thirty- 
six, consulted me on account of an anomaly of his sexual 
feelings, which had become a matter of anxiety to him 
in connection with an intended marriage. Patient's father 
was neuropathic, and suffered with nightmare and night- 
terrors. Grandfather was also neuropathic; father's 
brother an idiot. Patient's mother and her family were 
healthy and normal mentally. The patient had three 
sisters and one brother, the latter being subject to moral 
insanity. Two sisters were healthy, and enjoying happy 
married lives. 

As a child, the patient was weak, nervous, and subject 
to night-terrors, like his father; but he never had any 
severe illness, except coxitis, as a result of which he limped 
slightly. Sexual impulses were manifested early. At 
eight, without any teaching, he began to masturbate. 
From his fourteenth year, ejaculation. He was mentally 
well endowed, and his principal interest was in art and 
literature. He was always weak muscularly, and had no 
inclination for boyish sports and later for manly occupa- 
tions. He had a certain interest for female toilettes, orna- 
ments, and occupations. From the time of puberty the 
patient noticed in himself an inexplicable inclination 
toward male persons. Youths- of the lowest classes were 
most attractive to him. Cavalry men especially excited 
his interest. He experienced a lustful desire to press him- 
self against such individuals from behind. Occasionally, 
in crowds, it was possible for him to do this; and in such 
an event an intense feeling of pleasure passed t>ver him. 
After his twenty-second year, on such occasions, he now 
and then had an ejaculation. From that time ejaculation 
occurred when a sympathetic man laid his hand on the 
patient's thigh. He was now in great anxiety lest he 
might sometime assault a man sexually. People of the 



PSYCHICAL IIERMAIMIBODITISM. 355 

lower classes, wearing tight, brown trousers, were espec- 
ially dangerous for him. His greatest pleasure would be 
to embrace such a man and press himself to him; but, 
unfortunately, the morality of his country did not allow 
such a thing. Pederasty seemed disgusting to him. 

It gave him great pleasure to gain a sight of the gen- 
itals of males. He was always compelled to look at the 
genitals of every man he met. In circuses, theatres, etc., 
only male performers interested him. Patient had never 
noticed any inclination for women. He did not avoid 
them, even danced with them on occasion, but he never 
felt the slightest sensual excitation under such circum- 
stances. 

At the age of twenty-eight the patient was neuras- 
thenic as a result of his excessive masturbation: 

Then frequent pollutions in sleep occurred, which 
weakened him very much. It was only occasionally that 
he dreamed of men when he had pollutions; and never 
of women. A lascivious dream-picture (pederasty) had 
occurred but once. He dreamed of death-scenes, of being 
attacked by dogs, etc. After these, as before, he suffered 
with great libido serualis. Often there came up before 
him such lascivious thoughts as gloating over the death of 
animals in the slaughter-house, or allowing himself to be 
whipped by boys; but he always overcame such desires, 
and also the impulse to dress in a military uniform. 

In order to cure himself of masturbation, and to thor- 
oughly satisfy his libido, he determined to frequent broth- 
els. He first attempted sexual intercourse with a woman 
when twenty-one, after over-indulgence in wine. The 
beauty of the female form, and female nudity in general, 
made no impression on him. However, he was able to 
enjoy the act of coitus, and thereafter he visited brothels 
regularly for "purposes of health." 

From this time he took preat pleasure in hearing men 
tell stories of their sexual relations with the opposite sex. 

Ideas of flagellation would al*o oonr 1 to him while in 
a brothel, but the retention of such fancies was not easen- 



356 PSYCHOPATH! A SEXTTALIS. 

tial for the performance of coitus. He considered sexual 
intercourse with prostitutes only a' remedy against the de- 
sire for masturbation and men, a kind of safety-valve to 
prevent compromising himself with some man. 

The patient wished to marry, but feared not only that 
he could have no love for a decent woman, but also that 
he might be impotent for intercourse with her. Hence 
his thought and need of medical advice. 

The patient was very intelligent, and, in all respects, 
was of masculine appearance. In dress and manner he pre- 
sented nothing that would attract attention. Gait, voice 
and frame, the pelvis especially, masculine in character. 
Genitals of normal development. The normal growth 
of hair for a male was abundant. The patient's relatives 
and friends had not the slightest suspicion of his sexual 
anomalies. In his inverted sexual fancies he had never 
felt himself in the role of a woman toward a man. For 
some years he had been entirely free from neurasthenic 
troubles. 

The question as to whether he considered himself a 
subject of congenital sexual inversion he could not answer. 
It seems probable that there was a congenital weak inclina- 
tion for the opposite sex, with a greater one for the same 
sex, which, as a result of early masturbation in conse- 
quence of the homo-sexual instinct, was still more weak- 
ened, but not reduced to nil. With the cessation of mas- 
turbation, the feeling for women became in a measure 
more natural, but only in a coarsely sensual way. 

Since the patient explained that, for reasons of family 
and business, it was necessary for him to marry, it was 
impossible to eliminate this delicate point. 

Fortunately, the patient confined himself to the ques- 
tion as to his virility as a husband; and it was necessary 
to reply that he was virile, and that he would probably be 
so in conjugal intercourse with the wife of his choice, 
at least, if she were to be in mental sympathy with him; 
moreover that he could at all times improve his power by 
exercising his imagination in the right direction. 



PSYCHICAL HZBMAPHBODITI81C. 357 

The main object was to strengthen .the sexual inclina- 
tion for the opposite sex, which was defective, but not ab- 
solutely wanting. This could be done by avoiding and 
opposing all homo-sexual feelings and impulses, possibly 
with the help of the artificial inhibitory influences of hyp- 
notic suggestion, (removal of homo-sexual desires by sug- 
gestion) ; by the excitation and exercise of normal sexual 
desires and impulses; by complete abstinence from mas- 
turbation, and eradication of the remnants of the neuras- 
thenic condition of the nervous system by means of hydro- 
therapy, and possibly general faradisation. 

Case 135. V., age twenty-nine, official ; father hypo- 
chondriac, mother neuropathic; four other children nor- 
mal; one sister homo-sexual. 

V. was very talented, learned easily and had a most 
excellent religious education. Very nervous and emo- 
tional. At the age of nine he began to masturbate of his 
own accord. When fourteen he recognised the danger 
of this practice and fought with some success against it; 
but he began to rave about male statuary, also about young 
men. When puberty set in, he took slight interest in 
women. At twenty, first coitus cum rauliere, but though 
potent, he derived no satisfaction from it^ Afterwards 
only faute de mieux (alxnit six times) hetero-sexual inter- 
course. 

He admitted to have had very frequently intercourse 
with men (masturbatio mutua, coitus inter femora, inter- 
dum in os). He took either the active or passive role. 

At the consultation he was in despair and wept bitterly. 
He abhorred his sexual anomaly, and said that he had des- 
perately battled against it, but without success. In woman 
he found only moderate animal satisfaction, psychical 
gratification being totally absent. Yet he craved for the 
happiness of family life. 

Excepting an abnormally broad pelvis (100 cm.) there 
was nothing in his character or personal appearance that 
lacked the qualities of the masculine type. 



358 PSYCIIOPATIIIA SEXUALIS. 

Case 136. K., age 30; in the family on his mother's 
side there were several cases of insanity. 

Both parents were neurasthenic, irritable and excitable, 
and lived unhappily together. 

K. had from his early childhood sympathy only for 
men, chiefly for male servants. 

Pollutions at the age of fourteen, often coupled with 
homo-sexual dreams. 

Descriptions of bullfights and tortures of animals 
greatly excited him sexually. 

When fifteen he began, of his own accord, auto-mas- 
turbation. At the age of twenty-one, homo-sexual inter- 
course with men (only mutual masturbation). Off and on 
psychical onanism associated with thoughts of men. 

His inclinations to women were of a transient nature. 
When pressed to enter wedlock he could not decide in its 
favour. 

He never had coitus cum muliere partly because he 
had no confidence in his virility, and partly from fear of 
infection. 

For years he was highly neurasthenic, which rendered 
him for whole periods psychically unfit for any kind of 
work. He was listless and devoid of energy, but in struc- 
ture and personal appearance masculine. Genitals normal. 

Advice: Treatment for neurasthenia, energetic combat 
with homo-sexual desires, society of ladies, eventually coi- 
tus condomatus. Wedlock, when suited, as His station in 
life demanded it. 

After four months K. returned. He had conscien- 
tiously acted upon the medical advice, was successful in 
coitus, dreamed of women, disdained the idea of sexual 
relations with men, but during the heated season still ex- 
perienced homo-sexual impulses (due to exacerbation of 
neurasthenia, superinduced by the hot weather). 

He hoped to marry at an early date, and anticipated 
much happiness from the married state. 

Case 137. Psychical liermaphroditism. Hetero-sex- 



.MAi'iiuoi.rr 359 



ual feeling early interfere! with by masturbation, but epi- 
sodically vi TV intense. ll<m<> -sexual feeling ab orirjiiic 
erse (sexual excitation by men's boots). 
Mr. X., of high social position, aged twenty-eight, came 
to me in September, 1887, in a despairing mood, to con- 
sult me on account of a perversion of his vita scxualis, 
which made life seem almost unbearable to him, and which 
had repeatedly brought him near to suicide. The patient 
came of a family in which neuroses and psychoses had been 
of frequent occurrence. In the father's family there had 
been marriage between first cousins for three generations. 
The father was said to have been a healthy man, and to 
have lived morally in marriage. However, his father's 
preference for fine-looking servants seemed remarkable to 
the son. The mother's family was described as eccentric. 
The mother's grandfather and great-grandfather die.d mel- 
ancholic; her sister was insane; a daughter of the grand- 
father's brother was hysterical, and had nymphoraania. 
Only three of the mother's twelve brothers and sisters 
married. Of these, one brother was homo-sexual, and al- 
ways nervous as a result of excessive masturbation. The 
patient's mother was said to have been a bigot of small 
mental endowment, nervous, irritable, and inclined to mel- 
ancholia. 

Patient had a sister and a brother. The brother was 
neuropathic and frequently melancholic; and, though 
mature had never shown the slightest trace of sexual 
inclinations. The sister was an acknowledged beauty, and 
nmeh sought by gentlemen. This lady was married, but 
ehildless, as reported, owing to the impotence of her hus- 
band. She had always been indifferent to the attentions 
shown her by men. but was charmed by female beauty, 
and actually in love with some of her female friends. 

With respect to himself, the pntiont asserted that when 
four years old he dreamed of handsome jockeys wearing 
shining boots. He never dreamed of women when he grew 
older. His niirhtly pollutions were always induced by 
"boot-dreams". From his fourth year be had a peculiar 



360 PSYCHOPATIIIA SEXUALI9. 

partiality for men, or, more correctly, for lackeys wearing 
shining boots. At first they only excited his interest, but 
with development of his sexual functions, the sight of 
them caused powerful erections and lustful pleasure. It 
was only servants' boots that affected him; the same kind 
of boots on persons of like social station were without 
effect on him. In a homo-sexual sense, there was no sexual 
impulse connected with these situations. Even the thought 
of such a possibility was disgusting to him. At times, how- 
ever, he had sensually coloured ideas such as being his 
servant's servant, and drawing off his boots; the idea of 
being stepped on by him, or of having to blacken his boots, 
was most pleasing. The pride of the aristocrat rose up 
against such thoughts. In general, these notions about 
boots were disgusting and painful to him. 

Sexual instinct was early and powerfully developed. 
It first found expression in indulgence in sensual thoughts 
about boots, and, after puberty, in dreams accompanied by 
pollutions; otherwise, mental and physical development 
was undisturbed. Patient was well endowed mentally 
learned easily, finished his studies, and became an officer. 
On account of his distinguished, manly appearance and 
his high position, he was much sought in society. 

He characterised himself as a clever, quiet, strong- 
willed, but superficial man. He asserted that he was a 
passionate hunter and rider, and that he had never had 
any inclination for feminine pursuits. In the society of 
ladies he had always been reserved; dancing always tired 
him. He never had an interest in any lady of high social 
position. As for women, only the buxom peasant girls, 
such as are the models of painters in Rome, had taken his 
fancy. He had, however, never felt any sexual interest 
even in such representatives of the female sex. At thb 
theatre and circus only male performers had attracted him ; 
but, at the same time, they caused him no sensual feelings 
As for men, only their boots excited him, and, indeed, 
only when the wearers belonged to the servant class and 



PSYCHICAL HEEMAPIIEODITISM. 361 

were handsome men. Men of his own position, wearing 
ever so fine boots, were absolutely indifferent to him. 

With reference to his sexual inclinations, the patient 
was still uncertain whether he felt these more toward the 
opposite sex or his own. He was inclined to think that 
originally he had more inclination for women, but that this 
sympathy was, in any case, very weak. He stated with 
certainty that the sight of a naked man made no impres- 
sion on him, and that the sight of male genitals was even 
repugnant to him. As for woman, this was not exactly the 
case; but even the most beautiful feminine form did not 
excite him sexually. When a young officer, he was now 
and then compelled to accompany his comrades to brothels. 
He was the more easily persuaded to this, since he hoped 
by this means to get rid of his vile partiality for boots; 
but he was impotent unless he brought the thought of 
boots to his aid. Under such circumstances, the act of 
cohabitation was normally performed, but without pleasur- 
able feeling. Patient felt no impulse to intercourse with 
women, always requiring some external cause i.e., per- 
suasion. Left to himself his vita sexualis consisted in rev- 
elling in ideas about boots, and in corresponding dreams 
coupled with pollutions. As the impulse to kiss his ser- 
vant's boots, to draw them off, etc., became more and more 
connected with these dreams and ideas the patient deter- 
mined to use every means to rid himself of this disgust- 
ing desire, which deeply wounded his pride. At that time, 
being in his twentieth year, and in Paris, he recalled a 
very beautiful peasant girl, who lived in his distant home. 
He hoped, with her assistance, to free himself of his sexual 
perversion. He went home, and tried to win the girl's 
favour. He asserted that at that time he was deeply in 
love with this person, and that the sight of her, or the 
touch of her dress, gave him sensual pleasure; and, when 
she once kissed him, he had a powerful erection. After 
about a year and a half, the patient succeeded in gaining 
his desires with this person. 



rSYCIIOPATlIIA SEXUALIS. 

He was potent, but ejaculated tardily (ten to twenty 
minutes), and never had a pleasurable feeling in the act. 

After about a year and a half of sexual intercourse 
with this girl, his love for her grew cold, because he did 
not find her so "fine and pure" as he wished. From this 
time it was necessary for him to call upon ideas about boots 
for help, which had been latent, in order to be potent in 
sexual intercourse with her. In proportion as his power 
failed, these ideas arose spontaneously. Thereafter he had 
coitus with other women. Now and then, especially when 
the woman was in sympathy with him, the act took place 
without any assistance of imagination. 

It once happened that the patient committed rape. 
It is remarkable that on this single occasion he had a pleas- 
urable feeling in the (forced) act. Immediately after the 
deed he had a feeling of disgust. When, an hour after the 
forced indulgence, he had coitus with the same woman, 
with her consent, he experienced no feeling of pleasure. 

With the decline of virility i.e., when it was main- 
tained only with ideas about boots libido for the opposite 
sex decreased. The patient's slight libido and weak in- 
clination for women were evidenced by the fact that, while 
he still sustained sexual relations with the peasant girl, 
he began to masturbate. He learned the vice from 
"Rousseau's Confessions," the book accidentally falling 
into his hands. The boot-fancies immediately linked them- 
selves with corresponding impulses. He then had violent 
erections, masturbated, and ejaculation afforded him a 
lively feeling of pleasure, which was denied to him in 
coitus; and at first he felt himself mentally brighter and 
fresher, as a result of masturbation. 

In time, however, symptoms of sexual, and later on of 
general neurasthenia, with spinal irritation, appeared. He 
then temporarily gave up masturbation, and sought his 
first love; but she was now more than ever indifferent to 
him. Since he finally became impotent, even when he 
called ideas of boots to his assistance, he gave up women 
entirely, and again practised masturbation, which pro- 



PSYCHICAL 1 1 1: K M A P 1 1 Id iDITISlf. 

<1 him from the impulse to kiss and blacken, etc., ser- 
vants' boots. At the saint- tim-, ho felt his sexual position 
keenly. He again occasionally attempted coitus, and was 
successful in it as soon as he thought of blackened boots. 
After continued abstinence from masturbation, he was at 
times successful in coitus without any artificial an I. 

The patient said that his sexual needs wore intense. 
If no ejaculation had taken place for a long time, he be- 
came congestive, psychically much excited, and tormented 
by repugnant images of boots, so that he was forced to 
have coitus, or, preferably, to masturbate. 

During the past year his moral position became most 
painfully complicated by the fact that, as the last of a 
wealthy line of high position, and at the importunate de- 
sire of his parents, he must marry. The bride was of rare 
beauty, and mentally in perfect sympathy with him; but, 
as a woman, she was as indifferent to him as any other. 
J'sthetically she satisfied him "as any work of art would" ; 
in his eyes, she was simply ideal. To honour her in a 
platonic way would be happiness worth striving for; but 
to possess her as a wife was a painful thought. He was 
certain beforehand that with her he would be impotent, 
save with the help of ideas of boots. To use such means, 
however, was in opposition to his respect and his moral 
and aesthetic feelings for the lady. Were he to soil her 
with such thoughts, she would lose, in his eyes, all her 
aesthetic value; and then he would become impotent for 
her, and she would become repugnant to him. The patient 
considered his position one of despair, and confessed that 
he had of late been repeatedly near suicide. 

He was a man of much intelligence, and decidedly of 
masculine appearance, with abundant growth of beard, 
deep voice, and normal genitals. The eye had a neuro- 
pathic expression. No signs of degeneration. Symptoms 
of spinal neurasthenia. It was possible to reassure the 
patient, and give him hope of his future. 

The medical advice consisted in means for combating 
the neurasthenia, and the interdiction of masturbation and 



364' P8YCHOPATHIA SEXUALIS. 

indulgence of the fancy in images of boots, in the hope 
that, with the removal of the neurasthenia, cohabitation 
without ideas of boots would become possible ; and that, in 
time, the patient would become morally and physically 
capable of marriage. 

In the latter part of October, 1888, the patient wrote 
to me that he had resolutely resisted masturbation and his 
imagination. In the interval he had had but one dream 
about boots, and scarcely a pollution. He had been free 
from homo-sexual inclinations, but, in spite of this, there 
was often considerable sexual excitement, without any- 
thing like adequate libido for woman. In this deplorable 
situation, he was now compelled by circumstances to marry 
in three months. 

2. Homo-Sexual Individuals, or Urnings. 

In contradistinction from the preceding group of 
psycho-sexual hermaphrodites, there are here predominant, 
i ob origine, sexual desires and inclinations for persons of 
the same sex exclusively; but, in contrast with the follow- 
ing group, the anomaly is limited to the vita sexualis, and 
, does not more deeply and seriously affect character and 
mental personality. 

The vita sexualis of these urnings, mutatis mutandis, 
is entirely like that in normal hetero-sexual love ; but, since 
it is the exact opposite of the natural feeling, it becomes 
a caricature, and the more so as these individuals, at the 
same time, and as a rule, are subject to hypercesthesia sex- 
ualis; for which reason, their love for their own sex is 
emotional and passionate. 

The urning loves and deifies the male object of his 
affections, just as the normal man idealises the woman he 
loves. He is capable of the greatest sacrifice for him, and 
experiences the pangs of unhappy, often unrequited, love ; 
he suffers from the disloyalty of the beloved object, and 
is subject to jealousy, etc. 

The attention of the male-loving man is given only to 



HOMO-SEXUAL INDIVIDUALS. 365 

male dancers, actors, athletes, statues, etc. The sight of 

female charms i.-. indifferent t.. him, if not repulsive. A 

naknl woman is disgusting to him, while the sight of male 

hips, etc., affords him infinite pleasure. 

I'.odily contact with a sympathetic man induces a thrill 
of delight; and, since such individuals are in most cases 

:illv neurasthenic (congenitally or from onanism or 
enforced abstinence from sexual intercourse), under such 
circumstances ejaculation is very easily induced, which 
evm in the most intimate intercourse with women cannot 
be induced at all, or only by mechanical means. The 
sexual act with a man, in many instances, affords pleasure, 
and leaves behind a feeling of comfort. Should the urning 
be able to force himself to coitus, in which, as a rule, dis- 
gust has the effect of an inhibitory character, and makes 
the act possible, then his feeling is something like that 
of a man compelled to take disgusting food or drink. How- 
ever, experience teaches that not infrequently urnings be- 
longing to this group marry, either from ethical or social 
considerations. 

Such unfortunates are relatively potent, in so far that 
in marital intercourse they incite their imagination, and, 
instead of thinking of their wives, they call up the image 
of some loved male person. But for them coitus is a great 
sacrifice, and no pleasure. It makes them, for days after, 
nervous and miserable. If such urnings, by means of 
powerful stimulation of their fancy, or under the influence 
of alcoholic drink, or by erections induced by an overfilled 
bladder, etc., are not enabled to overcome the inhibitory 
feelings and ideas, then they are entirely impotent; while 
the mere touch of a man may induce intense erection, and 
even ejaculation. 

Dancing with a woman is unpleasant to an urning, 
but to dance with a man, especially one with an attractive 
form, is to him the greatest of pleasures. 

The male urniiii?, if he possess higher culture, is not 
opposed to non-sexual intercourse with woman, when by 



366 PSYCHOPATHIA SEXUALJ8. 

mind and refinement they make conversation charming. 
It is only woman in her sexual role that he abhors. 

In this degree of sexual degeneration, character and 
occupation correspond with the sex which the individual 
represents. Sexual perversion remains an isolated anom- 
aly of the mental being of the individual, deeply affecting 
the social existence. In ace rdance with this, these indi- 
viduals feel themselves during the sexual act in the same 
role which would naturally be theirs in hetero-sexual inter- 
course. 

However, transitions to group 3 occur, inasmuch as 
sometimes the passive role which corresponds with homo- 
sexual feeling is thought of or desired, or at least forms 
the subject of dreams. Moreover, leanings to occupations 
and tendencies of taste are manifested which do not cor- 
respond with the sex of the individual. In many cases 
one gets the impression that such symptoms are artificial, 
the result of educational influences; in other cases, that 
they represent deeper acquired degenerations of the orig- 
inal anomaly, superinduced by perverse sexual activity 
(masturbation), and analogous to the signs of progressive 
degeneration observed in acquired sexual inversion. 

Regarding the manner of sexual satisfaction, it must 
be stated that with many male urnings, the mere embrace 
is sufficient to induce ejaculation, subject as they are to 
irritable weakness of the sexual apparatus. In cases of 
sexual hyperaesthesia, and of parsesthesia of the moral 
sense, great pleasure is afforded by intercourse with persons 
of the lowest condition. 

On the same basis, desire to commit pederasty (active, 
of course) and other similar aberrations occur, though it 
is but seldom, and apparently only in cases of moral defect 
and by reason of libido mimia in individuals especially 
passionate, that active pederasty is indulged in. 

The sexual desire of mature urnings, in contradistinc- 
tion to old and decrepit debauchees, who prefer boys (and 
indulge in pederasty by preference}, seems never to be 
directed to immature males. Only for want of better 



HOMO-SEXUAL INDIVIDUALS. 367 

material, and in case of violent passion, does the urning 
become dangerous to boys. 

Case 138. Z., age thirty-six, wholesale merchant; 
parents were said to have been healthy ; physical and men- 
tal development normal; irrelevant children's disease?; at 
fourteen onanism of his own accord; began to rave about 
boys of his own age when fifteen. Never took the slight- 
est notice of the opposite sex. 

At twenty-four he went for the first time to a brothel, 
but took to flight when he saw the nude female figure. 

At twenty-five sexual intercourse with men of his own 
stamp (fervent embraces with ejaculation, at times mutual 
masturbation). 

For business reasons, and with a view to cure his abnor- 
mal passion, he married at the age of twenty-eight a lady 
endowed with many physical and mental charms. By the 
aid of imagination (thinking of intercourse with a hand- 
some young man), Z. succeeded in being potent with his 
wife, whom at heart he loved passionately. This strain, 
however, superinduced neurasthenia. When a child was 
'born he gradually withdrew from his wife, who was any- 
how endowed with a frigid nature, chiefly because he was 
haunted by the fear of procreating offspring afflicted with 
Jiis own anomaly. 

Homo-sexual feelings and thoughts began to sway him 
again, which he sought to eradicate by means of mastur- 
bation. 

He fell in love with a handsome young man, but over- 
came the weakness at the cost of his own health as the 
severe struggle brought on a pronounced attack of cerebral 
neurasthenia. lie came to me for advice, as his homo- 
sexual tendency had become too powerful to be resisted any 
longer. He was afraid that his secret affliction might be 
discovered, thus rendering his position in society impossi- 
ble. Like many of his fellow-sufferers he had taken to 
drink. Although he found that alcohol relieved his nerv- 



368 PSYCHOPATHIA SKXTTALIS. 

ou8 disorders (physical weakness, psychical inertness and 
depression), his libido was increased. 

Z. was a man of refined thought, mentally well en- 
dowed, in appearance masculine and normal. He deeply 
deplored his position and loathed his weakness to auto- 
masturbation (at times also mutual). 

Mutual kisses and embraces satisfied him. Morally, he 
said, he had sunk so low that he would feign abandon him- 
self to this perverse passion were it not for the considera- 
tion he had for his wife and child. 

My advice was to strenuously combat these homo-sexual 
impulses, perform his marital duties whenever possible, 
eschew alcohol and masturbation, which increases homo- 
sexual feelings and kills the love for woman, and undergo 
treatment for neurasthenia. If he could not find relief 
and the situation became unbearable he must confine him- 
self to kisses and embraces with the male. 

Case 139. V., age thirty-six, merchant; mother 
psychopathic ; sister healthy ; brother neuropsychopathic. 

V. was early drawn to persons of his own sex, at first 
to school- and playmates; with the advent of puberty to 
achilts ; never to persons of the opposite sex whose charms 
had no interest for him. At the age of six he felt annoyed 
at not being a girl. Dolls and girls' games he always pre- 
ferred. 

At twelve a schoolmate seduced him to masturbate. 
His dreams (with pollutions when virile) were exclusively 
of an homo-sexual character. He practised mutual mas- 
turbation with men, coitus inter femora, exceptionally 
succio membri alterius. He had felt a pronounced position 
as to the active or passive role in the act. Rarely and 
only faute de mieux coitus cum muliere. He was potent 
when he thought during the act of a man, but never expe- 
rienced real pleasure. The sexual act with a woman ap- 
peared to him as a miserable substitute for the homo-sexual 
act. During recent years intimate relations with a young 
man. 



HOMO-SEXUAL INDIVIDUALS. 369 

V. acknowledged the abnormality of his vita sexualis. 
ituls normal. Secondary physical and psychical 
sexual characteristics thoroughly masculine. No patholog- 
ical conditions. Arrested for having committed mutual 
masturbation, he was tried, found guilty and sent to prison. 
He felt his sentence keenly, but only because it brought 
dishonour to him and his family. He could not help feeling 
and acting in his abnormal manner. 

Case 140. H., age thirty, member of high society; 
mother neuropathic. 

When a boy he felt drawn 4o his schoolmates. At the 
age of fourteen a playmate older than himself committed 
paedicatio on him. He liked it, but nevertheless felt pangs 
of conscience and never allowed the act to be repeated 
again. Later on he practised mutual masturbation. As 
neurasthenia increased it sufficed when he embraced and 
pressed a companion to himself to produce ejaculation. He 
confined himself to this method when seeking satisfaction. 
He never had a liking for persons of the other sex and was 
unconscious of his anomaly. At twenty he made some at- 
tempts, apud puellas, in order to cure his vita sexualis. 
Up to that time he had looked upon his abnormal prac- 
tices merely as a youthful aberration. He was potent in 
coitus, but derived no gratification from it, for which rea- 
son he turned to man again. His weakness was for young 
men eighteen to twenty years of age. He had no sympathy 
for men older than that. He never played a well defined 
role in his relations with other men, but his social situa- 
tion affected him keenly. He was forever haunted by the 
fear of detection, and said he could never survive the 
shame of it. There was nothing in habits or behaviour 
Avhich betrayed antipathic sexual instinct. Genitals nor- 
mal. No signs of degeneration. He had no faith in ever 
changing his abnormal sexuality. For women he had no 
taste whatsoever. 

Case 141. Y., age forty, manufacturer; father neu- 

24 



370 PSYCHOPATHIA SEXUALIS. 

ropatliic; died of cerebral apoplexy; mother's family with 
taint of insanity; two other children of the family, though 
sexually normal, were constitutionally neuropathic. At 
eight masturbation of his own accord. At fifteen he felt 
drawn to other handsome boys of his own age, of whom he 
seduced several to masturbation. With puberty he was 
attracted by youths seventeen to twenty years of age, but 
they must be beardless arid have pretty, soft and girl-like 
features. Girls had no charm for him. 

He soon recognized the pathological character of his 
vita sexualis; but he considered his method of satisfying 
his abnormal needs as in accordance with nature and felt 
no remorse. To touch a woman was loathsome to him. He 
had twice attempted coitus, but without success. In like 
manner, he looked upon auto-masturbation as a filthy act. 
He averred that he had honestly striven to strip off this 
dreadful impulse, which made an outcast of him before the 
whole world. But all his efforts were in vain, for he felt 
forced by nature to seek satisfaction in his own manner. 
He always played the active rule and confined himself en- 
tirely to acts not proscribed by the law of the land. Yet 
he became involved in some affair, lost his position, which 
was one of confidence and good remuneration, became a 
vagabond until he decided to cross the ocean and begin a 
new life. Being clever and honourable he succeeded. 

When first I met Y., he was in despair and firmly con- 
templated suicide, especially since a medical man had 
failed with hypnotic treatment, on account of Y. not 
reacting to suggestion. 

He was inclined to neurasthenia. Penis small. No 
pathological symptoms. Masculine in every respect. 

Case 142. T., age thirty-four; merchant; mother 
neuropathic and weakly; father healthy. At the age of 
nine a schoolmate taught him how to masturbate. He 
practised mutual masturbation with his brother, who slept 
with him in the same bed; once receptio membri in os. 
On one occasion, when yet a boy, it happened quod Iambi t 



HOMO-SEXUAL INDIVIDUALS. 371 

locum quo prius mile* urinaverat At fourteen first love 
for a schoolmate of ten. At the age of seventeen lie 
took a dislike to handsome young men, and centred his 
affection in decrepid old nn n. 

One night he heard his aged father "give a groan of 
sexual satisfaction." This excited him immensely as he 
imagined his father performing the marital act. Since 
that time the picture of old men performing the homo- 
sexual act enlivened his dreams (with pollution), and was 

nt in his mind during masturbation. The older, the 
more decrepid and feeble the old man was, when he saw 
such, the stronger his sexual excitement would be even 
unto ejaculation. At twenty-three he sought a cure with 
a prostitute ; but erection failed him, and he made no other 
attempts. Young men and boys left him callous. 

At twenty-nine he conceived a violent love for an old 
man whom he accompanied for years on his daily walks. 
Intimate relations were, however, precluded. But he often 
had ejaculations on these walks. To free himself of this 
humiliating situation he once more went to a prostitute, 
but it proved a fiasco. lie now fell upon the idea to hire 
a decrepid old man, take him along and make him have 
coitus whilst he looked on. This caused erection in him, 
and he was able to have coitus himself. The act, however, 
gave him no pleasure, but he felt psychically relieved, 
especially when he was potent in the absence of the old 
man. But this did not last long. He became sexually and 
generally neurasthenic, depressed, shy and impotent, and 
gave himself up to psychical onanism coupled with 
thoughts of old men in homo-sexual situations. 

T. was masculine in appearance, and presented no 
special marks beyond his heavy sexual neurasthenia. 

Case 143. Z., age twenty-eight, merchant; father 
very nervous and irritable; mother hysteropathic. He 
was himself constitutionally nervous, suffered from enure- 
Bis to his eighteenth year, and was a frail boy. Proper 
physical development really began only when he waa 



372 PSYC1IOPATHIA 8EXUALI8. 

twenty years of age. The first sexual emotions he experi- 
enced when, a boy of eight, he witnessed other boys being 
caned ad podicem. Although he felt compassion for the 
boys, he yet had a feeling of lustful pleasure pervading his 
whole body. Some time afterwards he was late for school 
and on the way the anticipation of a caning ad podicem 
excited him so much that for a short time he could not 
move and had a violent erection. 

At eleven he fell in love with a "beautiful, blond boy 
who had wondrously lovely, intelligent and lustrous eyes." 

It gave him immense pleasure to see this boy home, 
and he often craved for kisses and caresses from him. But 
he recognized the unbecoming nature of this desire, and 
did not allow the boy to have an inkling of them. 

At that time he met a girl once, two years his junior, 
who pleased him so much that he covered her with kisses. 
This, however, remained a solitary episode. 

At thirteen he was seduced to onanism. But he did 
not cultivate the habit, as he found protection in his "more 
refined feelings for young men" and disdained to "drag 
his pure, divine love" in the gutter. 

At seventeen he became desperately enamored with a 
companion "with lovely brown eyes, noble features and 
dark complexion". He suffered untold tortures through 
this unhappy love for two and one-half years, when he 
was separated from his companion. If ever he were to 
meet him again, the old fire would be certain to flare up 
anew. On two other occasions he fell in love with com- 
rades, but not so violently as in the first instance. At 
twenty he had coitus, but derived no pleasure from the act. 
He continued his relations with women for the purpose 
of avoiding masturbation, to appear potent and to mask 
his homo-sexual tendency. 

Although he had no horror feminsp, women did not 
excite him. "A woman is a work of art, a statue." 

Endowed with a strong will power he was able to mas- 
ter his abnormal inclination! But his sexual position ap- 
peared to him unsatisfactory, especially as he looked upon 



MO-SEXUAL INDIVIDUALS. 373 

coitus as a coarsely sensual enjoyment, and erection became 
difficult 

In the n.iisultation no abnormal signs could be de- 
tected, lie app< an (1 to be virile and mentally sound. 

Case 144. P., age thirty-seven ; mother very nervous, 
suffered from migraine. As a boy he was subject to attacks 
of hysteria gravis. Was always drawn to handsome young 
men and became highly excited when he could see their 
genitals. With puberty he practised mutual masturbation 
with men; but they must be about twenty-five to thirty 
years old. He played the female role in the sexual act. 
He loved with the whole intensity of woman, and only 
posed as a man like an actor on the stage. Other boys 
sneered at him on account of his girlish ways and habits. 
In the hope of correcting his vita sexualis he married. He 
forced himself to coitus with the wife and produced po- 
tency by imagining her to be a young man. They had 
one child. But he himself became neurasthenic, his imag- 
ination waned and he became potent. For two years 
he avoided coitus, resumed his homo-sexual practices and 
was apprehended by the police in the act of mutual mas- 
turbation with a young man. 

He pleaded that prolonged sexual abstinence had un- 
duly excited him when he saw the genitals of a man and 
in his confusion he had yielded to the impulse. 

There was no amnesia. Thoroughly virile. Decent 
appearanee. Genitals normal. Short imprisonment. 

Case 145. N., aged forty-one, unmarried. Father 
and mother near relatives, but both psychically normal. 
An uncle on the father's side was insane. N.'s brothers 
\\( TO hyper- and hetero-sexual. At the age of nine he felt 
strong inclinations to other boys. At fifteen mutual mas- 
turbation and coitus inter femora. 

At sixteen a love affair with a young man. His homo- 
sexual love developed, so he clailned, just as the love affairs 
between man and woman do in novels. 



374 PSYCIIOPATUIA SEXUALI8. 

Only handsome young men of the age of twenty to 
twenty-four attracted him. His erotic dreams were solely 
homo-sexual. He played the female role, also in actual 
intercourse with men. 

His soul was of feminine character, so he said. He 
never cared for boys' games, only for cooking and girls' 
work. Manly sports and smoking and drinking he dis- 
dained. He led a varied life, served as cook in a foreign 
country and gave great satisfaction; but he lost his place 
because he entered upon a love-affair with the son of his 
employer. 

At twenty-two he recognized the abnormality of his 
sexual position. He became alarmed and began to fre- 
quent brothels to cure himself of his perverse habits, but 
erection absolutely failed him. 

When his family discovered the true state of affairs he 
became confused with shame and made an attempt on his 
own life. But he recovered, went abroad (cast out by his 
family), disgusted with himself and his unhappy life. His 
only hope was that with old age relief would come. He 
came for medical advice to find "honour and rest." The 
secondary physical sexual characteristics were quite nor- 
mal and of the masculine type. Genitals normal. He 
thought of castration or entering a monastery. 

Advice: Suggestive treatment. 

Case 146. On a summer evening, at twilight, X. 
Y., a physician of a city in North Germany, was detected 
by a watchman while committing a misdemeanour with a 
countryman in a field. He was practising masturbation 
on him, and then mentulam alius in os suum immisit. X. 
escaped legal prosecution by flight. The authorities dis- 
missed the complaint, because there had been no publicity, 
and because immissio membri in anum had not taken place. 
Among X.'s effects was found an extensive correspond- 
ence of a perverse sexual character, which showed that 
he had had perverse intercourse for years with all classes 
of people. 



\CO-SEXCAI. I/CIMVIDUALS. 375 

X. came of a neurotic family. Ilia paternal grand- 
father died by suicide while insane. Ilia father waa a 
weak, peculiar man. One brother masturbated at the age 
of two. A cousin was sexually perverse, and practised 
I ><T verse acts, similar to those of X., while a youth; he 
became weak-minded, and died of spinal disease. A pater- 
nal great-uncle was an hermaphrodite. His mother's sister 
was insane. His mother is said to have been healthy. X.'s 
brother is nervous and irascible. 

X., likewise, was nervous as a child. The mewing of 
a cat would create great fear in him; and if one but imi- 
tated the voice of a cat he would cry bitterly, and run 
to others for protection. Slight physical disturbance 
caused violent fever. He was a quiet, dreamy child, of 
excitable imagination, but of slight mental capabilities. 
He did not indulge much in boyish games; he preferred 
feminine pursuits. It gave him especial pleasure to curl 
the hair of the housemaid or of his brother. 

At thirteen X. went to an institute. There he prac- 
tised mutual masturbation, seduced his comrades, and his 
cynical conduct made him unmanageable; so that he had 
to be taken home. At that time the parents found love- 
letters with lascivious contents, showing perverse sexuality. 
From the age of seventeen he studied under the strict 
surveillance of a professor in a gymnasium. He made but 
sad progress in learning. He had only a talent for music. 

After finishing his studies, the patient entered the uni- 
versity at the age of nineteen. There he attracted attention 
by his cynical character and his association with young 
persons who were thought to be given to masculine love. 
He began to be dandified; wore striking cravats, and low 
cut shirts; he forced his feet into narrow shoes, and curled 
his hair in a remarkable way. This peculiarity disappeared 
when he left school and returned home. 

At the age of twenty-four he was for a long time neu- 
rasthenic. From that time until hia twenty-ninth year 
h<- was earnest and skilful in his profession; but he avoided 



376 PSYCHOPATH I A SEXUALIS. 

the society of the opposite sex, and constantly associated 
with men of doubtful character. 

The patient would not allow a personal examination. 
In writing, he made the excuse that this would be of no 
use, because his impulse to his own sex had existed from 
his earliest childhood, and was congenital. He had always 
had horror femina?, and had never been inclined to avail 
himself of the charms of women. Toward men he felt 
himself in the role of a man. He recognised his impulse 
toward his own sex as abnormal, and excused his sexual 
indulgence as being the result of an abnormal natural con- 
dition. 

Since his flight, X. lived out of Germany, in Southern 
Italy, and, as I heard from a letter, now, as before, he 
indulged in perverse love. X. was an earnest, stately man, 
of masculine features, well-grown beard, and normally de- 
veloped genitals. Dr. X. furnished me a short time ago 
with his autobiography, of which the following is worthy 
of mention: 

"When, at the age of seven, I entered a private school, 
I felt very uncomfortable, and found very little sympathy 
with my companions. Only toward one of them, who was 
a very handsome child, did I feel attracted, and I loved 
him wildly. In childish games I always knew how to 
arrange it so that I could appear in feminine attire; and 
my greatest pleasure was to form intricate coiffures for 
our servant-girls. I often regretted that I was not a girl. 

"My sexual instinct awakened when I was thirteen, 
and from the moment of its appearance it was directed 
toward youthful, strong men. At first I was not really 
certain that this was abnormal, but consciousness of it came 
when I saw and heard how my companions were charac- 
terized sexually. I began to masturbate at the age of 
thirteen. At seventeen I left home and went to the gym- 
nasium of a large capital, where I was put to board with 
a married professor of the gymnasium, with whose son I 
afterward had sexual relations. It was with him that I 
first had sexual satisfaction. Thereafter I made the ao- 



HOMOSEXUAL IM'IMDUALS. 377 

<iuuintance of a young artist, who very soon noticed that 
I was abnormal, and confessed to me that be was in tbe 
same condition. I learned from him that tliir abnormality 
was very frequent; ami tlii> kimwlcdgo overcame the 
trouble that I had had in supposing that I was alone in 
my abnormality. This young man had an extensive ac- 
quaintance with persons in like condition, to which he 
introduced me. There I became the object of general 
attention, for on all sides I was declared to be very attract- 
ive physically. I soon became insanely loved by an old 
gentleman; but, not finding him to my taste, I endured 
him but a short time, and then gave ear to a young and 
handsome officer who lay at my feet He was really my 
first love. 

"After passing my final examination, at the age of 
nineteen, free from the discipline of school I made the 
acquaintance of a great number of people like myself, and 
among them Karl Ulrichs (Numa Numantius). 

"When, later, I took up the study of medicine, and 
associated with many normal youths, I was often in a posi- 
tion where I was compelled to visit public prostitutes. 
After having consorted to no purpose with various pros- 
titutes, some of whom were very beautiful, the opinion was 
spread among my acquaintances that I was impotent, and 
I strengthened this by telling of previous sexual excesses. 
At that time I had numerous external relations with per- 
sons who prized my physical peculiarities, which were 
considered very beautiful. The result of this was, that I 
was exciting somebody all the time; and I received such a 
mass of love-letters that I was often in embarrassment. 
The acme of this was reached later, when, as a physician, 
I lived in the hospital. There I moved about like a cele- 
brated person, and the scenes of jealousy that took place 
on my account almost led to the discovery of the whole 
thing. Shortly after this, I fell ill with an inflammation 
of my shoulder-joint, from which I recovered after three 
months. During this illness I received subcutaneous in- 
jections of morphine several times daily, which were sud- 



378 PSYCHOPATHIA SEXUALIS. 

denly discontinued, and which I practised thereafter 
secretly after my recovery. For the purpose of special 
study, I spent some months in Vienna, before entering into 
private practice, and there, by means of some recommen- 
dations, I gained entrance to various circles of people like 
myself. I there learned that the abnormality in question, 
in its various forms, is spread through the lower classes 
as well as the higher, and that those who are approachable 
for money are not infrequently met among the higher 
classes. 

"When I established myself in the country, I hoped 
to cure myself of the morphine habit by means of cocaine; 
and then I became a victim of cocaine, of which, only 
after three relapses, I was able to rid myself (about two 
years ago). In my position, it was impossible for me to 
find sexual satisfaction, and I noticed with pleasure that 
the use of cocaine had overcome my desire. When, on 
the first occasion, at the urgent request of my aunt, I had 
emancipated myself from cocaine, I travelled for a few 
weeks in order to improve my health, the perverse im- 
pulses were again awakened in their old strength, and, 
one evening, while out in the fields by the city amusing 
myself with a man, I noticed that I had been detected by 
the authorities and advertised; but that the act of which 
I was accused was not punishable, in accordance with the 
opinion expressed by the highest court of the German 
kingdom. I had, therefore, to be careful; for already the 
announcement of the crime had been heralded on all sides. 
I saw that after this I should be compelled to leave Ger- 
many, and find a new home where neither the law nor 
public opinion would be opposed to that impulse, which, 
like all abnormal instincts, could not be overcome by the 
will. Since I was never deceived for a moment about 
the matter, in recognizing my impulses as opposed to social 
usages, I repeatedly attempted to become master of them ; 
but by these efforts they were increased in power. This 
same observation has been communicated to me by ac- 
quaintances. Since I was exclusively drawn toward strong, 



HoUO-BEXUAL INDIVIDUALS. 879 

youthful and masculine individuals, and they were very 
seldom inelim-d i vit 'Id to my wishes, 1 was compelled 
to buy them. Since my desire was limited to persons of 
the lower classes, I was always able to tiiul such as were 
purchasable with money. I hope that the following state- 
is will not awaken your repugnance. At first I in- 
tended to omit them; but, for the completeness of this 
communication, I may include them, since they serve to 
enrich the clinical material. I am compelled to perform 
the sexual act in the following way: 

' T< -ne juvcnis in os recepto, ita ut commovendo ore 
meo effecerhn, ut is quern cupio, semen ejaculaverit, 
in periiui-um exspuo, femora comprimi jubeo et 
meuin adversus et intra femora compressa immitto. 
1 him luec Hunt, necesse est, ut juvenis me, quantum potest, 
amplectatur. Quae prius me fccisse narravi, eandem mihi 
afferunt voluptatem, acsi ipse ejaculo. Ejaculationem 
in aiiuin iiuinittendo vel manu terendo assequi, mihi 
nequaquam amoenum est. 

"Sed inveni, qui penem meum receperint atque ea 
facientes, quae supra exposui, effecerint, ut libidines mea 
plane sint saturate?. 

"Concerning my person, I must still mention the fol- 
lowing: I am 180 centimetres tall, of masculine appear- 
ance, and with the exception of abnormal irritability of 
the skin, healthy. My hair and beard are black and thick. 
My genitals are of medium size and normally formed. I 
am able, without any trace of fatigue, to perform the 
sexual act from four to six times in twenty-four hours. 
My life is very regular. I use alcohol and tobacco very 
sparingly. I play the piano quite well, and some of my 
unpretentious compositions have been much applauded. I 
have lately finished a novel, which, as my first work, has 
very favourably critiei--ed by my friends. The story 
has several problems taken from the life of urn ings in the 
>ulject-matter. 

"Aiiioni: the large number of fellow-sufferers that are 
personally known to me, I have naturally been in a poei- 



380 PSYCHOPATHIA SEXTJALIS. 

tion to make observations concerning the condition and 
the degrees of abnormality; and, perhaps, the following 
communications may be of service to you : 

"The most abnormal thing that I am acquainted with 
was the impulse of a gentleman who lived in Berlin. He 
preferred, above all others, young fellows with unwashed 
feet, which he would lick passionately. A gentleman in 
Leipzig was similar to him; who, where it was possible, 
would linguam in anum immittere, preferring the parts to 
be uncleaned. Several have assured me that the sight of 
riding-boots or of parts of military uniforms induced such 
excitement in them that spontaneous ejaculation resulted. 
A man in Paris compelled a friend ut in os ei mingat. 

"With reference to the degree in which many feel 
themselves as women, which is with me not the case, two 
persons in Vienna are examples. They bore feminine 
names. One is a barber who calls himself 'French Laura ;' 
the other was formerly a butcher, who calls himself 'Sel- 
cher-Fanny'. Both of them never missed an opportunity 
during the carnival time, to show themselves in very fan- 
tastic feminine masks. In Hamburg there is a person that 
many people believe to be a woman, because he always 
goes about the house in feminine attire, and only occa- 
sionally leaves the house, and always in such clothing. 
This man wished to stand as godmother at a christening, 
and, as a result of it, gave rise to great scandal. 

"Feminine timidity, frivolity, obstinacy and weakness 
of character are the rule in such individuals. 

"Several cases of perverse sexuality are known to me 
in whom epilepsy and psychoses are present. Hernias are 
remarkably frequent. In practice many persons come to 
me to be treated for diseases of the anus, because of rec- 
ommendation by friends. I saw two syphilitic and one 
local chancre, and several fissures; and at present I am 
treating a gentleman for condylomata of the anus, which 
form a rounded tnmor as lanre as a fist. One case of 
primary affection of the soft palate I saw in Vienna, in a 
young man who used to frequent fancy-dress balls in girl's 



HOMO-SEXUAL INDIVIDUALS. 381 

attire, and entice young men; lie would then pretend that 
he was menstruating, and thus induce tin- others to use 
him per os. The assertion was made that in this way he 
had deceived fourteen men in one evening. Since, in none 
of the publications concerning antipathic sexuality that I 
have seen, I have found anything concerning the inter- 
course of pederasts among themselves, I venture to com- 
municate something concerning it in conclusion: 

"As soon as individuals that are affected with inverted 
sexuality become acquainted, there is a detailed narration 
of their experiences, loves and seductions, as far as the 
social difference between them allows such entertainment. 
Only in very few cases is this amusement uncommon with 
new acquaintances. Among themselves, they call them- 
selves 'aunts'; in Vienna, 'sisters'; and two very mascu- 
line public prostitutes in Vienna, whom I accidentally 
became acquainted with, and who lived in a perverse sex- 
ual relation with each other, told me that for the corre- 
sponding condition in women the name 'uncle' was used. 
Since I became conscious of my abnormal instinct I have 
met thousands of such individuals. 

"Almost every large city has some meeting-place, as 
well as a so-called promenade. In smaller cities there 
are relatively few 'aunts,' though in a small town of 2300 
inhabitants I found eight, and in one of 7000 eighteen of 
whom I was absolutely sure, to say nothing of those 
ulmm I suspected. In my own town of 30,000 inhabitants 
I personally know about 120 'aunts'. The greater number 
of them, and I especially, possess the capability of judging 
another immediately as to whether they are alike or not, 
which, in the language of the 'aunts,' is called 'reason- 
able' or 'unreasonable'. My acquaintances are often as- 
tounded at the certainty of my judgment. Individuals 
that are apparently absolutely masculine I recognize as 
'aunts' at the first sight. On the other hand, I am able to 
behave myself in such a masculine way that, in circles to 
which I have been introduced by acquaintances, there is 



382 PSYCHOPATHIA 8EXUALJS. 

a doubt as to my genuineness. When I am in the mood, 
I can act exactly like a girl. 

"Since the majority of 'aunts,' like myself, in no way 
regret their abnormality, but would be sorry if the condi- 
tion were to be changed ; and, moreover, since the congeni- 
tal condition, according to my own and all other experi- 
ence, cannot be influenced, all our hope rests upon the 
possibility of a change of the laws with reference to it, so 
that only rape or the commission of public offence, when 
this can be proved at the same time, shall be punishable." 

3. Effemination. 

There are various transitions from the foregoing cases 
to those making up this category, characterised by the 
degree in which the psychical personality, especially in 
general manner of feeling and inclinations, is influenced 
by the abnormal sexual feeling. In this group are fully 
developed cases in which males are females in feeling; and 
vice versa women, males. This abnormality of feeling 
and of development of the character is often apparent in 
childhood. The boy likes to spend his time with girls, 
play with dolls, and help his mother about the house; he 
likes to cook, sew, knit; he develops tastes in female 
toilettes, and even becomes the adviser of his sisters. As 
he grows older he eschews smoking, drinking and manly 
sports, and, on the contrary, finds pleasure in adornment 
of persons, art, belle-lettres, etc., even to the extent of 
giving himself entirely to the cultivation of the beautiful. 
Since woman possesses parallel inclinations, he prefers to 
move in the society of women. 

If he can assume the role of a female at a masquerade 
it is his greatest delight. He seeks to please his lover, so 
to speak, by studiously trying to represent what pleases 
the female-loving man in the opposite sex modesty, sweet- 
ness, taste for aBsthetics, poetry, etc. Efforts to approach 
the female appearance in gait, attitude and attire are fre- 
quently seen. 



EFFEMINATIOW. 383 

With reference to the sexual feeling and instinct of 
these urnings, so thoroughly permeated in all their mental 
being, the men, without exception, feel themselves to be 
females. Thus they feel themselves to be antagonistic to 
persons of their own sex constituted like themselves, as of 
course, they are like them in form. But, on the other 
hand, they are drawn toward those of their own sex that 
are homo-sexual or sexually normal. The same jealousy 
wlu'ch occurs in normal sexual life also occurs here, when 
rivalry is threatened; and, indeed, since they are, as a rule, 
hvpersesthetic sexually, this jealousy is often boundless. 

In cases of completely developed inverted sexuality, 
hetero-sexual love is looked upon as a thing absolutely in- 
comprehensible; sexual intercourse with a person of the 
opposite sex is unthinkable, impossible. Such an attempt 
brings on the inhibitory concept of disgust or even horror, 
which makes erection impossible. Only two of my cases 
transitional to the third category were able, with the aid 
of imagination which made the female in question assume 
the role of man, to have coitus for the time being; but 
the act, which yielded no gratification, was a great sacri- 
fice, and afforded no pleasure. 

In homo-sexual intercourse effeminated man feels him- 
self in the act always as a woman. The means of indul- 
gence, where there is irritable weakness of the ejaculation 
centre, are simply succubus, or passive coitus inter femora; 
in other cases, passive masturbation, or ejaculaiio viri di- 
lecti in ore. Some have a desire for passive pederasty; 
occasionally a desire for active pederasty occurs. In one 
attempt of this kind, the man desisted because of the dis- 
gust which seized him when the act reminded him of 
coitus. 

There was never inclination for immature persons (boy- 
love.) Not infrequently there were only platonic desires. 

Case 147. E., aged thirty-one, son of an inveterate 
drunkard. No other taint in the family. Grew up in a 
village. At the age of six he began to feel happy when 



384 PSYCHOPATH IA 8EXUALIS. 

in the company of men with beards. At the age of eleven 
he began to blush whenever he met a handsome man, and 
dared not look at them. He was at ease when in the com- 
pany of women. He wore girl's garments up to his sev- 
enth year, and was very unhappy when he was deprived 
of them. Occupation in the kitchen and about the house 
he liked best. Ilis school time passed without events. 
Now and then he had intimate liking for a certain school- 
mate, but this wore off. 

Dreams of men with beards clad in blue clothes became 
more frequent. 

He joined an athletic society that he might converse 
with men, liked to go to balls, not on account of the girls, 
who were a matter of indifference to him, but to see the 
fine men, thinking all the time that he was in the embrace 
of one of them. He felt lonely, however, and dissatisfied, 
and gradually became conscious of being quite unlike the 
other young fellows. All his thoughts and aims were to 
find a man who could love him. 

At seventeen he was seduced by another man to mutual 
masturbation. Delight, shame and fear were the reaction. 
He recognized the abnormality of his sexual feelings, be- 
came depressed, came near committing suicide. He finally 
became reconciled with his abnormal position and craved 
for men, but being shy by nature he found but little op- 
portunity. He felt uneasy when girls sought his company. 
When twenty-six he went to live in a large city and now 
found plenty of opportunities for homo-sexual intercourse. 
For some time he lived with another man of his own age 
as husband and wife. He felt happy in the role of woman. 
Sexual gratification was obtained by mutual masturbation 
and coitus inter femora. 

He was a skilful workman, well liked, and in appear- 
ance and behaviour masculine. Genitals normal. No 
signs of degeneration. 

His younger brother was also homo-sexual. 

Two sisters, who both died young, avoided men, never 



EFF KM i: NATION. 385 

cared for work in the kitchen, but preferred that in the 
stable, and were skilful in all handicrafts of m< n. 

Case 148. C., age twenty-eight, gentleman of lei- 
sure; father neuropathic; mother very nervous. One 
brother suffered from paranoia, another was psychically 
degenerated. Three younger members of the family were 
normal. 

C. was neuropathically tainted; slight convulsive tic. 
As long as he can remember he felt drawn to male per- 
sons, at first only to his schoolmates. When puberty set 
in he fell in love with male teachers, who used to visit at 
the house of his parents. He felt himself in the female 
role. His dreams, with pollutions, were always about men. 
He was gifted in music and poetry and loved the theatre. 
For science, especially mathematics, he had no talents and 
passed his final examinations only with difficulty. Psychic- 
ally, he declared, he was a woman. Loved to play with 
dolls and concerned himself by preference with woman's 
affairs, disdaining all the pursuits of men. He liked best 
the society of young girls, because they were sympathetic 
and had an affinity of soul. When in the company of men 
he was shy and confused like a maiden. He never 
smoked, and disliked alcoholic drinks. He feign would 
have liked to spend his time in cooking, knitting and em- 
broidering. He had no libido. Sexual intercourse with 
men only a few times, although his ideal was to play the 
role of the woman on such occasions. Coitus cum muliere 
he abhorred. After reading "Psychopathia Sexualis," he 
became alarmed, was afraid of coming in conflict with the 
police and avoided sexual relations with men. But pollu- 
tions became very frequent, and neurasthenia supervened. 
He came for medical advice. 

C. had an abundant beard, and was of a decidedly mas- 
culine type, excepting soft features and a remarkably fine 
skin. (Irnitals normal, except a deficient dcscensus of 
one of the testicles. In his behaviour, gait, and appearance 
nothing unusual, though he had the illusion that everybody 

25 



386 PSYCHOPATIIIA SEXUALM. 

noticed his abnormal sexual proclivity. He shunned soci- 
ety for that reason. Lascivious talk made him blush like 
a maiden. Once when someone turned the topic of con- 
versation on antipathic sexual instinct, he fainted. Music 
brought on a heavy perspiration all over his body. Upon. 
closer acquaintance he showed psychical femininity; he 
was as timid as a girl, and without a vestige of independ- 
ence. Nervous restlessness, convulsive tic, numerous neu- 
rasthenic complications put on him the stamp of a consti- 
tutionally tainted neuropathic individual. 

Case 149. B., waiter, forty-two years of age, un- 
married, was sent to me by his own physician (with whom 
he had fallen in love), as a case of sexual inversion. B. 
gave readily in modest language an account of his vita 
anteacta and especially sexualis. He seemed pleased to 
obtain at last an authentic explanation of his abnormal 
state which he had always considered a disease. 

B. possessed no knowledge of his grandparents. The 
father was of an irascible, excitable nature, a drinker, and 
of strong sexual wants. After begetting twenty-four chil- 
dren with the same woman, he obtained a divorce, and 
after that had three children by his housekeeper. The 
mother was a healthy woman. Of the twenty-four 
children only six are now among the living, several of 
whom suffer from nervous affections, but are sexually nor- 
mal, except one sister who for ever runs after the men. 

B. claimed to have always been delicate and sickly. 
His vita sexualis awoke at the age of eight. He began 
to masturbate and derived much pleasure from penem 
aliorum puerorum in os arrigere. At the age of twelve he 
began to fall in love with men, preferring those in the 
thirties and with moustache. His sexual needs at that 
period were extraordinary and erections and pollutions 
were frequent. He masturbated daily, thinking of some 
man whom he loved. His ambition was always penem 
viri in os arrigere, which thought caused ejaculation ac- 
companied by the utmost lust. But only twelve times 



ZFFEMINATION. 387 

tnus far had he been successful in this. He never felt 
nausea at the penis of others if they were sympathetic; on 
the contrary. Active as well as passive pederasty dis- 
gusted him thoroughly and he never accepted such offers. 
During the perverse act he played the role of woman. His 
love for sympathetic men was boundless. He could do any- 
thing for the man whom he thus loved, and when beholding 
him he trembled with excitement and lustful feelings. 

When nineteen he was several times lured by his com- 
panions to a brothel, but coitus did not please him and 
only at the moment of ejaculation did he experience a sort 
of gratification. lie could only be virile with woman 
when he thought of her during the act as the man whom 
he loved. He much rather would have preferred the 
woman to allow him immissio penis in os; but she refused. 
Faute de mieux he indulged in coitus; twice even he was 
a father. The younger of the two children, now a girl of 
eight, has already begun masturbation and mutual onan- 
ism, which fact troubled him very much. Was there no 
remedy for this? 

Patient said that towards men he always felt himself 
to be of feminine type (this also during sexual intercourse). 
His idea was that this sexual perversion originated from 
the fact that his father when begetting him wished to 
beget a girl. The other children of the family always 
teased him on account of his girlish ways and manners. 
To sweep the rooms and wash the dishes were ever pleasant 
occupations for him. His housework was always much 
admired and praised because he was cleverer than the girls. 
Whenever he could he would don girl's attire. At the 
Mardi-cjras balls he always wore the female mask. He 
made a capital coquette on account of his female nature. 

Drinking, smoking, manly sports and occupations never 
suited him, but he was passionately fond of sewing and 
was often upbraided on account of his weakness for dolls 
when a boy. When at the circus or the theatre his atten- 
tion was only drawn to the male performers. He had an 



388 PSYCHOPATHIA SEXUALIS. 

irresistible desire to loiter about W.C's. in order to get a 
look at the men's genitals. 

Female charms never attracted him. Coitus was only 
possible when aided by the thought of a beloved man. 
Nocturnal pollutions were always produced by lascivious 
dreams about men. 

Despite numerous sexual excesses B. had never suf- 
fered from neurasthenia sexualis; neither were there symp- 
toms of neurasthenia of any kind. 

Features delicate ; sparse side whiskers and moustache, 
which began to grow only when he was twenty-eight. His 
external appearance, excepting a light, swinging gait, did 
not indicate female nature. He observed that he was 
often teased on account of his womanish carriage. His 
manners were highly modest. Genitals large, well devel- 
oped, quite normal, with abundance of hair; pelvis mas- 
culine. Cranium rachitic, slightly hydrocephalic ; parietal 
bones rather bulging. Countenance exceptionally small. 
Patient said he was easily provoked to wrath. 

Case 150. Taylor had occasion to examine a certain 
Eliza Edwards, aged twenty-four. It was discovered that 
she was of masculine sex. E. had worn female clothing 
from her fourteenth year, and had also been an actress. 
The hair was worn long, after the manner of females, and 
parted in the middle. The form of the face was feminine, 
but otherwise the body was masculine. The beard was 
carefully pulled out. The masculine, well-developed gen- 
itals were fixed in an upward position by an artful band- 
age. The condition of the anus indicated passive peder- 
asty (Taylor, "Med. Jurisp." 1873, ii., p. 473). 

Case 151. An official of middle age, who for some 
years had been happy in family life, and was married to a 
virtuous woman, presented a peculiar manifestation of anti- 
pathic sexual feeling. 

One day, through the indiscretion of a prostitute, the 
following scandal became public: About once a week X. 



ANDROGYNY. 389 

would appear in a house of prostitution, and there dress 
himself up as a woman, always requiring, as a part of his 
costume, a coiffure. When his toilet was completed, he 
would lie down on the bed, and have the prostitute perform 
manustupration. But he very much preferred to have 4 
male person (a servant of the house). This man's father 
was heriditarily tainted, had been insane several times, 
and was afflicted with hypercesthesia and parcesthesia sex- 
ualis. 

4. Androgyny. 



Forming direct transitions from the foregoing groups 
are those individuals of antipathic sexuality in whom not 
only the character and all the feelings are in accord with 
the abnormal sexual instinct, but also the frame, the feat- 
ures, voice, etc.; so that the individual approaches the 
opposite sex anthropologically, and in more than a psychi- 
cal and psycho-sexual way. This anthropological form of 
the cerebral anomaly apparently represents a very high de- 
gree of degeneration ; but that this variation is based on an 
entirely different ground than the teratological manifesta- 
tion of hermaphroditisrn, in an anatomical sense, is clearly 
shown by the fact that thus far, in the domain of inverted 
sexuality, no transitions to hermaphroditic malformation 
of the genitals have been observed. The genitals of these 
persons always prove to be fully differentiated sexually, 
though not infrequently there are present anatomical signs 
of degeneration (epispadiasis, etc.), in the sense of arrests 
of development in organs that are otherwise well marked. 

There is yet wanting a sufficient record of cases belong- 
ing to this interesting group of women in masculine attire 
with masculine genitals. Every experienced observer of 
his fellow-men remembers masculine persons that were 
very remarkable for their womanish character and type 
(wide hips, form rounded by abundant development of 
adipose tissue, absence or insufficient development of beard, 
feminine features* delicate complexion, falsetto voice, etc.). 



390 P8YCHOPATIIIA 8EXTTALIS. 

In persons belonging to the fourth group, and in cer- 
tain ones in the third, forming transitions to the fourth, 
there seems to be a feeling of shame (sexual) toward per- 
sons of the same sex, and not toward those of the opposite 
sex. 

Case 152. Androgyny. Mr. v. H., aged thirty, sin- 
gle; of neuropathic mother. Nervous and mental diseases 
were said not to have occurred in the patient's family, and 
his only brother was said to be mentally and physically 
completely normal. The patient developed tardily physi- 
cally, and, therefore, spent much of his time at the sea- 
shore and climatic resorts. From childhood he was of neu- 
ropathic constitution, and, according to the statements of 
his relatives, unlike other boys. His disinclination for 
masculine pursuits and his preference for feminine amuse- 
ments were early remarked. Thus he avoided all boyish 
games and gymnastic exercises, while doll-play and femi- 
nine occupations were particularly pleasing to him. Sub- 
sequently he developed well physically, and escaped severe 
illnesses, but he remained mentally abnormal, incapable of 
an earnest aim in life, and decidedly feminine in thought 
and feeling. 

In his seventeenth year pollution occurred, became 
more frequent, and finally took place during the day; so 
that the patient grew weak, and manifested various ner- 
vous disturbances. Symptoms of neurasthenia spinalis 
made their appearance, and lasted for some years, but they 
became milder with the decrease in the number of pollu- 
tions. Onanism was denied, but was very probable. An 
indolent, effeminate, dreamy habit of thought had become 
more and more noticeable ever since puberty. All efforts 
to induce the patient to take up an earnest pursuit in life 
were in vain. His intellectual functions, though formally 
quite undisturbed, were never equal to the motive of an 
independent character, and the higher ideals of life. He 
remained dependent, an overgrown child; and nothing 
more clearly indicated his original abnormal condition than 



ANDROGYNY. 391 

an actual incapability to take care of money, and his own 
confession that ho had no ability to use money reasonably ; 
that as soon as he had money he wasted it for curios, toilet- 
articles, and the like. 

Incapable as he was of a reasonable use of money, the 
patient was no more capable of leading a social existence, 
indeed, he was incapable of gaining an insight into its 
significance and value. 

He learned very poorly, spending his time in toilettes 
and artistic nothings, particularly in painting, for which 
he evinced a certain capability; but in this direction he 
accomplished nothing, since he was wanting in persever- 
ance. He could not be brought to take up any earnest 
thought; he had a mind only for externals, was always 
distracted, and serious things quickly wearied him. Pre- 
posterous acts, senseless journeys, waste of money and 
debts repeatedly occurred throughout the course of his later 
life; and even for these positive faults in his life he was 
wanting in understanding. He was self-willed and intracta- 
ble, and never did well when an attempt was made to 
put him on his feet and point out to him his own interests. 

With these manifestations of an original abnormal and 
defective mind, 'there were notable indications of perverse 
sexual feeling, which were also indicated in the somatic 
habitus of the patient. Sexually, the patient felt like a 
woman toward men, and had inclinations toward people of 
his own sex, with indifference, if not actual disinclination, 
for females. 

In his twenty-second year it was asserted that he had 
sexual intercourse with women, and was able to perform 
the act of coitus normally; but, partly on account of in- 
crease of neurasthenic symptoms which was occasional 
after coitus, and partly on account of fear of infection 
but really by reason of a want of satisfaction he soon 
ceased to indulge in such intercourse. Concerning his 
abnormal sexual condition, he was not quite clear; he was 
r..Tiv ( .j,,us of an inclination toward the male sex, but con- 
fessed, only in a shame-faced way, that he had certain 



392 PSYCHOPATHIA SEXUALIS. 

pleasurable feelings of friendship for masculine individ- 
uals, which, however, were not accompanied by any sensual 
feelings. The female sex he did not exactly abhor; he 
could even bring himself to marry a woman who could 
have an attraction for him, by means of similarity in 
artistic tastes, if he could but be freed from conjugal 
duties, which were unpleasant to him, and the performance 
of which made him tired and weak. He denied having 
had sexual intercourse with men, but his blushing and 
embarrassment, and, still more, an occurrence in N., where 
the patient some time before provoked a scandal by at- 
tempting to have sexual intercourse with youths, gave him 
the lie. 

His external appearance also, habitus, form, gestures, 
manners and dress were remarkable, and decidedly recalled 
the feminine form and characteristics. The patient, how- 
ever, was over middle height, but thorax and pelvis were 
decidedly of feminine form. The body was rich in fat; 
the skin was well groomed, delicate and soft. This im- 
pression of a woman in masculine dress was further in- 
creased by a thin growth of hair on the face, which was 
shaven, with the exception of a small moustache; by the 
mincing gait; the shy, effeminate mannel % ; the feminine 
features; the swimming, neuropathic expression of the 
eyes ; the traces of powder and paint ; the curtailed cut of 
the clothing, with the bosom-like prominence of the upper 
garments ; the fringed feminine cravat ; and the hair 
brushed down smoothly from the brow to the temples. The 
physical examination made undoubted the feminine form of 
the body. The external genitals were well developed, though 
the left testicle had remained in the canal ; the growth of 
hair on the mons veneris was thin, and the latter was 
unusually rich in fat and prominent. The voice was high, 
and without masculine timbre. 

The occupation and manner of thought of v. H. were 
decidedly feminine. He had a boudoir and a well-supplied 
toilet-table, at which he spent many hours in all kinds 
of arts for beautifying himself. He abhorred the chase, 



AWDBOOYNT. 393 

practice with arms, and such masculine pursuits, and 
called himself an aesthete; spoke with preference of his 
paintings and attempts at poetry. He was interested 
in feminine occupations, in which e.g., embroidery 
he engaged, and called his greatest pleasure. He could 
spend his life in an artistic and esthetic circle of ladies 
and gentlemen, in conversation, music and aesthetics. 
His conversation was preferably about feminine things, 
fashions, needlework, cooking and household work. 

The patient was well nourished, but anaemic. He was 
of neuropathic constitution, and presented symptoms of 
neurasthenia, which were maintained by a bad manner of 
life, lying abed, living in-doors, and efferainateness. 

He complained of occasional pain and pressure in the 
head, and had habitual constipation. He was easily fright- 
ened ; complained of occasional lassitude and fatigue, and 
drawing pains in the extremities, in the direction of the 
lumbo-abdominal nerves. After pollutions, and regularly 
after eating, he felt tired and relaxed ; he was sensitive to 
pressure over the spinous processes of the dorsal vertebrae, 
as also to pressure along accessible nerves. He felt peculiar 
sympathies and antipathies towards certain persons, and, 
when he met people for whom he had an antipathy, he 
fell into a condition of peculiar fear and confusion. His 
pollutions, though later on they occurred but seldom, were 
pathological, in that they occurred by day, and were un- 
accompanied by any sensual excitement 

Opinion. 

1. Mr. v. H., according to all observations and reports, 
was mentally an abnormal and defective person, and that, 
in fact, ab origine. His antipathic sexual instinct repre- 
sented a part of his abnormal physical and mental condi- 
tion. 

2. This condition, in that it was congenital, was in- 
curable. There existed defective organisation of the high- 
est cerebral centres, which rendered him incapable of 



394 PSYCIIOPATHIA SEXUALJS. 

leading an independent life, and of obtaining a position in 
life. His perverse sexual instinct prevented him from 
exercising normal sexual functions ; and this was attended 
by all the social consequences of such an anomaly, and 
the danger of satisfaction of perverse impulses arising out 
of his abnormal organisation, with consequent social and 
legal conflicts. Fear of the latter, however, could not be 
great, since the (perverse) sexual impulse of the patient 
was weak. 

3. Mr. v. H., in the legal sense of the word, was not 
irresponsible, and neither fit for, or in need of, treatment 
in a hospital for the insane. 

It was possible for him though but an overgrown 
child, and incapable of personal independence to live in 
society, even under the care and guidance of normal 
individuals. To a certain extent, it was possible for him 
to respect the laws and restrictions of society, and to judge 
his own acts; but, with respect to possible sexual errors 
and conflicts with criminal laws, it must be emphasised 
that his sexual instinct was abnormal, having its origin 
in organic pathological conditions; and this circumstance 
should have been eventually used in his favour. On ac- 
count of his notorious lack of independence, he could not 
be discharged from parental care or guardianship, inas- 
much as otherwise he would be ruined financially. 

4. Mr. v. H. was also physically ill. He presented 
signs of slight anaemia and of neurasthenia spinalis. 

A rational regulation of his manner of life and a tonic 
regimen, and, if possible, hydro-therapeutic treatment, 
seemed necessary. The suspicion that this trouble had its 
origin in early masturbation should be entertained, and 
the possibility of the existence of spermatorrhoea, that is 
of importance etiologically and therapeutically, was proba- 
ble. (Personal case. Zeilschr. f. Psychiatric.) 



CONGENITAL SEXUAL INVERSION IN WOMAN. 395 
CONGENITAL SEXUAL INVERSION IN WOMAN.* 

Science in its present stage has but few data to fall 
back on, so far as the occurrence* of homosexual instinct 
in woman is rono-rued as compared with man. 

It would not be fair to draw from this the conclusion 
that sexual inversion in woman is rare, for if this anomaly 
is really a manifestation of functional degeneration, then 
degenerative influences will prevail alike in the female 
as well as in the male. 

The causes of apparent infrequency in woman may be 
found in the following facts: (1) It is more difficult to 
gain the confidence of the sexually perverse woman; (2) 
this anomaly, in so far as it leads to sexual intercourse, 
inter feminas, does not fall (in Germany at any rate) under 
the criminal code, and therefore remains hidden from 
public knowledge; (3) sexual inversion does not affect 
woman in the same manner as it does man, for it does 
not render woman impotent; (4) because woman (whether 
sexually inverted or not) is by nature not as sensual and 
certainly not as aggressive in the pursuit of sexual needs 
as man, for which reason the inverted sexual intercourse 

'Literature: Hanelock Ellis, "Alienist and Neurologist," April, 
1895 ; Moll, " Contriire Sexualempfindung," second edition, p. 322. 
Moll, Contrfire Sexualempfindung, 3rd ed., p. 504. Moraglia, Neue 
Forschungen aus d. Gehiet der weiblichen Criminalitat. v. Krafft, 
Jahrb. f. sexuclle Zwischenstufen, Hi., p. 20. 

Observations: (1) Westphal, "Arch. f. Psych.," ii., p. 73; 
(2) Oock, op. cit., No. 1.; (3) Wite, "The Alienist and Neurol- 
ogist," January, 1883; (4) Cantarano, "La Psichiatria, 1883," p. 
201; (5) Berieux, op. cit., obs. 14; (6) Kiernan, op. cit.; (7) 
MAller, Friedreich't " Bliltter f. gor. Mt-d.," 1891, Heft 4.; (8-19) 
Moll, " ContrRre Sexualempfindung," 2 Aufl. Beob., 18, 19, 20, 21, 22, 
23; (20) Meyhdfer, " Zeitsch. f. Medicinalbeamte," v., 16; (21 22) 
Zuccarelli, " Inversione congenita in due donne," Napoli, 1888; 
(23-33) it oil, " Untrrsuchungen liber Libido sexualis," Fftlle 10-12, 
40-44, 47, 50, 57; (34-36) Uavelock Ellit, op. cit.; (37) Penta 
Vrto, " Ardiiv. delle psichopatie sexuali," p. 33; (38) Penta, ibid., 
p. 04. (39-40) Ftrc, 1'instinct sexuelle, observ. 15, p. 242, observ. 22, 
p. 291. (41) Case Urban of the 18th century, reported by Moll, 
Contr. Sexualempfindung, 3rd ed. p. 533. (42-43) v. Krafft, Jahr- 
bOdier fUr texuelle Zwischenstufen, iii., p. 27 and 29. 



396 PSTCHOPATHIA SEXUALIS. 

among women is less noticeable,, and by outsiders is 
considered mere friendship. Indeed, there are cases on 
record (psychical hermaphroditism, even homosexuality) 
in which the causes of frigiditas uxoris remain unknown 
even to the husband. 

Certain passages in the Bible, 1 the history of Greece 
("Sapphic Love"), the moral history of ancient Rome 
and of the Middle Ages, 2 offer proofs that congressus in- 
tersexualis feminarum took place at all times, the same 
as it is practised now-a-days in the harem, in female 
prisons, brothels and young ladies' seminaries (vide infra, 
amor lesbicus). 

Still it must be admitted that many of these cases 
are to be reduced to causes of perversity and not per- 
version. 8 

The chief reason why inverted sexuality in woman 
is still covered with the veil of mystery is that the homo- 
sexual act so far as woman is concerned, does not fall 
under the law. 

I cannot lay sufficient stress upon the fact that sexual 
acts between persons of the same sex do not necessarily 
constitute antipathic sexual instinct. The latter exists 
only when the physical and psychical secondary sexual 
characteristics of the same sex exert an attracting influ- 
ence over the individual and provoke in him or her the 
impulse to sexual acts. 

1 Paul, Epist. ad Rom. * Ploss, op. cit. 

' It is a remarkable fact that in fiction, lesbic love is frequently 
used as the leading theme, viz., Diderot, " La Religieuse " ; Balzac, 
" La fille aux yeaux d'or " ; Th. Gautier, " Mademoiselle de Maupin " ; 
Feydeau, "La Comtesse de chalis"; Flaubert, "Salammbo"; Belot, 
"Mademoiselle Giraud, ma femme"; Rachilde, "Monsieur Venus." 

The heroines of these (lesbic) novelles appear to the beloved 
persons of the same sex in the character and the rdle of a man; their 
love is most intense. 

The oldest case of sexual inversion recorded thus far in Germany 
is one of viraginity dating as far back as the beginning of the 
eighteenth century. It is that of a woman who was married to 
another woman cohabiting with the consort by means of a leathern 
priapus. Vide Dr. Miiller in Friedreich'a " Blatter f. ger. Med.," 1891, 
Heft 4. 



CONGENITAL SEXUAL INVERSION IN WOMAN. 397 

I have through long experience gained the impression 
that inverted sexuality occurs in woman as frequently 
as in man. But the chaster education of the girl deprives 
the sexual instinct of its predominant character; seduction 
to mutual masturbation is less frequent; the sexual in- 
stinct in the girl begins to develop only when she is, with 
the advent of puberty, introduced to the society of the 
other sex, and is thus naturally led primarily into hetero- 
sexual channels. All these circumstances work in her 
favour, often serve to correct abnormal inclinations and 
tastes, and force her into the ways of normal sexual in- 
tercourse. We may, however, safely assume that many 
cases of frigidity or anaphrodisia in married women are 
rooted in undeveloped or suppressed antipathic sexual 
instinct. 

The situation changes when the predisposed female is 
also tainted with other anomalies of an hypersexual char- 
acter and is led through it or seduced by other females to 
masturbation or homosexual acts. 

In these cases we find situations analogous to those 
which have been described as existing in men afflicted 
with "acquired" antipathic sexual instinct. 

As possible sources from which homosexual love in 
woman may spring, the following may be mentioned: 

1. Constitutional hypersexuality impelling to auto- 
masturbation. This leads to neurasthenia and its evil 
consequences, to anaplimdisia in the normal sexual inter- 
course so long as libido remains active. 

2. Hypersexuality also leads faute de mieux to homo- 
sexual intercourse (inmates of prisons, daughters of the 
higher classes of society who are guarded so very care- 
fully in their relations with men, or are afraid of im- 
pregnation, this latter group is very numerous). Fre- 
quently female servants are the seducers, or lady friends 
with perverse sexual inclinations, and lady teachers in 
seminaries. 

3. Wives of impotent husbands who can only sexually 
excite, but not satisfy, woman, thus producing in her 



398 PSTCHOPATHIA SEXUALI8. 

libido insatiata, recourse to masturbation, pollutiones fem- 
inw, neurasthenia, nausea for coitus/ and ultimately disgust 
with the male sex in general. 

4. Prostitutes of gross sensuality who, disgusted with 
the intercourse with perverse and impotent men by whom 
they are used for the performance of the most revolting 
sexual acts, seek compensation in the sympathetic embrace 
of persons of their own sex. These cases are of very fre- 
quent occurrence. 

Careful observation among the ladies of large cities 
soon convinces one that homosexuality is by no means a 
rarity. Uranism may nearly always be suspected in fe- 
males wearing their hair short, or who dress in the fashion 
of men, or pursue the sports and pastimes of their male 
acquaintances; also in opera singers and actresses, who 
appear in male attire on the stage by preference. 

So far as the clinical aspect is concerned I may be 
brief, for this anomaly shows the same qualifications alike 
in man and woman, mutatis mutandis, and runs through 
the same grades. Psychico-hermaphrodisic and many 
homosexual women do not betray their anomaly by ex- 
ternal appearances nor by mental (masculine) sexual 
characteristics. Remarkable, however, it is that Dr. 
Flatau (Moll, op. cit., p. 334) in examining the larynx of 
twenty-three homosexual women found in several of them a 
decidedly masculine formation. 

In the transition to the subsequent grade, i.e., that of 
viraginity (analogous to effeminatio in the male) strong 
preference for male garments will be found. In dreams, 
but also in the ideal or real homosexual function, the 
individual in question plays an indifferent sexual role. 

Where viraginity is fully developed, the woman so 
acting assumes definitely the masculine role. 

In this grade modesty finds expression only towards 
the same but not the opposite sex. 

In such cases the sexual anomaly often manifests itself 
by strongly marked characteristics of male sexuality. 

The female urning may chiefly be found in the haunts 



CONGENITAL, SEXUAL INVERSION IN WOMAN. 399 

of boys. She is (ho rival in their play, preferring the 
nx-kin^-horse, playing at soldiers, etc., to dolls and other 
girlish occupations. The toilet is neglected, and rough 
boyish manners are affected. Love for art finds a sub- 
stitute in the pursuits of the sciences. At times smoking 
and drinking are cultivated even with passion. 

Perfumes and sweetmeats are disdained. The con- 
sciousness of being a woman and thus to be deprived of 
the gay college life, or to be barred out from the military 
career, produces painful reflections. 

The masculine soul, heaving in the female bosom, 
finds pleasure in the pursuit of manly sports, and in 
manifestations of courage and bravado. There is a strong 
desire to imitate the male fashion in dressing the hair 
and in general attire, under favourable circumstances even 
to don male attire and impose in it Arrests of women 
in men's clothing are by no means of rare occurrence, 
A case of a woman who for years successfully posed as 
a man (hunter, soldier, etc.,) is related by Mutter in 
Friedreich's "Blatter"; another by Wise (op. cit.) and 
others. 

The ideals of such viragines are certain female char- 
acters who in the past or the present have excelled by virtue 
of genius and brave and noble deeds. 

Gynandry represents the extreme grade of degenerative 
homosexuality. The woman of this type possesses of the 
feminine qualities only the genital organs ; thought, senti- 
ment, action, even external appearance are those of the 
man. 

Often enough does one come across in life such 
characters, whose frame, pelvis, gait, appearance, coarse 
masculine features, rough deep voice, etc., betray rather 
the man than the woman. Moll (op. cit. p. 331) has given 
many interesting items about the mode of life led by these 
men-women, and about the way in which they satisfy 
their sexual needs. 

Mutatis mutandis, the situation is the same as with the 
man-loving man. These creatures seek, find, recognise, 



400 PSYCHOPATHIA SEXUALIS. 

love one another, often live together as "father" and 
"mother" in pseudo marriage. Suspicion may always 
be turned toward homosexuality when one reads in the 
advertisement columns of the daily papers: "Wanted, by 
a lady, a lady friend and companion". 

Numerous psychical hermaphrodites of the female 
gender, and even homosexualists, enter upon matrimony 
with men partly on account of being ignorant of their 
own anomaly, and partly because they wish to be pro- 
vided for. Some of these marriages linger on in a way, 
the husband, perhaps, being psychically sympathetic, thui 
rendering the marital act possible to the unhappy wife. 
But in most cases, when one or two children have been 
born, she seeks under all kinds of pretexts to avoid the 
connubial duty. 

More frequently, however, incompatibility wrecks these 
unions. Homosexual intercourse continues after marriage 
just the same as with the homosexual man. 

When viraginity prevails marriage is impossible, for 
the very thought of coitus cum viro arouses disgust and 
horror. 

The intersexual gratification among these women 
seems to be reduced to kissing and embraces, which seems 
to satisfy those of weak sexual instinct, but produces 
in sexually neurasthenic females ejaculation. 

Automasturbation, faute de mieux, seems to occur in all 
grades of the anomaly the same as in men. 

Strongly sensual individuals may resort to cunnilingus 
or mutual masturbation. 

In grades 3 and 4 the desire to adopt the active role 
towards the beloved person of the same sex seems to in- 
vite the use of the priapus. 

Case 153. Psychical hermaphroditism. Mrs. X., 
twenty-six years of age, suffered from neurasthenia. She 
was hereditarily tainted, suffered periodically from delu- 
sions. She had been married seven years, had two healthy 
children, a boy of six and a girl of four years. Success in 



CONGENITAL SEXUAL INVERSION IN WOMAN. 401 

gaining the confidence of the patient. She confessed that 
she always inclined more to persons of her own sex, and 
that, although she esteemed and liked her husband, sexual 
intercourse disgusted her. Since the birth of the younger 
of the two children she had prevailed upon him to give it 
up altogether. When at the seminary she interested her- 
self in other young ladies in a manner which she could only 
describe as love. At times, however, she also found her- 
self drawn to certain gentlemen, and especially of late 
her virtue had been sorely tried by an admirer to whose 
advances she was afraid she might succumb, for which 
reason she avoided being alone with him. But such 
episodes were only of a quite transient character as com- 
pared with her passionate liking for persons of her own 
sex. Her whole desire was to be kissed and embraced by 
them and have the most intimate intercourse with them. 
She suffered much from nervousness because she could 
not always realise these desires. The patient is not 
aware of this inclination to persons of the same sex being 
of a sexual character, for beyond kissing, embracing, or 
fondling them she would not know what to do with them. 
Patient thought herself to be of a sensual nature. It was 
likely that she was addicted to masturbation. 

She considered her sexual perversion as "unnatural, 
morbid." 

There was nothing in the behaviour or the manners or 
the external appearance of this lady which in the least 
betrayed her anomaly. 

Case 154. Psychical hermaphrodUism. Mrs. M., 
forty-iour years of age, claimed to be an instance illus- 
trating the fact that in one and the same human being, be 
it man or woman, the inverted as well as the normal di- 
rection of sexual life may be combined. The father of this 
lady was very musical, generally possessed considerable 
talents for art, was a great admirer of the gentle sex, and 
himself of exceptional beauty. He died, after repeated 
apoplectic attacks, with dementia in an asylum. His 

2G 



402 PSYCIIOPATHIA SEXUALIS. 

brother was neuropsychopathic, as a child was afflicted with 
somnambulism, and later on with hypercesthesia sexualis. 
Although married and father of several married sons, he 
fell desperately in love with Mrs. M., then eighteen years 
of age, and attempted to abduct her. 

Her grandfather (on the paternal side) was very ec- 
centric and a well known artist, who had originally studied 
theology, but for love of the dramatic art became a mimic 
and singer. He was given to excess in Baccho et Venere, 
extravagant and fond of splendour, and died at the age of 
forty-nine from apoplexia cerebri. Her mother's father 
and her mother both died of pulmonary phthisis. 

She had eleven brothers and sisters, but only six sur- 
vived. Two brothers died at the age of sixteen and twenty 
of tuberculosis. One brother was suffering from laryngeal 
phthisis. Four living sisters the same as Mrs. M. were 
physically like unto the father, very nervous and shy. 
Two younger sisters were married and in good health, and 
both had healthy children. Another one, a maiden, was 
suffering from nervous affection. 

Mrs. M. was the mother of four children, mostly deli- 
cate and neuropathic. 

There was nothing of importance in the history of the 
patient's childhood. She learned easily, had gifts for 
poetry and aesthetics, was somewhat affected, loved to 
read novels and sentimental literature, was of neuropathic 
% constitution and very sensitive to changes of temperature, 
the slightest draught would make her flesh creep. It is 
noteworthy, however, that one day when ten years of age 
she fancied her mother did not love her. Thereupon she 
put a lot of sulphur matches in her coffee and drank it to 
make herself ill, in order to draw her mother's love to 
herself. 

Puberty began without difficulty at the age of eleven, 
with subsequent regular menses. Even previous to that 
period sexual life had awakened, which ever since was 
very potent. The first sentiments and emotions lay in 
vthe homosexual direction. She conceived a passionate, 



CONGENITAL SEXUAL INVERSION IN WOMAN. 403 

though platonie, affection for a young lady, wrote love- 
songs and sonnets to her, and never was happier than 
\\licn, upon one occasion, she could admire the "charms 
"f her beloved" in the bath, or when she could gaze 
upon the- neck, shoulders and breasts of this lady whilst 
dressing. She could resist only with difficulty the desire 
to touch these physical charms. When a girl she was 
deeply in love with Raphael's and Quido Reni's Madonnas. 
She was irresistibly impelled to follow pretty girls and 
ladies by the hour, no matter how inclement the weather 
might be, admiring their air of refinement and watching 
for a chance of showing them a favour, giving them 
flowers, etc. The patient asserted that up to her nineteenth 
year she had not the slightest knowledge of the difference 
of sexes, since she had been brought up by a prudish old 
maiden aunt like a nun in a cloister. In consequence of 
this crass ignorance she fell a victim to a man who loved 
her passionately and insidiously betrayed her virtue. She 
became the wife of this man, gave birth to a child, and 
led an "eccentrically" sexual life with him, but felt sat- 
isfied with the sexual intercourse. A few years later 
she became a widow. Since then her affections again 
turned to persons of her own sex, the principal reason for 
which was, the patient averred, the fear of the results of 
sexual intercourse with man. 

At the age of twenty-seven she entered upon a second 
marriage with a man of infirm constitution. It was not 
a love match. Thrice she became a mother, and fulfilled 
all the conditions of maternity; but her health ran down, 
and during the latter years her dislike for coitus ever 
increased, chiefly on account of her husband's infirmity, 
although her desire for sexual gratification remained 
strong. 

Three years after her second husband's death, she dis- 
covered that her daughter by the first husband, now nine 
years of age, was given to masturbation and going into 
decline. She read an article about this vice in the Ency- 
clopcedia, and now could not resist the temptation to try 



404 PSYCHOPATHIA SEXUALI8. 

it herself and thus became an onanist. She hesitated to 
give a full account of this period of .her life. She stated, 
however, that she became sexually so excited that she had 
to send her two daughters away from home in order to 
preserve them from something "terrible". The 'two boys 
could remain at home. 

Patient became neurasthenic ex masturbatione (spinal 
irritation, pressure in the head, languor, mental constipa- 
tion, etc.) at times even dysthymic, with worrying tcedium 
vita. 

Her sexual inclinations turned now to woman, now 
to man. But she controlled herself, suffered much from 
her abstinence, especially since she resorted to mastur- 
bation on account of her neurasthenic afflictions only at 
the last instance. At the age of forty-four still having 
regular periods the patient suffered from a violent pas- 
sion for a young man with whom, on account of her avoca- 
tion, she was bound to be in constant contact. 

The patient did not offer anything extraordinary in 
her external appearance, though graceful of build, she was 
slight of form. Pelvis decidedly feminine, but arms and 
legs large, and of pronounced masculine type. Female 
boots did not really fit her, and she had quite crippled 
and malformed her feet by forcing them into narrow 
shoes. Genitals quite normal. Excepting a descensus 
uteri with hypertrophy of the vaginal portion, no changes 
were noticeable. She still claimed to be essentially homo- 
sexual, and declared that her inclination and desire for the 
opposite sex were only periodical and grossly sensual. Al- 
though she had strong sexual feelings towards the man 
aforementioned, yet her greatest and noblest pleasure she 
found in pressing a kiss upon the soft cheek of a sweet 
girl. This pleasure she enjoyed often, for she was the 
"favourite aunt" among these "dear creatures," to whom 
she rendered the services of the "cavalier" unstintingly, 
always feeling herself in the role of the man. 

Case 155. Homosexuality. Miss L., fifty-five years 



CONUKMTAL SEXUAL INVERSION IN WOMAN. 405 

of age. No information about her father's family. The 
I >a rents of her mother were described as irascible, ca- 
pricious and nervous. One brother of her mother was an 
epileptic, another eccentric and mentally abnormal. 

Mother was sexually hypenesthetic, and for a long 
time a messalina. She was considered to be psychopathic 
and died at the age of sixty-nine of cerebral disease. 

Miss L. developed normally, had only slight illnesses 
in childhood, and was mentally well endowed, but of a 
neuropathic constitution, emotional, and troubled with 
numerous fads. 

At the age of thirteen, two years previous to her first 
menstruation, she fell in love with a girl-friend ("a dreamy 
feeling, quite pure of sensuality"). 

Her second love was for a girl older than herself who 
was a bride; this was accompanied by tantalising sensual 
desires, jealousy, and an "undefined consciousness of mys- 
tical impropriety". She was refused by this lady and 
now fell in love with a married woman, who was a mother 
and twenty years her senior. As she controlled her sensual 
emotions, this lady never even divined the true reason of 
this enthusiastic friendship which lasted for twelve years. 
Patient described this period as a veritable martyrdom. 

Since she was twenty-five she had begun to mastur- 
bate. Patient seriously thought that, perhaps, by marriage 
she might save herself, but her conscience objected, for 
her children might inherit her weakness, or she might 
make a sincere husband unhappy. 

At the age of twenty-seven she was approached with 
direct proposals by a girl who denounced abstinence as 
alisurd, and plainly described the homosexual instinct 
\\hich ruled her and was very impetuous in her demands. 
She suffered the caresses of the girl, but would not con- 
sent to sexual intercourse, as sensuality without love dis- 
gusted her. 

Mentally and bodily dissatisfied the years fled by, 
leaving the consciousness of a spoiled life. Now and then 
she became enthusiastic about ladies of her acquaintance, 



406 PSYCHOPATHIA SEXUALIS. 

but controlled herself. She also rid herself from mastur- 
bation. 

When she was thirty-eight years of age she became 
acquainted with a girl nineteen years her junior, of ex- 
ceptional beauty, who came from a demoralized family, 
and had been at an early age seduced by her cousins to 
mutual masturbation. It could not be ascertained whether 
this girl A. was a case of psychical hermaphrodism or of 
acquired sexual inversion. The former hypothesis seems 
the likelier of the two. 

The following is taken from an autobiography of Miss 
Jj. ' 

"Miss A., my pupil, began to show me her idolatrous 
love. She was sympathetic to the highest degree. Since 
I knew that she was entangled in a hopeless love affair 
with a dissolute fellow and continued intimate intercourse 
with demoralised female cousins, I decided not to repulse 
her. Compassion and the conviction that she was surely 
drifting into moral decay determined me to suffer her 
advances. 

"I did not consider her affection as dangerous, as I did 
not think it possible that (considering her love affair) in 
ONE soul two passions (one for a man and another for a 
woman) could exist simultaneously. Moreover, I was 
certain of my power of resistance. I kept, therefore, Miss 
A. about me, renewed my moral resolutions, and con- 
sidered it to be my duty to use her love for me for en- 
nobling her character. The folly of this I soon found 
out. One day whilst I lay asleep Miss A. took occasion 
to satisfy her lust on me. Although I woke up just in 
time, I did not have the moral strength to resist her. I 
was highly excited, intoxicated as it were and she pre- 
vailed. 

"What I suffered immediately after this occurrence 
beggars description. Worry over the broken resolutions, 
which to keep I had made such strenuous efforts, fear of 
detection and subsequent contempt, exuberant joy at last 
to be rid of the torturing watcbings and longings of the 



CONGENITAL SEXUAL INVERSION IN WOMAN. 407 

single state, unspeakable sensual pleasure, wrath against 
tin- evil companion, mingled with feelings of the deepest 
tenderness towards her. Miss A. calmly smiled at my 
excitement, and with caresses soothed my anger. 

"1 accepted the situation. Our intimacy lasted for 
years. We practised mutual masturbation, but never to 
excess or in a cynical fashion. 

"Little by little this sensual companionship ceased. 
Miss A.'s tenderness weakened; mine, however, remained 
as before, although I felt no longer the same sensual 
cravings. Miss A. thought of marriage, partly in order to 
find a home, but especially because her sensual desires had 
turned into the normal paths. She succeeded in finding 
a husband. I sincerely hope she will make him happy, 
but I doubt it. Thus I have the prospect before me to 
linger on the same joyless, peaceless life as it ever was in 
youthful days. 

"It is with sadness that I remember the years of our 
loving union. It does not disturb my conscience to have 
had sexual intercourse with Miss A., for I succumbed to 
her seduction, having honestly endeavoured to save her 
from moral ruin and to bring her up an educated and 
moral being. In this I honestly think I have succeeded 
after all. Besides, I rest in the thought that the moral 
code is established only for normal humans, but is not 
binding for anomalies. Of course, the human being who 
is endowed by nature with sentiments of refinement, but 
whose constitution is abnormal and outside the conven- 
tionalities of society, can never be truly happy. But I 
experienced a sad tranquillity and felt happy when I 
thought Miss A. to be so too. 

"This is the history of an unhappy woman who, by 
the fatal caprice of nature, is deprived of all joy of life 
and made a victim of sorrow." 

The author of this woeful story was a lady of great 
refinement. But she had coarse features, a powerful but 
throughout feminine frame.* She passed through the 
climacterium without trouble, and since then had been 



408 PSYCHOPATHIA SEXUALIR. 

entirely free from sensual worry. Sexually she had never 
played a defined role towards the, woman she loved; for 
men she never felt the slightest inclination. 

Her statements about the family relations and the 
health of her paramour, Miss A., establish a heavy taint 
beyond doubt. The father died in an insane asylum, the 
mother was deranged during the period of her climac- 
terium, neuroses were of frequent occurrence in the family, 
and Miss A. herself suffered at times heavily from hystero- 
pathy, with hallucinations and delirium. 

Case 156. Homosexuality. S. J., age thirty-eight, 
governess. Came to me for medical advice on account 
of nervous trouble. Father was periodically insane, and 
died from cerebral disease. Patient was an only child. 
She suffered early from anxiety and alarming fancies, 
e.g., that she would wake up in a coffin after it had been 
fastened down; that she would forget something when 
going to confession, and thus receive holy communion 
unworthily. Was often troubled with headaches, very 
excitable, easily startled, but notwithstanding had a great 
desire to see exciting things such as funerals, etc. 

From the earliest youth she was subject to sexual 
excitement, and spontaneously practised masturbation. 
At the age of fourteen she began to menstruate. Her 
periods were often accompanied by colicky pains, intense 
sexual excitement, neuralgia and mental depression. With 
the age of eighteen she gave up masturbation successfully. 

The patient never experienced an inclination towards 
a person of the opposite sex. Marriage to her only meant 
to find a home. But she was mightily drawn to girls. 
At first she considered this affection merely as friendship, 
but she soon recognised from the intensity of her love 
for girl friends and her deep longings for their constant 
society that? it meant more than mere friendship. 

To her it is inconceivable that a girl could love a man, 
although she can comprehend the feeling of man toward 
woman. She always took the deepest interest in pretty 



CONGENITAL SEXUAL INVERSION IN WOMAN. 409 

girls and ladies, the sight of whom caused her intense 
"input. Her desire was ever to embrace and kiss 
these dear creatures. She never dreamed of men, always 
of girls only. To revel in looking at them was the acme 
of pleasure. Whenever she lost a "girl friend" she felt 
in despair. 

Patient claimed that she never felt in a defined role, 
even in her dreams, towards her girl friends. In appear- 
ance she was thoroughly feminine and modest. Feminine 
pelvis, large mammse, no indication of beard. 

Case 157. Homosexuality. Mrs. R., aged thirty-five, 
of high social position, was brought to me in 1886 by her 
husband for advice. 

Father was a physician; very neuropathic. Paternal 
grandfather was healthy and normal, and reached the age 
of ninety-six. Facts concerning paternal grandmother 
are wanting. All the children of father's family were said 
to have been nervous. The patient's mother was nervous, 
and suffered with asthma. The mother's parents were 
healthy. One of the mother's sisters had melancholia. 

From her tenth year patient had been subject to 
habitual headache. With the exception of measles, she 
had no illness. She was gifted, and enjoyed the best of 
training, having especial talent for music and languages. 
It became necessary for her to prepare herself for the 
work of a governess, and during her earlier years she 
was mentally overworked. She passed through an attack 
of melancholia sine delirio, of some months' duration, at 
seventeen. The patient asserted that she had always had 
sympathy only for her own sex, and found only an sesthetic 
interest in men. She never had any taste for female work, 
As a little girl, she preferred to play with boys. 

She said she remained well until her twenty-seventh 
year. Then, without external cause, she became depressed 
and considered herself a bad, sinful person, had no plea- 
sure in anything, and was sleepless. During this time of 
illness she was also troubled with delusions: she must 



410 PSYCHOPATHIA SEXUALIS. 

think of her death and that of her relatives. Recovery 
after about five months. She then became a governess, 
was overworked, but remained well, except for occasional 
neurasthenic symptoms and spinal irritation. 

At twenty-eight she mada the acquaintance of a lady 
five years younger than herself. She fell in love with 
her, and her love was returned. The love was very sensual, 
and satisfied by mutual masturbation. "I loved her as 
a god ; hers is a noble soul," she said, when she mentioned 
this love-bond. It lasted four years and was ended by the 
(unfortunate) marriage of her friend. 

In 1885, after much emotional strain, the patient be- 
came ill with symptoms of hystero-neurasthenia (dyspep- 
sia, spinal irritation, and tonic spasmodic attacks; attacks 
of hemiopia with migraine and transitory aphasia; 
pruritus pudendi ei am). In February, 1886, these symp- 
toms disappeared. 

In March she became acquainted with her present 
husband, whom she married without taking much time 
for reflection; for he was rich, much in love with her, 
and his character was in sympathy with her own. 

On 6th April, she read the sentence, "Death misses 
no one." Like a flash of lightning in a clear sky, the 
former delusions of death returned. She was forced to 
meditate on the most horrible manner of death for 
herself and those about her, and constantly imagined 
death-scenes. She lost rest and sleep, and took no 
pleasure in anything. Her condition improved. Late in 
May, 1886, she was married, but was still troubled by 
painful thoughts at that time: that she would bring 
misfortune on her husband and those about her. 

First coitus on 6th June, 1886. She was deeply de- 
pressed morally by it. She had no such conception 
of matrimony. The husband, who really loved his wife, 
did all he could to quiet her. He consulted physicians, 
who thought all would be well after pregnancy. The 
husband was unable to explain the peculiar behaviour 
of his wife. She was friendly toward him, and suffered 



CONGENITAL SEXUAL INVERSION IN WOMAN. 411 

his caresses. In coitus, which was actually carried out, 
she was entirely passive, and after the act she was tired, 
exhausted all day long, nervous, and troubled with spinal 
irritation. 

A bridal tour brought about a meeting with her old 
friend, who had lived in an unhappy marriage for three 
years. The two ladies trembled with joy and excitement 
as they sank into each other's arms, and became insepar- 
able. The husband saw that this friendly relation was 
a peculiar one, and hastened their departure. lie had an 
opportunity of ascertaining, through the correspondence 
of his wife with this friend, that the letters interchanged 
were like those of two lovers. 

Mrs. R. became pregnant. During pregnancy the 
remains of depression and delusions disappeared. In 
September, during about the ninth week of pregnancy, 
abortion took place. After that, renewed symptoms of 
hystero-neurasthenia. In addition to this, there were 
anteflexio et latero-positio dextra uteri, anosmia, et atonia 
ventriculi. 

At the consultation the patient gave the impression 
of a very neuropathic, tainted person. The neuropathic 
expression of the eyes cannot be described. Appearance 
entirely feminine. With the exception of a very narrow 
arched palate, there was no skeletal abnormality. With 
difficulty the patient could be brought to give the details 
of her sexual abnormality. She complained that she had 
married without knowing what marriage between men 
and women was. She loved her husband dearly for his 
mental qualities, but marital intercourse was a pain to 
her; she did it unwillingly, without ever finding any 
satisfaction in it. Post actum, all day long she was weary 
and exhausted. Since the abortion and the interdiction 
of sexual intercourse by tin- physicians, she had been 
better; but she thought of the future with horror. She 
esteemed her husband, and l<>\i<l him mentally; but she 
would do anything for him, if he would but avoid her 
sexually in the future. She hoped to have sexual feeling 



412 PSYCHOPATHIA SEXUALIS. 

for him in time. When he played the violin, she seemed 
to feel the beginning of an inclination for him that was 
something more than friendship; but it was only tran- 
sitory, and she could get no assurance for the future 
in it Her greatest happiness was in correspondence with 
her former lover. She felt that this was wrong, but she 
could not give it up ; for to do so made her miserable. 

Case 158. Homosexuality. Miss X., of the middle 
class in a large city. At the end of my observations she 
was twenty-two years of age. 

She was considered a beauty; much admired by men; 
decidedly sensual; a born Aspasia; refused all proposals 
of marriage. She reciprocated, however, the advances of 
one admirer, a youthful scholar, entertained relations with 
him, that is to say, she allowed him to kiss her, but not 
as a lover. When on one occasion, Mr. T. thought he had 
obtained the aim of his attentions, she begged him under 
tears to desist, alleging that her refusal was not based 
upon moral principles, but rooted in deeper psychical 
reasons. Subsequently epistolary correspondence between 
the two disclosed the existence of sexual inversion. 

Her father was given to drink, her mother hystero- 
pathic. She herself was of neuropathic constitution, had a 
large bust and the appearance of an exceptionally hand- 
some woman, but was strikingly mannish in her manners, 
had masculine tastes, loved gymnastics and horseback 
exercise, smoked, and had masculine carriage and gait, 
She would like to go on the stage. 

Recently she caused much talk on account of her en- 
thusiastic friendships with young ladies. One young lady 
lived with her. They slept in the same bed. 

Up to her puberty Miss X. claimed to have been sex- 
ually indifferent. 

At the age of seventeen, whilst at a spa, she made the 
acquaintance of a young foreigner whose "royal" appear- 
ance fascinated her. She was happy when, on a certain 
occasion, she could dance with him the whole evening. 



CONGENITAL SEXUAL INVERSION IN WOMAN. 413 

The next evening at twilight she happened to witness the 
revolting scene of this charming young man right opposite 
from her window in the shrubbery of the gardens futuare 
more bestiarum inulierem quondam inter menstruationem. 
Aspect u sanguinis currentis et libidinis quasi bestialia viri 
Miss X. was horrified, almost annihilated, and felt it 
difficult to recover her mental balance. For a long time 
she lost her sleep and appetite, and from that time she 
saw in man only the embodiment of coarse vulgarity. 

Two years later, in a public park, she was approached 
by a young lady who smiled and looked upon her in such 
a peculiar fashion that she felt a thrill through her soul. 

The day after, Miss X. was irresistibly impelled to go 
to the park again. The young lady was already there, 
and seemed to be waiting for her. They greeted each 
other like old acquaintances; talked and joked together, 
made fresh appointments, and when the weather became 
too inclement they met at the boudoir of the young lady. 

"One day," Miss X. relates in her confidential revela- 
tions, "she led me to her divan, and whilst she was seated 
I knelt down at her feet She fastened her timid eyes 
upon me, stroked away the hair from my forehead, and 
said, 'Ah ! if I only could love you once really ! May I ?' 
I consented, and whilst we thus sat together, gazing into 
each other's eyes, we drifted into that current which al- 
lows of no retreat. . . . She was enchantingly beauti- 
ful. All I wished was to possess the power of the artist 
to immortalise that form upon the canvas. To me it was 
a novel experience. I was intoxicated. We abandoned 
ourselves to each other without restriction, drunk with 
the ravages of sensual feminine pleasure. I do not believe 
that man can ever grasp the exuberance of such piquant 
tenderness; man is not sufficiently refined; he is much 
too coarse. . . . Our wild orgy lasted until I sank down 
exhausted, powerless, unnerved. I fell asleep on her bed. 
Suddenly I awoke with an unspeakable thrill, hitherto 
unknown to me, running through my whole being. She 
was upon me cunnilingum perficiens the highest plea- 



414 PSYCHOPA.THIA SEXUALI8. 

sure for her, tandem mihi non licebat altnim quam osculos 
dare ad mammas, which caused her to quiver convulsively. 

"This intercourse lasted for a whole year, when the 
removal of her father to another city separated us." 

Miss X. admitted that in this homosexual intercourse 
she always felt in the role of man towards the woman, 
and that on one occasion, faute de mieux, she granted 
cunnilingus to one of her male admirers. 

Case 159. Homosexuality. Mrs. C., aged thirty-two 
wife of an official, a large, not uncomely woman, feminine 
in appearance, came of a neuropathic and emotional 
mother. A brother was psychopathic, and died of drink. 
Patient was always peculiar, obstinate, silent, quick-tem- 
pered, and eccentric. The brothers and sisters were ex- 
citable people. Pulmonary phthisis had been frequent 
in the family. When only a girl of thirteen, with signa 
of great sexual excitement, she attracted attention by 
enthusiastic love for a female friend of her own age. Her 
education was strict, though the patient secretly read many 
novels, and wrote innumerable poems. She married at 
eighteen to free herself from unpleasant circumstances 
at home. 

She said she had always been indifferent toward men. 
In fact, she avoided balls. Female statues pleased her. 
Her greatest happiness was to think of marriage with 
a beloved woman. She was not aware of her sexual 
peculiarity until marriage, and the thing had remained 
inexplicable to her. Patient did her marital duty, and 
bore three children, two of whom were subject to con- 
vulsions. She lived pleasantly with her husband, but she 
esteemed him only for his moral qualities. She gladly 
avoided coitus. "I should have preferred intercourse with 
a woman." 

Until 1878 she had been neurasthenic. On the occa- 
sion of a sojourn at a watering-place she made the ac- 
quaintance of a female urning, whose history I have 
reported as case 6, in the "Irrenfreund," No. 1, 1884. 



CONGENITAL SEXUAL INVERSION IN WOMAN. 415 

The patient came home a changed person. Her 
husband said: "She was no longer a woman, no longer 
had any love for me and the children, and would have 
no more of marital approaches. She was inflamed with 
passionate love for her female friend, and had taste for 
in >tliing else." After the husband forbade her lover the 
house, there was interchange of letters with such expres- 
sions in them as "My dove! I live only for you, my 
soul." There were meetings and frightful excitement 
when an expected letter did not come. The relation was 
in nowise platonic. From certain indications it was pre- 
sumable that mutual masturbation was the means of sexual 
satisfaction. This relation lasted until 1882, and made the 
patient decidedly neurasthenic. 

She absolutely neglected the house, and her husband 
hired a woman of sixty years as a housekeeper, and also 
a governess for the children. The patient fell in love 
with both, who, at least, allowed caresses, and profited ma- 
terially through the love of their mistress. 

In the latter part of 1883, on account of developing 
pulmonary tuberculosis, she had to go south. There she 
became acquainted with a Russian lady of forty years, and 
fell passionately in love with her; but she did not meet 
with a return of love in her sense. One day insanity be- 
came manifest She thought the Russian lady a nihilist; 
that she was magnetised by her; and she presented formal 
persecutory delusions. She fled, was caught in an Italian 
city, and placed in a hospital, where she soon became quiet. 
Again she worried the lady with her love, felt herself very 
unhappy, and planned suicide. 

When she returned home she was greatly depressed 
because she did not have the lady, and was harsh toward 
her family. A delusive, erotic state of excitement came 
on about the end of May, 1884. She danced, shouted, 
and called herself a man ; demanded her former lover, and 
said she was of royal blood. She escaped from the house 
in male attire, and was taken to the asylum in a state of 
eroto-maniacal excitement. After a few days the exalta- 



416 PSYCIIOPATHTA SEXUALIS. 

tion disappeared. The patient became quiet, and made a 
desperate attempt at suicide; after it she was in great an- 
guish of mind with toedium vitce. The perverse sexual 
feeling grew less and less noticeable as tuberculosis pro- 
gressed. The patient died of phthisis in the beginning of 
1885. 

The examination of the brain presented nothing unu- 
sual so far as architecture and arrangement of convolu- 
tions were concerned. Weight of brain 1150 grammes. 
Skull slightly asymmetrical. No anatomical signs of de- 
generation. External and internal genitals without anom- 
aly. 

Case 160. (Homo-sexuality in Transition to Vira- 
ginity.) Mrs. v. T., wife of a manufacturer; age twenty- 
six; married only a few months; was brought by her 
husband for consultation because after a banquet she had 
fallen upon the neck of a lady guest, covered her profusely 
with kisses and caressed her like a lover, thus causing a 
scandal. 

Mrs. T. said that she had before their marriage ex- 
plained to her husband her antipathic sexual feelings, and 
had told him that she esteemed him solely for his mental 
qualities. She accepted her conjugal duties merely as a 
matter of unavoidable necessity. Her only condition was 
that she should be incubus. In this position she obtained 
a sort of gratification, for she imagined his body to be 
that of a beloved woman in succubus. 

Her brother was neuropathic, of feminine type, suf- 
fered from hysteria, and was very weak in his sexual needs; 
one of his sisters, it was said, bought her conjugal rights 
from her husband for a sum of money, giving him full 
liberty to find sexual satisfaction elsewhere. The mother 
was hyper-sexual, and known as a Messalina. She made 
her daughter sleep in the same bed with her till she reached 
the age of fourteen. At fifteen v. T. was sent to a girl's 
school. Being extraordinarily bright, she learned quickly 
and soon dominated over all the other girls in her form. 



COMM-.MTAL SEXUAL INVERSION IX WOMAN. 417 

At the ago of seven she IKK! a iv<-ltieul trauma when 
a friend of the family exhibits! him.-eh' l.rfuiv lier. 

Menses began at twelve, were regular and without 
in rvoiiv enm-omitants. At that age she began already to 
be powerfully drawn to other girls. Although for several 
years she never associated these yearnings with sexual feel- 
ings, she yet looked upon them as an anomaly. She only 
felt bashful when undressing in the presence of persons 
of her own sex. At twenty the sexual instinct awoke. At 
once she turned to girls for gratification, avoiding men 
entirely. She had sensual love affairs with girls by the 
scores. When she returned home from school, having no 
Mipervision and plenty of money, she found it easy to give 
her passion full sway. She always felt like a man towards 
woman. Masturbatio feminro dilectae was the common 
occurrence in her orgies, until a female cousin taught her 
the mysteries of Lesbian love. She now coupled the act 
with etinuiliugus. She always played the active role, and 
never allowed others to satisfy themselves on her own body. 
Homo-sexual woman she disdained. She gave preference 
to unmarried women of high standing endowed with men- 
tal gifts, of voluptuous, Diana-like figure, but of modest 
and retiring disposition. (Sensual women she did not care 
for.) Whenever she met such a woman, she would be- 
come erotically so excited that she fell upon her person 
like a hungry wild beast. She said that at such momenta 
everything appeared to her in a reddish gleam, and con- 
sciousness was obliterated for the time being. Her nerves 
were easily unstrung, and she could not master her feel- 
ings. 

At the age of twenty-three she became acquainted with 
a young woman who, to all appearances, was not homo- 
Mi, but very hypersexual, and could not find sexual 
satisfaction on account of impotence in her husband. The 
relations with this woman stimulated T.'s homo-sexuality 
to a very high pitch and increased her sexual needs. She 
furnished an apartment away from home, where she had 
regular orgies cum digito et lingua, sometimes for hours, 

27 



418 PSYCHOPATHIA 8EXUALIS. 

until she herself collapsed in a state of exhaustion. She 
had a love affair with a dressmaker's model with whom 
she had herself photographed in man's attire, visited, in 
the same costume, with her places of amusement and was 
finally arrested on one of these occasions. She escaped 
with a warning and gave up male attire out-of-doors. 

A year before her marriage she had a period of melan- 
cholia. At that time she meditated suicide, and wrote a 
farewell letter to an intimate lady friend, a sort of con- 
fession, from which a few passages are given: 

"I was born a girl, but a misdirected education forced 
my fiery imagination early into the wrong direction. At 
twelve I had a mania to pose as a boy and court the atten- 
tion of ladies. I recognised this abnormal impulse as a 
mania, but, like fate, it grew with the years. The power 
to rid myself of it was lost. It was my hashish, my happi- 
ness, and grew into an overpowering passion. I felt like 
a man, forced to play the active role. My exuberant dis- 
position, tierce sensuousness and deep-rooted perverse in- 
stinct gradually forged me into the chains of Lesbian love. 
I took a certain interest in man, but a single touch by a 
woman made my whole nervous system tremble. I have 
suffered untold tortures in the bane of this passion. 

"The reading of French novels and lascivious compan- 
ions taught me all the tricks of perverse erotics, and the 
latent impulse became a conscious perversity. Nature has 
made a mistake in the choice of my sexuality and I must 
do a life-long penance for it, for the moral power to suffer 
the unavoidable with dignity is lost. Irresistibly I have 
been drawn into the maelstrom of passion and shall be 
swallowed up by it 

"I languished for your sweet body. I was jealous of 
your Victor as one rival is of the other. In my jealousy 
I suffered the tortures of hell. I hated that man unto 
death. I cursed my fate that made me a woman. I was 
satisfied to play a stupid comedy before you, to endow 
you with an artificial membrum. It only increased the 
heat of my passion. Courage failed me to tell you the 



CONGENITAL SEXUAL INVERSION IN WOMAN. 419 

(ruth, because it would have been so miserable and ludi- 
crous. Now you know all. You will not despise me, 
though; you will only feel what I have suffered. All my 
joys resemble more a momentary intoxication than the real 
gold of happiness. It was all but an illusion. I have fooled 
life and life has fooled me. We are quits. I say good-bye. 
Think sometimes in the hour of happiness of your poor, 
comical fool who loved you truly and so well . . . 

The vita sexualis of this woman contained also traces 
of masochism and sadism. If the woman whom she wor- 
shipped had chided or even struck her, it would have been 
a delight, so she claimed and at the time of sex^ial ex- 
citement she felt more like biting than kissing the object 
of her love. 

She was highly cultured and intellectual, felt her false 
position painfully, but rather on account of her family 
than her own self. She looked upon it all as fate, over 
which she had no control. She bewailed it and declared 
herself ready to do anything to rid herself of this perversion 
and become a true wife and good mother, for she would 
take good care that her child were brought up in the right 
way. She would do everything to reconcile her husband 
and perform her marital duties, but she could not bear 
his moustache, and she must first rid herself of her un- 
fortunate impulsive passion. 

The physical and psychical secondary sexual charac- 
teristics were partly masculine, partly feminine. Her 
love for sport, smoking and drinking, her preference for 
clothes cut in the fashion of men, her lack of skill in and 
liking for female occupations, her love for the study of 
obtuse and philosophical subjects, her gait and carriage, 
severe features, deep voice, robust skeleton, powerful mus- 
cles and absence of adipose layers bore the stamp of the 
masculine character. The pelvis also (small hips), dis- 
tantia spinarum 22cm., cristarum 26, trochanterum 31, ap- 
proached the masculine figure. Vagina, uterus, ovaries 
normal, clitoris rather large. Mammae well developed, 
hair on mons veneris female. 



420 PSYCHOPATHIA SF.XTTALIS. 

I sent her to an hydropathic establishment, where an 
experienced colleague succeeded in a few months to free 
this patient by means of hydro- and suggestive treatment, 
from her homo-sexual affliction. She became a decent, 
sexually at least, neutral person. The relatives with whom 
she lived afterwards for a considerable time found her be- 
haviour absolutely correct. 

Case 161. Viraginity. Miss N"., twenty-five years 
of age. Parents supposed to be healthy. Her brothers 
and sisters were all neuropathic. Three of her sisters were 
married. She was very talented, especially in the fine arts. 
Even in her earliest childhood she preferred playing at 
soldiers and other boys' games; she was bold and torn- 
boyish, and tried even to excel her little companions of 
the other sex. She never had a liking for dolls, needle- 
work or domestic duties. Puberty at fifteen. She soon 
foil in love with young ladies, but only in a platonic fash- 
ion, for she was a "respectable girl." For several years since 
then her libido was very strong. She could hardly restrain 
herself. Her dreams were of a lascivious character, only 
about females, with herself in the role of man. She was 
desperately in love with a woman of forty, whom she tor- 
mented with her jealous conduct. 

Miss N. was indifferent to men. She could safely live 
with a man in the same room, whilst towards persons of 
her own sex she was most bashful. 

She was quite conscious of her pathological condition. 

Masculine features, deep voice, manly gait, without 
beard, small mammse; cropped her hair short, and made the 
impression of a man in woman's clothes. 

Case 162. Viraginity. C. R., maid-servant, aged 
twenty-six, suffered from the time of her development 
with original paranoia and hysteria. As a result of her 
delusions, her life had been somewhat romantic, and in 
1884, in Switzerland, where she had gone on account of 
delusions of persecution, she came under the observation 



CONGENITAL SEXUAL INVEK8ION IN WOMAN. 421 

of tbe authorities. On this occasion it was ascertained that 
R. was affected with sexual inversion. 

Concerning her parents and relatives, there was no in- 
formation at hand. R. asserted that, with the exception 
of an inflammation of the lungs at the age of sixteen, she 
had never been severely ill. 

First menstruation at fifteen, without any difficulties; 
thereafter it was very often irregrtlar and abnormally ex- 
cessive. The patient declared that she never had had 
inclinations toward the opposite sex, and had never allowed 
the approach of a man. She never could understand how 
her friends could describe the beauty and amiability of 
men. But it was charming and inspiring for her to im- 
print a kiss on the lips of a beloved female friend. She 
had a love for girls that was incomprehensible to her. 
She had passionately loved and kissed some of her female 
friends, and she would have given up her life for them. 
Her greatest delight would have been to have constantly 
lived with such a friend and absolutely possessed her. 

In this she felt toward the beloved girl like a man. 
Even as a little child she had an inclination only for the 
play of boys, and she loved to hear shooting and military 
music, was always much excited by them, and would 
gladly have gone as a soldier. The chase and war have 
been her ideals. In the theatre only feminine performers 
interested her. She knew very well that the whole of this 
inclination was unwomanly, but she could not help it. It 
had always been a great pleasure for her to go about in 
male clothing, and in the same way she had always pre- 
ferred masculine work, and had shown unusual skill in it; 
while with reference to feminine occupations, especially 
handiwork, she had to say the contrary. The patient had 
also a weakness for smoking and spirits. On account of 
persecutory delusions, in order to rid herself of her per- 
secutions, the patient had often gone about in male attire 
and played the part of a man. She did this with such 
(natural) skill that, as a rule, she was able to deceive peo- 
ple concerning her sex. 



422 PSYCHOPATHIA SEXUALIS. 

It is authoritatively established that in 1884 for a 
long time the patient went about in male attire, now in 
the garments of a civilian, now in the uniform of a lieu- 
tenant ; and in August of the same year, dressed as a male 
servant, she fled to Switzerland through delusions of per- 
secution. There she found service in a merchant's family 
and fell in love with the daughter of the house, "the beau- 
tiful Anna," who, on her side, not recognising the sex of 
R., fell in love with the handsome young man. 

Concerning this episode the patient made the follow- 
ing characteristic statement: "I was madly in love with 
Anna. I don't know how it came about, and I cannot put 
myself right concerning this impulse. In this fatal love 
lies the reason why I played the role of a man so long. 
I have never yet felt any love for a man, and I believe 
that my love is for the female and not the male sex. I 
can in nowise understand my condition." 

From Switzerland R. wrote letters home to her friend 
Amelia, which were produced at the examination. They 
are letters showing passionate love, which goes beyond 
the bounds of friendship. She apostrophises her friend: 
"My flower, sun of my heart, longing of my soul". ' She 
was her greatest happiness on earth; her heart was hers. 
And in her letters to her friend's parents she wrote : "You, 
too, should watch my 'flower/ for if she should die I also 
would be unable to endure life". 

For the purpose of investigating her mental condition, 
R. remained for some time in an asylum. On one occa- 
sion, when Anna was allowed to pay R. a visit, there was 
no end of passionate embraces and kisses. The visitor 
acknowledged freely that they had before secretly em- 
braced and kissed in the same way. 

R. was a tall, slim, stately person, of feminine form in 
all respects, but masculine features. Cranium regular; 
no anatomical signs of degeneration. Genitals normal and 
indicative of virginity. R. made the impression of a mor- 
ally pure and modest person. All the circumstances in- 
dicated that she had only indulged in platonic love. Eye 



CONGENITAL SEXUAL INVERSION IN WOMAN. 423 

and appearance were indicative of a neurasthenic person. 
Severe hysteria, occasional cataleptoid attacks, with vision- 
ary and delirious states. The patient was very easily 
brought into a state of somnambulism by hypnotic influ- 
ence, and in this condition was susceptible to all possible 
suggestions. (Personal case. "Friedreich's Blatter," 
1881, Heft i.) 

Case 163. Viraginity. Miss O., twenty-three years 
of age. Mother constitutionally and heavily hysteropathic. 
Mother's father insane. Father's family untainted. 

Father died early of pneumonia. Patient was brought 
to me by her trustee because she ran away recently from 
home in male attire in order to rove through the world 
and become an "artiste". Very gifted in music. 

For several years she attracted much attention by her 
bold, mannish behaviour, and by wearing her hair and 
attire in male fashion. Since she was thirteen she was 
demonstrative in her love for girl friends, whom she often 
wearied with fervent embraces. 

She did not seek to conceal her passionate fondness 
for persons of her own sex. Claimed that since her thir- 
teenth year she was fully conscious of the fact that she 
could love only women. She felt as a man towards woman ; 
though she looked like a man, and would much rather wear 
men's clothes. 

A short time ago she seriously asked a relative who 
was in the police department to obtain permission for her 
to go about in male attire. 

Her erotic dreams dealt only with intimate intercourse 
with female friends. She never took the slightest interest 
in men, and never thought of marriage. 

She felt quite happy in her abnormal sexual condi- 
tion, and did not recognise it as pathological. She could 
not comprehend that her sexual instinct differed from that 
of other women. 

The circumference of the head was 51 cm. Frame 
quite feminine; but the feet were exceptionally large and 



424 PSYCIIOPATHIA SEXUALIS. 

more of masculine type. Carriage, attitude and gait quite 
masculine. Female voice. Monthly periods regular since 
her thirteenth year. 

Case 164. (Viraginity.) On the 5th of October, 
1898, the police brought to my clinic W., age thirty-six, 
a charwoman, for examination as to her sanity. She had 
engaged herself to a young girl under the pretext that she 
was a man and belonged to an aristocratic family. Exam- 
ination proved this to be a classical case of original para- 
noia. When she was five she imagined that the couple 
with whom she lived were only her foster parents, at 
eighteen that she came from a distinguished family, at 
twenty-nine that her father was a king, her mother a 
countess. Circumference of cranium 53 cm., parietal 
bones slightly bulging. Ears abnormally small, of uneven 
size, misformed, the right lobe joined groin-like to the 
cheek, the left properly developed. Palate very narrow 
and steep. Teeth carious, many missing (Rachitis). Stat- 
ure medium size, willowy. Chest strongly arched. Waist 
and region of hips smaller than in the normal. A promi- 
nent gynecologist examined the pelvic regions and found 
a small pelvis, narrow at the inferior outlet, in form almost 
typically masculine. Ilium less inclined than in the nor- 
mal. 

The hard lines and severe features of the face gave it 
a rather masculine appearance. Her hair was cut short. 
Gait and bearing masculine. Skin very rough, adipose 
layers sparse, mamma stunted. Genitals normal, hymen 
intact. She was loath to speak of her vita sexualis, but 
wanted an explanation why she had no desire for men and 
only for persons of her own sex. "Her genitals could not 
be right." Menses from the age of sixteen, but the flow 
of blood came but seldom, and even then very sparsely. 
With the advent of puberty inclinations to persons of her 
own sex. She never was sensual. Her sexual ideas were 
always about the female sex in general, never concentrated 
on an individual. In this wise she had lived with another 



CONGENITAL SEXUAL INVERSION IN WOMAN. 425 

girl of her own age; but their relations had been those of 
sisters; sexual acts had never taken place between them. 
She felt towards other women as a man does; she loathed 
the idea of sexual intercourse with a man. When a child 
she preferred playing with boys. "When playing at "rob- 
bers" she would be the captain and chose a girl for her 
wife, but without any sexual moment. At sixteen she 
thought she possessed the qualities of a man. She was 
then in a convent and there learned from a woman mas- 
turbation. The thought of this woman was always pres- 
ent when she masturbated, and acted as a sexual stimulus. 
Later on she thought of other females during the act, but 
without decided individuality. 

At thirty-three she became neurasthenic, gave up the 
practice successfully. She bewailed the fact that she was 
not born a man, as she hated feminine things and dress 
generally. "Would much, rather have been a soldier. 
Sweetmeats she disdained, preferring a cigar. She was a 
bright, intelligent person. Larynx and voice feminine. 
She became convinced that she could not marry a woman 
and upon promise to conquer her perverse sexual inclina- 
tions she was dismissed. 

Case 165. Miss X., aged thirty-eight, consulted me 
late in the fall of 1881, on account of severe spinal irri- 
tation and obstinate sleeplessness, in combating which she 
had become addicted to morphine and chloral. Her mother 
and sister were nervous sufferers, but the rest of the fam- 
ily were healthy. The trouble dated from a fall on her 
back in 1872, at which time the patient was terribly 
frightened, though, when a girl, she had been subject to 
muscular cramps and hysterical symptoms. Following 
this shock, a neurasthenic and hysterical neurosis devel- 
oped, with predominating spinal irritation and sleepless- 
ness. Episodically, hysterical paraplegia, lasting as long 
as eight months, and hysterical hallucinatory delirium, 
with convulsive attacks, occurred. In the course of this, 
symptoms of morphinism were added. A stay, of some 



426 PSYCHOPATHIA SEXUALlS. 

months in the hospital relieved the latter, and considerably 
improved the neurasthenic neurosis, in the treatment of 
which general faradisation exerted a remarkably favour- 
able influence. 

Even at the first meeting, the patient produced a re- 
markable impression by reason of her attire, features and 
conduct. She wore a gentleman's hat, her hair closely cut, 
eye-glasses, a gentleman's cravat, a coat-like outer gar- 
ment of masculine cut that reached well down over her 
gown, and boots with high heels. She had coarse, some- 
what masculine features; a harsh, deep voice; and made 
rather the impression of a man in female attire than that 
of a lady, if one but overlooked the bosom and the decid- 
edly feminine form of the pelvis. During the long time 
that she was observed, there were never signs of erotism. 
When questioned concerning her attire, she would only 
respond that the style she chose suited her better. Gradu- 
ally it was ascertained from her that, even when she was 
a small girl, she had had a preference for horses and 
masculine pursuits, and never any interest in feminine 
occupations. Later she developed a particular pleasure in 
reading, and prepared herself to be a teacher. Dancing 
had never pleased her; it had always seemed silly to her. 
The ballet had never interested her. Her greatest pleasure 
had always been in the circus. Until her sickness, in 
1872, she had neither had inclination for persons of the 
opposite nor of those of her own sex. From that time 
she had, what was remarkable to herself, a peculiar 
friendship for females, particularly for young ladies; 
and she had a desire, and satisfied it, to wear hats and 
coats of masculine style. Since 1869, she had worn her 
hair short, and parted it on the side, as men do. She as- 
serted that she was never sexually excited in the company 
of men, but that her friendship and self-sacrifice for sym- 
pathetic ladies was unbounded; while from that time she 
also experienced repugnance for gentlemen and their so- 
ciety. 

Her relatives reported that, before 1872, the patient 



CONGENITAL SEXUAL INVERSION IN WOMAN. 427 

had a proposal of marriage, which she refused ; and that 
when she returned from a sojourn at a watering place, in 
1874, she was sexually changed, and occasionally showed 
that she did not regard herself as a female. 

Since that time she would associate only with ladies, 
had a kind of love-relation with one or another, and made 
remarks which indicated that she looked upon herself as 
a man. This predilection for women was decidedly more 
than mere friendship, since it expressed itself in tears, 
jealousy, etc. 

When, in 1874, she was stopping at a watering place, 
a young lady, who took her for a man in disguise, fell in 
love with her. When this lady married, later, the patient 
was for a long time depressed, and spoke of unfaithful- 
ness. Moreover, since her illness, her relatives were struck 
by her desire for masculine attire, her masculine conduct, 
and disinclination for feminine pursuits ; while, previously, 
at least sexually, she had presented nothing unusual. 

Further investigation showed that the patient had a 
love-relation, which was not purely platonic, with the lady 
described in case 159; and that she wrote her affectionate 
letters like those of a lover to his beloved. In 1887 I again 
saw the patient in a sanatorium, where she had been placed 
on account of hystero-epileptic attacks, spinal irritation, 
and morphinism. The inverted sexual feeling existed un- 
changed, and only by the most careful watching was the 
patient kept from improper advances toward her fellow- 
patients. 

Her condition remained quite unchanged until 1889. 
Then the patient began to fail, and she died of "exhaus- 
tion," in August, 1889. The autopsy showed, in the vege- 
tative organs, amyloid degeneration of the kidneys, fibroma 
of the uterus, and cyst of the left ovary. The frontal bone 
was much thickened, uneven on the inner surface, with 
numerous exostoses; dura adherent to vault of cranium. 
Long diameter of skull, 175 millimetres; lateral diameter, 
148 millimetres; weight of the oedematous, but no atro- 
phied brain, 1175 grammes. The meuinges delicate, easily 



428 PSYCHOPATHIA SEXUALIS. 

removed. Cortex pale. Convolutions broad, not numer- 
ous, regularly arranged. Nothing abnormal in cerebellum 
and great ganglia. 

Case 166. Gynandry. 1 History: On 4th November, 
1889, the father-in-law of a certain Countess V., com- 
plained that the latter had swindled him out of 800f., 
under the pretence of requiring a bond as secretary of 
a stock company. It was ascertained that Sandor had 
entered into matrimonial contracts and escaped from the 
nuptials in the spring of 1889; and, more than this, that 
this ostensible Count Sandor was no man at all, but a 
woman in male attire Sarolta (Charlotte), Countess V. 

S. was arrested, and, on account of deception and 
forgery of public documents, brought to examination. At 
the first hearing S. confessed that she was born on the 
6th Sept., 1866; that she was a female, Catholic, single, 
and worked as an authoress under the name of Count 
Sandor V. 

From the autobiography of this man-woman I have 
gleaned the following remarkable facts that have been 
independently confirmed : 

S. came of an ancient, noble and highly respected 
family of Hungary, in which there had been eccentricity 
and family peculiarities. A sister of the maternal grand- 
mother was hysterical, a somnambulist, and lay seventeen 
years in bed, on account of fancied paralysis. A second 
great-aunt spent seven years in bed, on account of a fancied 
fatal illness, and at the same time gave balls. A third had 
the whim that a certain table in her salon was bewitched. 
When anything was laid on this table, she would become 
greatly excited and cry, "Bewitched! bewitched!" and 
run with the object into a room which she called the "Black 
Chamber," and the key of which she never let out of her 
hands. After the death of this lady, there were found in 
this chamber a number of shawls, ornaments, bank-notes, 

1 Cf. the expert medical opinion of this case, by Dr, 
in " Friedreich't Blatter f. ger. Med.," 1891, Heft 1. 



CONGENITAL SEXUAL INVERSION IN WOMAN. 429 

A fourth great-aunt during two years did not leave 
In r room, and neither washed herself nor combed her hair; 
ilicn she again made her appearance. AH these ladies 
were, nevertheless, intellectual, finely educated and 
amiable. 

>.'s mother was nervous, and could not bear the light 
of the moon. 

She inherited many of the peculiarities of her father's 
family. One line of the family gave itself up almost 
entirely to spiritualism. Two blood relations on the 
father's side shot themselves. The majority of her male 
relatives were unusually talented; the females were de- 
cidedly narrow-minded and domesticated. S.'s father had 
a high position, which, however, on account of his eccen- 
tricity and extravagance (he wasted over a million and a 
half), he lost. 

Among many foolish things that her father encouraged 
in her was the fact that he brought her up as a boy, 
called her Sandor, allowed her to ride, drive and hunt, 
admiring her muscular energy. 

On the other hand, this foolish father allowed his 
second son to go about in female attire, and had him 
brought up as a girl. This farce ceased when the son 
was sent to a higher school at the age of fifteen. 

Sarolta-Sandor remained under her father's influence 
till her twelfth year, and then came under the care of her 
eccentric maternal grandmother in Dresden, by whom, 
when the masculine play became too obvious, she was 
placed in an institute and made to wear female attire. 

At thirteen she had a love-relation with an English 
girl, to whom she represented herself as a boy, and ran 
away with her. 

Surolta returned to her mother, who, however, could 
do nothing, and was- compelled to allow her daughter to 
again become Sandor, wear male clothes, and, at least 
once a year, to fall in love with persons of her own sex. 

At the same time S. received a careful education and 
made long journeys with her father, of course always as a 



430 PSYCUOrATHIA SEXUALI8. 

young gentleman. She early became independent and 
visited cafes, even those of doubtful character, and, indeed, 
boasted one day that in a brothel she had had a girl sitting 
on each knee. S. was often intoxicated, had a passion for 
masculine sports and was a very skilful fencer. 

She felt herself drawn particularly toward actresses, 
or others of similar position, and, if possible, toward those 
who were not very young. She asserted that she never 
had any inclination for a young man, and that she had 
felt, from year to year, an increasing dislike for young 
men. 

"I preferred to go into the society of ladies with ugly, 
ill-favoured men, so that none of them could put me ill 
the shade. If I noticed that any of the men awakened 
the sympathies of the ladies, I felt jealous. I preferred 
ladies who were bright and pretty; I could not endure 
them if they were fat or much inclined toward men. It 
delighted me if the passion of a lady was disclosed under 
a poetic veil. All immodesty in a woman was disgusting 
to me. I had an indescribable aversion for female attire, 
indeed, for everything feminine, but only in as far as it 
concerned me; for, on the other hand, I was all enthu- 
siasm for the beautiful sex." 

During the last ten years S. had lived almost con- 
stantly away from her relatives, in the guise of a man. 
She had had many liaisons with ladies, travelled much, 
spent much, and made debts. 

At the same time she carried on literary work, and was 
a valued collaborator on two noted journals of the capital. 

Her passion for ladies was very changeable; con- 
stancy in love was entirely wanting. 

Only once did such a liaison last three years. It was 
years before that S., at Castle G., made the acquaintance 
of Emma E., who was ten years older that herself. She 
fell in love with her, made a marriage contract with her, 
and they lived together as man and wife for three years 
at the capital. 

A new love, which proved fatal to S., caused her to 



CONGENITAL SEXUAL INVERSION IN WOMAN. 431 

sever her matrimonial relations with E. The latter would 
not have it so. Only with the greatest sacrifice was S. 
able to purchase her freedom from E., who still looked 
upon herself as a divorced wife, and regarded herself as 
the Countess V.! That S. also had the power to excite 
passion in other women was shown by the fact that when 
she (before her marriage with E.) had grown tired of a 
Miss D., after having spent thousands of guldens on her, 
she was threatened with shooting by D. if she should be- 
come untrue. 

It was in the summer of 1887, while at a watering- 
place, that S. made the acquaintance of a distinguished 
official's family. Immediately she fell in love with the 
daughter, Marie, and her love was returned. 

Her mother and cousin tried in vain to break up 
this affair. During the winter the lovers corresponded 
zealously. In April, 1888, Count S. paid her a visit, and 
in May, 1889, attained her wish; in that Marie who, 
in the meantime, had given up a position as teacher 
became her bride in the presence of a friend of her lover, 
the ceremony being performed in an arbour, by a pseudo- 
priest, in Hungary. S., with her friend, forged the mar- 
riage certificate. The pair lived happily, and, without 
the interference of the father-in-law, this false marriage, 
probably, would have lasted much longer. It is remark- 
able that, during the comparatively long existence of the 
relation, S. was able to deceive completely the family of 
her bride with regard to her true sex. 

S. was a passionate smoker, and in all respects her 
tastes and passions were masculine. Her letters and 
even legal documents reached her under the address of 
"Count S." She often spoke of having to drill. From 
remarks of the father-in-law it seems that S. (and she 
afterward confessed it) knew how to imitate a scrotum 
with handkerchiefs or gloves stuffed in the trousers. The 
father-in-law also, on one occasion, noticed something 
like an erected member on his future son-in-law (probably 
a priapus). She also occasionally remarked that she was 



432 PSYCHOPATHIA SEXUALIS. 

obliged to wear a suspensory bandage while riding. The 
fact is, S. wore a bandage around- the body possibly as a 
means of retaining a priapus. 

Though S. often had herself shaved pro forma, the 
servants in the hotel where she lived were convinced that 
she was a woman, because the chambermaids found traces 
of menstrual blood on her linen (which S. explained, how- 
ever, as haemorrhoidal) ; and, on the occasion of a bath 
which S. was accustomed to take, they claimed to have 
convinced themselves of her real sex by looking through 
the key-hole. 

The family of Marie make it seem probable that she 
for a long time was deceived with regard to the true 
sex of her false bridegroom. The following passage in 
a letter from Marie to S., 26th August, 1889, speaks in 
favour of the incredible simplicity and innocence of this 
unfortunate girl : "I don't like children any more, but ' 
if I had a little Bezerl or Patscherl by my Sandi ah, 
what happiness, Sandi mine!" 

A large number of manuscripts allow conclusions to 
be drawn concerning S.'s mental individuality. The 
chirography possesses the character of firmness and 
certainty. The characters are genuinely masculine. The 
same peculiarities repeat themselves everywhere in their 
contents wild, unbridled passion; hatred and resistance 
to all that opposes the heart thirsting for love; poetical 
love, which is not marred by one ignoble blot, enthusiasm 
for the beautiful and noble; appreciation of science and 
the arts. 

Her writings betray a wonderfully wide range of 
reading in classics of all languages, in citations from 
poets and prose writers of all lands. The evidence of 
those qualified to judge literary work shows that S.'s 
poetical and literary ability was by no means small. The 
letters and writings concerning the. relation with Marie 
are psychologically worthy of notice. 

S. speaks of the happiness there was for her when 
by M.'s side, and expresses boundless longing to see her 



CONGENITAL SEXUAL INVERSION IN WOMAN. 433 

beloved, if only for a moment. After such a happiness 
she could have but one wish to exchange her cell for 
the grave. The bitterest thing was the knowledge that 
now Marie, too, hated her. Hot tears, enough to drown 
herself in, she had shed over her lost happiness. Whole 
quires of paper are given up to the apotheosis of this 
love, and reminiscences of the time of the first love and 
acquaintance. 

S. complained of her heart, that would allow no reason 
to direct it; she expressed emotions which were such 
as only could be felt not simulated. Then, again, there 
were outbreaks of most silly passion, with the declara- 
tion that she could not live without Marie. "Thy dear, 
sweet voice; the voice whose tone perchance would raise 
me from the dead; that has been for me like the warm 
breath of Paradise! Thy presence alone were enough 
to alleviate my mental and moral anguish. It was a 
magnetic stream; it was a peculiar power your being 
exercised over mine, which I cannot quite define; and, 
therefore, I cling to that ever-true definition: I love you 
because I love you. In the night of sorrow I had but 
one star the star of Marie's love. That star has lost 
its light; now there remains but its shimmer the sweet, 
sad memory which even lights with its soft ray the 
deepening night of death a ray of hope." 

This writing ends with the apostrophe: "Gentlemen, 
you learned in the law, psychologists and pathologists, 
do me justice! Love led me to take the step I took; all 
my deeds were conditioned by it God put it in my 
heart 

"If he created me so, and not otherwise, am I then 
guilty; or is it the eternal, incomprehensible way of 
fate? I relied on God, that one day my emancipation 
would come; for my thought was only love itself, which 
is the foundation, the guiding principle, of His teaching 
and His kingdom. 

"O God, Thou All-pitying, Almighty One! Thou 
seest my distress; Thou knowest how I suffer, Incline 

28 



434 PSYCHOPATHIA SEXUALIS. 

Thyself to me; extend Thy helping hand to me, deserted 
by all the world. Only God is just. How beautifully 
does Victor Hugo describe this in his 'Legendes du 
Siecle* ! How sad do Mendelssohn's words sound to 
me : 'Nightly in dreams I see thee' !" 

Though S. knew that none of her writings reached 
her lover, she did not grow tired writing of her pain 
and delight in love, in page after page of deification of 
Marie. And to induce one more pure flood of tears, on 
one still, clear summer evening, when the lake was aglow 
with the setting sun like molten gold, and the bells of 
St. Anna and Maria-Worth, blending in harmonious mel- 
ancholy, gave tidings of rest and peace, she wrote: "For 
that poor soul, for this poor heart that beats for thee till 
the last breath". 

Personal examination: The first meeting which the 
experts had with S. was in a measure, a time of embarrass- 
ment to both sides; for them, because perhaps S.'s some- 
what dazzling and forced masculine carriage impressed 
them; for her, because she thought she was to be marked 
with the stigma of moral insanity. She had a pleasant 
and intelligent face, which, in spite of a certain delicacy 
of features and diminutiveness of all its parts, gave a 
decidedly masculine impression, had it not been for the 
absence of a moustache. It was even difficult for tho 
experts to realise that they were concerned with a woman, 
despite the fact of female attire and constant association; 
while, on the other hand, intercourse with the man Sandor 
was much more free, natural, and apparently correct. 
The accused also felt this. She immediately became more 
open, more communicative, more free, as soon as she was 
treated like a man. 

In spite of her inclination for the female sex, which 
had been present from her earliest years, she asserted that 
in her thirteenth year she first felt a trace of sexual feeling, 
which expressed itself in kisses, embraces, and caresses, 
with sexual pleasure, and this on the occasion of her 
elopement with the red-haired English girl from the Dres- 



CONGENITAL SEXUAL INVERSION IN WOMAN. 435 

den institute. At that time feminine forms exclusively 
appeared to her in dream-pictures, and ever since, in 
sensual dreams, she felt herself in the situation of a man, 
and occasionally, also, at such times, experienced ejacu- 
lation. 

She knew nothing of solitary or mutual onanism. 
Such a thing seemed very disgusting to her, and not 
conducive to manliness. She had, also, never allowed 
herself to be touched ad genitalia by others, because it 
would have revealed her great secret. The menses began 
at seventeen, but were always scanty and without pain. 
It was plain to be seen that S. had a horror of speaking 
of menstruation; that it was a thing repugnant to her 
masculine consciousness and feeling. She recognised the 
abnormality of her sexual inclinations, but had no desire 
to have them changed, since in this perverse feeling she 
felt both well and happy. The idea of sexual intercourse 
with men disgusted her, and she also thought it would be 
impossible. 

Her modesty was so great that she would prefer to 
sleep among men rather than among women. Thus, 
when it was necessary for her to answer the calls of 
nature or to change her linen, it was necessary for her to 
ask her companion in the cell to turn her face to the 
window, that she might not see her. 

When occasionally S. came in contact with this com- 
panion, a woman from the lower walks of life, she 
experienced a sexual excitement that made her blush. 
Indeed, without being asked, S. related that she was 
overcome with actual fear when, in her cell, she was 
compelled to force herself into the unusual female attire, 
HT only comfort was that she was at least allowed to 
keep a shirt. Remarkable, and what also speaks for the 
significance of olfactory sensations in her vita sexualis, is 
hf-r statement that, on the occasions of Marie's absence, 
she had sought those places on which Marie's head waa 
accustomed to repose, and smelled them, in order to ex- 
perience the delight of inhaling the odour of her hair. 



436 PSYCHOPATHIA SEXUALIS. 

Among women, those who were beautiful, or voluptuous, 
or quite young, did not particularly interest her. The 
physical charms of women she made subordinate. As 
by magnetic attraction, sli3 felt herself drawn to those 
between twenty-four and thirty. She found her sexual 
satisfaction exclusively in corpore femincs (never in her 
own person), in the form of manustupration of the beloved 
woman, or cunnilingus. Occasionally she availed herself 
of a stocking stuffed with oakum as a priapus. These 
admissions were made only unwillingly by S., and with 
apparent shame; just as in her writings immodesty or 
cynicism are never found. 

She was religious, had a lively interest in all that is 
noble and beautiful, men excepted, and was very sensi- 
tive to the opinion others entertained of her morality. 

She deeply regretted that in her passion she made Ma- 
rie unhappy, and regarded her sexual feelings as perverse, 
and such a love of one woman for another, among normal 
individuals, as morally reprehensible. She had great 
literary talent and an extraordinary memory. Her only 
weakness was her great frivolity and her incapability to 
manage money and property reasonably. But she was 
conscious of this weakness, and did not care to talk 
about it. 

She was 153 centimetres tall, of delicate build, thin, 
but remarkably muscular on the breast and thighs. Her 
gait in female attire was awkward. Her movements were 
powerful, not unpleasing, though they were somewhat 
masculine and lacking in grace. She greeted one with 
a firm pressure of the hand. Her whole carriage was 
decided, firm and somewhat self-conscious. Her glance 
was intelligent ; mien somewhat diffident. Feet and hands 
remarkably small, having remained in an infantile stage 
of development. Extensor surfaces of the extremities 
remarkably well covered with hair, while there was not the 
slightest trace of beard, in spite of all shaving experi- 
ments. The hips did not correspond in any way with 
those of a female. Waist wanting. Pelvis so slim and 



CONGENITAL SEXUAL INVERSION IN WOMAN. 437 

so little prominent, that a line drawn from the axilla to 
the- corresponding knee was straight not curved inward 
by a waist or outward by the pelvis. The skull slightly 
oxycephalic, and in all its measurements below the aver- 
age of the female skull by at least one centimetre. 

Cireu inference of the head 52 centimetres; occipital 
half circumference, 24 centimetres; line from ear to ear, 
over the vertex, 23 centimetres; anterior half-circumfer- 
ance, 28.5 centimetres; line from glabella to occiput, 30 
centimetres; ear-chin line, 26.5 centimetres; long diam- 
eter, 17 centimetres; greatest lateral diameter, 13 centi- 
metres; diameter at auditory incut i, 12 centimetres; zygo- 
matic diameter, 11.2 centimetres. Upper jaw strikingly 
projecting, its alveolar process projecting beyond the under 
jaw about 0.5 centimetre. Position of the teeth not fully 
normal ; right upper canine not developed. Mouth remark- 
ably small; ears prominent; lobes not differentiated, pass- 
ing over into the skin of the cheek. Hard palate, narrow 
and high ; voice rough and deep ; mammre fairly developed, 
soft and without secretion. Mons veneris covered with 
thick, dark hair. Genitals completely feminine, without 
trace of hermaphroditic appearance, but at the stage of 
development of those of a ten-year-old girl. The labia 
majora touching each other almost completely ; labia 
minora having a cock's-comb-like form, and projecting 
under the labia majora. Clitoris small and very sensitive. 
Frenulum delicate; perineum very narrow; introitus 
vaginae narrow ; mucous membrane normal. Hymen want- 
ing (probably congenitally) ; likewise the carunculsc myrti- 
formes. Vagina so narrow that the insertion of a mem- 
brum virile would be impossible, also very sensitive; cer- 
tainly coitus had not taken place. Uterus felt, through the 
rectum, to be about the size of a walnut, immovable and 
retroflected. 

Pelvis generally narrowed (dwarf -pelvis), and of de- 
cidedly masculine type. Distance between anterior su- 
perior spines 22.5 centimetres (instead of 26.3 centi- 
metres). Distance between the create of the ilii, 26.5 



438 PSYCHOPATHIA SEXTJALIS. 

centimetres (instead of 29.3 centimetres) ; between the tro- 
chanters, 27.7 centimetres (31) ; the external conjugate 
diameter, 17.2 centimetres (19 to 20); therefore, the in- 
ternal conjugate, presumably, 7.7 centimetres (10.8). On 
account of narrowness of the pelvis, the direction of the 
thighs not convergent, as in a woman, but straight. 

The opinion given showed that in S. there was a 
congenitally abnormal inversion of the sexual instinct, 
which, indeed, expressed itself, anthropologically, in ano- 
malies of development of the body, depending upon great 
hereditary taint; further, that the criminal acts of S. 
had their foundation in her abnormal and irresistible 
sexuality. 

S.'s characteristic expressions "God put love in my 
heart. If He created me so, and not otherwise, am I, 
then, guilty; or is it the eternal, incomprehensible way 
of fate?" are really justified. 

The court granted pardon. The "countess in male 
attire," as she was called in the newspapers, returned 
to her home, and again gave herself out as Count Sandor. 
Her only distress was her lost happiness with her beloved 
Marie. 

A married woman, in Brandon, Wisconsin, whose 
case is reported by Dr. Kiernan ("The Medical Standard," 
1888, November and December), was more" fortunate. 
She eloped, in 1883, with a young girl, married her, and 
lived with her as husband undisturbed. 

An interesting "historical" example of androgyny is 
a case reported by Spitzka ("Chicago Medical Review," 
20th August, 1881). It was that of Lord Cornbury, 
Governor of New York, who lived in the reign of Queen 
Anne. He was apparently affected with moral insanity; 
was terribly licentious, and, in spite of his high position, 
could not keep himself from going about in the streets 
in female attire, coquetting with all the allurements of a 
prostitute. 

In a picture of him that has been preserved, his narrow 
brow, asymmetrical face, feminine features, and sensual 



CON KtJAL INVEB8ION IN WOMAN. 439 

mouth at onco attract attention. It is certain that he 
r actually regarded himself as a woman. 

Complications of Antipathic Sexual Instinct. 

Moreover, in individuals afflicted with sexual inver- 
sion, in themselves, the perverse sexual feeling and inclina- 
tion may be complicated with other perverse manifesta- 
tions. Thus here, with reference to the activity of the in- 
stinct, there may be acts quite analogous to acts indulged in 
by individuals in perverse satisfaction of the instinct, but 
who, at the same time, have a natural inclination toward 
persons of the opposite sex. 

Owing to the circumstance that abnormally increased 
sexuality is almost a regular accompaniment of anti- 
pathic sexual feeling, acts of lustful sadistic cruelty in 
the satisfaction of libido are easily possible. A remarkable 
example of this is the case of Zastrow (Casper-Liman, 7. 
Auflage, Bd. i., p. 160; ii., p. 487), who bit one of his 
victims (a boy), tore his prepuce, slit the anus, and 
strangled the child. 

Z. came of a psychopathic grandfather and melan- 
cholic mother. His brother indulged in abnormal sexual 
pleasures, and committed suicide. 

Z. was a congenital urning, and in habitus and occupa- 
tion masculine. There was phimosis. Mentally, he was 
a weak, perverse, socially useless man. He had horror 
femince, and, in his dreams, he felt himself like a woman 
toward a man. He was painfully conscious of his want 
of normal sexual feeling and of his perverse instinct, and 
sought satisfaction in mutual onanism, with frequent 
desire for pederasty. 

Similar sadistic feelings of this kind, in those afflicted 

with antipathic sexual instinct, are found in some of the 

roing histories (rf. oases 128 and 129 of this edition, 

and case 96 of the sixth edition; also Moll, "Contr. Sex- 

ualempfindung," second edition, p. 189; v. Krafft, "Jahrb. 



440 PSYCIIOPATIIIA SEXUALIS. 

f. Psychiatric," xii., pp. 357 and 389; Moll, "Unter- 
siichungen iiber Libido sexualis," clases 26 and 27). 

As examples of perverse sexual satisfaction dependent 
on antipathic sexual instinct, may be mentioned the Greek, 
who, as Athendus reports, was in love with a statue of 
Cupid, and defiled it, in the temple of Delphi ; and besides 
the monstrous cases reported by Tardieu ( " Attentats," p. 
272), the terrible one reported by Lombroso ("L'uomo 
delinquente," p. 200), of a certain Artusio, who wounded 
a boy in the abdomen, and abused him sexually by means 
of the incision. 

Cases 92, 110 and 115 (eighth edition) show that 
fetichism may also occur with antipathic sexual instinct ; 
moreover a case of shoe-fetichism related by me in "Jahr- 
biicher f. Psychiatric," xii., 1 ; Moll, op. cit., second edi- 
tion, p. 179 ; Gamier, "Les Fetichistes," p. 98. 

The following case, taken from Gamier, is a classical 
example of boot-fetichism. At times masochism forms a 
complication of sexual inversion Cf. Moll, second edition, 
p. 172 (case 12) and p. 190; Hem, "Internat. Centralbl. 
f. d. Physiol. and Pathol. der Harn- und Sexualorgane," 
iv., Heft 5 (homosexuality in a woman with passive flagel- 
lantism and koprophagia) ; v. Krafft, case 43 in sixth 
edition of this book, also case 137 of this edition and 
114 of eighth edition; ditto "Jahrbiicher fur Psychiatric," 
xii., p. 339 (homosexuality, abortive masochism), p. 351 
(psych, hermaphrod. masochism). 

Case 167. Homosexuality. X., twenty-six years of 
age, of the upper class, was arrested for having prac- 
tised masturbation in a public park. By heredity heavily 
tainted ; skull abnormal ; was peculiar from earliest youth ; 
psychically abnormal ; at the age of ten he began to show 
a peculiar interest in patent leather shoes; began to mas- 
turbate at thirteen, but in order to procure ejaculation 
he had to fasten his eyes upon patent leather shoes. He 
never felt any inclination towards woman, and when, at 
the age of twenty-one, he once attempted coitus at a 



CONGENITAL HDP \l. I N v I.KM >.\ IN WOMAN. -Ill 



brothd driivid no satisfaction from the act. With the 
twenty-fourth year his luiiuH-xual instinct began to 
assert itself more and more. But he felt himself drawn 
only to young men who wore elegant clothes and patent 
leather boots. Thinking of such nun, he masturbated. 
II is ideal was to live with such a man and practice mutual 
masturbation. Unable to realise his wishes, he would 
introduce a ball into his anus, and moving it in and out 
fancy himself to have coitus with his ideal young man 
wearing patent leather boots. Simultaneously he would 
masturbate. During this imitation of passive pederasty 
he would wear drawers made of red silk. For some time 
he was wont to stick notices on public buildings to this 
effect: "My nates are at the disposal of handsome gentle- 
men who wear patent leather boots". Whilst writing 
such notices and looking at his own patent leather shoes, 
he would have an erection. Since his sixteenth year, 
when young men began to interest him, he had eyes only 
for their patent leather boots. He loved to loiter about 
the show-windows of boot shops and the drilling-grounds 
of the military school, where he had opportunity for ad- 
miring the officers in their patent leather boots. One 
day he bought a pair for himself and became quite in- 
toxicated by gazing at them. The very smell of them 
was sufficient to excite him very much sexually. He 
finally put them on, that in them he might make con- 
quests; but he was not successful. Now he used them 
for another purpose. He would masturbando ejaculate 
into them. The most intense lustful pleasure he derived 
when he put, during this act, one of the shoes to his anus 
or inter femora, rubbing it about there. When one day 
X. found a defect on the uppers of one of these shoes, 
which he always saved most carefully, he was very de- 
jected. He looked upon himself as a person who has 
just discovered the first wrinkle in the face of his beloved. 
One day when in the park he thought that a young man 
made advances to him according to his own desire; he 
was highly elated, and could not resist to expose hi per- 



442 PSYCHOPATH I A SKXUALIS. 

son. He was arrested, but not sentenced. He was sent to 
an insane asylum (Gamier, "Les Fetichistes," p. 114). 

In general, the acquired cases are characterised in 
that : 

1. The homo-sexual instinct appears as a secondary 
factor, and always may be referred to influences (mas- 
turbatic neurasthenia, mental) which disturbed normal 
sexual satisfaction. It is, however, probable that here, in 
spite of powerful sensual libido, the feeling and inclination 
for the opposite sex are weak ab origine, especially in a 
spiritual and aesthetic sense. 

2. The homosexual instinct, so long as inversio sexualis 
has not yet taken place, is looked upon, by the individual 
affected, as vicious and abnormal, and yielded to only 
faute de mieux. 

3. The heterosexual instinct long remains predominant, 
and the impossibility to satisfy it gives pain. It weakens 
in proportion as the homosexual feeling gains in strength. 

On the other hand, in congenital cases : 

(a) The homosexual instinct is the one that occurs 
primarily, and becomes dominant in the vita sexualis. It 
appears as the natural manner of satisfaction, and also 
dominates the dream-life of the individual. 

(&) The heterosexual instinct fails completely, or, if 
it should make its appearance in the history of the indi- 
vidual (psycho-sexual hermaphroditism), it is still but an 
episodical phenomenon which has no root in the mental 
constitution, and is essentially, but a means to satisfaction 
of sexual desire. 

The differentiation of the above groups of congenital 
inverted sexuality from one another, and from the cases 
in which the anomaly is acquired, will, after the foregoing, 
present no difficulties. 

The jjrognQjSJs of the cases of acquired antipathic sexual 

| instinct is, at all events, much more favourable than that 

of the congenital cases. In the former, the occurrence 

of effemination the mental inversion of the individual, in 



ANTIPATHIC SEXUAL IWBTIWOT. 443 

the sense of perverse sexual feeling is the limit beyond 
which there is no longer hope of benefit from therapy. In 
the congenital cases, the various categories established in 
this book form as many stages of psycho-sexual taint, and 
benefit is probable only within the category of the psychical 
hermaphrodites, thought possible (vide the case of Schrenk- 
Notzing) in that of the timings. 

The prophylaxis of these conditions becomes thus the 
more important for the congenital cases, prohibition of 
the reproduction of such unfortunates; for the acquired 
cases, protection from the injurious influences which expe- 
rience teaches may lead to the fatal inversion of the sexual 
instinct. 

Numerous predisposed individuals meet this sad fate, 
because parents and teachers have no suspicion of the 
danger which masturbation brings in its train to children. 

In many schools and academies masturbation and vice 
are actually cultivated. At present much too little atten- 
tion is given to the mental and moral peculiarities of the 
pupils. 

If only the tasks are done, nothing more is asked. 
That many pupils are thus ruined in body and soul is never 
considered. 

In obedience to affected prudery, the vita sexualis is 
made a mystery to the developing youth, and not the slight- 
est attention given to the excitations of his sexual instinct. 
How few family physicians are ever called in, during the 
years of development of children, to give advice to their 
patients that are often so greatly predisposed! 

It is thought that all must be left to Nature; in the 
meantime, Nature rises in her power, and leads the help- 
less, unprotected innocent into dangerous by-paths. 

Diagnosis, Prognosis and Therapie of Antipathic kxual 

Instinct 

The diagnosis of antipathic sexual instinct is of great 
clinical and. particularly, forensic, import. At the first 



444 PSTCHOPATHIA 8EXTTALIS. 

glance, it opens some difficulties, since the symptoms are 
rather of a subjective nature and the perverse acts offer 
so many aspects which may mean perversion as well as 
perversity. Much depends on the veracity of the patient, 
and that leaves in many cases much to be desired. Auto- 
biographies are to be taken cum grano sails, and should 
be discounted. Nevertheless the expert will soon be able 
to weed out exaggeration and untruth. Antipathic sexual 
instinct is such a complicated psychical anomaly that only 
the experienced specialist can quickly distinguish between 
truth and fiction. 

True knowledge is easiest ascertained from those who 
despair of their existence, meditate suicide (which fre- 
quently is found in those who have cultured minds and 
realise the anomaly of their position), but as a last resort 
come to the medical man for advice; also from those who 
are confronted with legal proceedings, or who through cir- 
cumstances are forced into marriage and doubt their 
virility. These patients have an urgent need for help, and 
will tell the truth. In strong contrast to these really un- 
fortunate beings stand those, generally of but little ethical 
and intellectual value, who seek to enrich medical 
knowledge by fatuous gossip about their disease. Every 
case of genuine homosexuality has its etiology, its concom- 
itant physical and psychical symptoms, its reactions upon 
the whole psychical being, and must be reduced to an ab- 
normal sexual instinct which is diametrically opposed to 
the physical sex of the affected individual, as it can be 
explained upon that basis only. The diagnosis is to be 
found in the anamnesis, the aetiology, the vita anteacta, 
the psycho-sexual development of the case. To form a 
clear opinion it behooves to judge the case from the stand- 
point of the anthropological clinical history of its devel- 
opment, and to collect synthetically all the various details. 

The opinion will then be as definitely established as in 
any other clinical case. 

The first important point based upon ripe experience 
is the fact that antipathic sexual instinct as an anomaly 



ANTIPATHIC SEXUAL INSTINCT. 445 

of sexual life is only found in individuals who are tainted, 
as a rule, hereditarily. In foro particular stress should be 
laid upon this point. In all cases in which anamnesis has 
been proved, this taint will be readily found. Per &e, thi* 
proof is of no value, for perversity also grows in this soil. 
But it assumes importance when the same frailty is found 
to exist in several members of the same family or appears 
in the form of other perversions of the sexual life either 
in the individual himself under consideration, or in other 
members of his family. Often enough the patient pre- 
sents other psychical or neurotic anomalies, even psychical 
diseases, defects or such like. They are so frequent and 
numerous that one is often led to doubt whether the man- 
ifestation under observation belongs in the sphere of neu- 
ropathia or that of psychopathia. 

These neurotic and psychopathic manifestations de- 
mand a most careful scrutiny as to their meaning. Not 
uncommonly they are signs of taint or degeneration of 
equivalent value with antipathic sexual instinct, or they 
may be reactions emanating from external defects to which 
tainted individuals are more subject than normal man is, 
often indirectly depending on antipathic sexual instinct 
on the ground of psychical conflicts in which these unfor- 
tunates are frequently implicated by virtue of their sexual 
perversions ; or they may be found to spring from the im- 
perfect or perverse gratification of their sexual needs 
(onanism). 

Certain it is that these persons are, as a rule, also 
abnormal so far as character is concerned. They are neither 
man nor woman, a mixture of both, with secondary psy- 
chical and physical characteristics of the one as well as the 
other sex, which grow out of the interfering influences of 
a bisexual predisposition and disturb the development of a 
well defined and complete being. But this peculiarity is 
only found in fully developed cases. A psychical disease 
per se is not a necessary adjunct to antipathic sexual in- 
stinct. All nations and all eras have produced perverse 



446 PSYCHOPATHIA SKXUALIS. 

men, whose renown and greatness adorn the history of 
their mother country or that of the world. 

This abnormality must not be looked upon as a patho- 
logical condition or as a crime, but the development of the 
vita sexualis with its reacting effects upon the mind and 
the moral sense; it may proceed with the same harmony 
and satisfying influence as in the normally disposed, a fur- 
ther argument in favour of the assumption that antipathic 
sexual instinct is an equivalent for heterosexuality. If 
ethical and intellectual defects are present, they may be 
looked upon merely as complicated anomalies resulting 
from the taint. 

An important factor is precocity in sexual life, which 
together with its antithesis, i.e., retarded puberty, is the 
distinguishing mark of a degenerated constitution. It is 
quite another thing when the vita sexualis takes an inverted 
course at an early period, particularly at a time when evil 
influences or bad examples cannot be at work. For in- 
stance, when little boys prefer male adults to their female 
relations, or show a predilection for girls' games and oc- 
cupations or particular skill in sewing, knitting, embroid- 
ering, etc., or inclination for female toilet, find pleasure in 
wearing girls' clothing, choose girls' characters in private 
theatricals or in masquerades and betray great cleverness 
in impersonating the female character, etc. 

Homosexual acts (mutual masturbation, etc.) previous 
to puberty are no proof of antipathic sexuality. They 
may spring from hypersexuality, precocity or some exter- 
nal influences. They do not necessarily lead to inverted 
sexuality, only then when the individual is predisposed. 
It is at the time of puberty that the vita sexualis is devel- 
oped and receives its direction for the rest of life. An 
unconscious desire for sexual union, often enough stimu- 
lated by individuals of the same sex, brings the playmates 
together, tickling and other tactile irritations quite apart 
from the genuine sexual instinct lead to acts of mastur- 
bation in corpore virili, but they are not coupled with psy- 
chical feelings in the sense of homosexual acts. The same 



ANTIPATHIC SEXUAL INSTINCT. 447 

analogous manifestations may be observed in young ani- 
mals. 

But rarely antipathic sexuality develops from these 
horseplays. Puberty teaches the youthful sinner to know 
his true sex soon enough. From the sexual instinct, baaed 
upon a series of physical and psychical attractions, ema- 
nates the sexual leaning to persons of the opposite gender, 
and the earlier homosexual encounters are remembered 
with shame and confusion. But the homosexual act com- 
mitted after puberty has set in, is the decisive step in the 
wrong direction. The stadium of sexual differentiation 
covers sometimes a long period and often reaches far be- 
yond that of physical sexual development. 

Of great value in diagnosing a case is to ascertain the 
dream-life and that of sleep in the patient. The true 
status of the sexual instinct is here often pitifully por- 
trayed. Nocturnal pollutions are found to be coloured (a) 
in cases of psychical herinaphroditism predominantly, (b) 
in all the other grades of the anomaly exclusively in the 
sense of homosexuality. In cases of effeminatio (viragin- 
ity) they are accompanied by dream-pictures delineating 
the passive (in man) or the active (in woman) role in the 
sexual act 

The presence of physical or psychical abnormal char- 
acteristics may aid diagnosis if they are coupled with other 
more distinctive signs. By themselves they prove nothing, 
as they are also found in individuals not tainted, for in- 
stance, in gyn&ecomasts, bearded women, etc., etc. 

In the well-pronounced cases of antipathic sexual in- 
stinct (effeminatio and viraginity) the physical and psy- 
chical characteristics of inverted sexuality are so plentiful 
that a mistake cannot occur. They are simply men in 
women's garb, and women in men's attire, especially if they 
have full freedom of action. Psychically they consider 
themselves to belong to the opposite sex. We have seen 
women urnings in the army, and men urnings among the 
waitresses in restaurants. They act, walk, gesticulate and 
behave in every way exactly as if they were persons of the 



448 PSYCHOPATHIA 8EXUAI.I8. 

f i 

sex which they simulate. I have known malo urnmgs 
who excelled woman in wiles, loquacity, coquetry, etc., 
etc. 

In pronounced cases hashfulness and timidity in the 
presence of persons of his own sex will be observed in the 
homosexual individual. 

That urnings know each other instinctively is a fable. 
They recognize one another by their gait, natural shyness 
and by signs just the same as normal persons of opposite 
sexes do if they go adventure hunting. 

The higher grades of homosexuality show horror fem- 
inse to the extent of absolute impotence. Imagination 
sometimes assists in producing erection and rendering coi- 
tus possible. Diagnosis is definitely established when abso- 
lute proof is at hand that a homosexual person is perma- 
nently attracted by a person of the same sex and led to a 
sexual act with that person, the act granting full satisfac- 
tion to the sexual instinct, whilst similar attractions do not 
exist in persons of the opposite sex, and if the disgust for 
persons of the opposite sex is insuperable. 

The distinction between congenital and acquired (or 
rather retarded) homosexuality is considered to be of theo- 
retical and therapeutical value. 

Some authors claim that congenital homosexuality 
does not exist, but that this anomaly is acquired from oth- 
ers. But I cannot accept their arguments, for they do 
not explain the presence of the distinguishing symptoms so 
often found in the earliest years of the individuals af- 
flicted, i.e., at a period in which external influences may be 
considered to be absolutely excluded. 

Case 1 68. Taken from Moll, "Libido Sexualis," case 
69, p. 726. A young man, thirty-four years of age, was 
from age seventeen drawn to young men, and had no 
liking for girls. He was an effeminated character, had a 
girl's nickname, and played with dolls. When drunk he 
allowed men to masturbate him. When sober, however, 
he would not permit it, because he thought it stupid. 



ANTIPATHIC SEXUAL INSTINCT. 449 

To parents and teachers, the experiences detailed in 
this and numerous other scientific works on masturbation, 
present valuable suggestions. 

Educators are often too "naive" in their views, and 
their power of observation is too limited to notice the sexual 
abuses rampant among the boys entrusted to their care 
and practised even during lesson time. In a few excep- 
tional cases they have even become seducers of boys. 
Everything that is calculated to unduly further the devel- 
opment of the vita sexualis such as prolonged sitting on 
the form, the use of alcoholic drinks, etc. should be 
strictly avoided. A boy with inverted sexuality should be 
rigidly excluded from all public educational institutions 
for boys and sent to a hospital for nervous disorders. Boys 
should not be permitted to sleep together at home. Swim- 
ming lessons and bathing en masse should be under the 
careful and strict supervision of a competent person. 

Neither should "a child with antipathic sexual instinct 
be placed under the isolated tuition of a tutor or private 
master, for frequently the first object of homosexual love 
is the instructor at home. Care should be taken that 
tainted children are not caressed and fondled by persons 
of the same sex. Flagellatio ad podicem should never be 
permitted. 

The best place for children that are perversely (sex- 
ually) inclined is the public school where co-education of 
the sexes prevails. An early preference for games, occu- 
pations and pastimes of the opposite sex should be strongly 
discountenanced and interdicted. Masturbation should be 
carefully watched in both sexes. Early signs of antipathic 
sexual instinct should at once be noticed, and hypnotic and 
(suggestive treatment applied, for there is more hope for 
(eradicating the evil in its earlier stages than when the in- 
dividual so tainted has already been lost in the quagmire 
of sexual perversion. 

The lines of treatment, when antipathic sexual instinct 
exists, are the following: 

29 



450 P8YCHOPATHIA 8EXDALI8. 

1. Prevention of onanism and removal of other influ- 
ences injurious to the vita sexualis. 

2. Cure of the neurosis (neurasthenia sexualis and tmi- 
versalis') arising out of the unhygienic conditions of the 
vita sexualis. 

3. Mental treatment, in the sense of combating homo- 
sexual, and encouraging heterosexual, feelings and im- 
pulses. 

The momentum of the treatment lies in fulfilling the 
third indication, particularly with reference to onanism. 

Only in very few cases, where acquired antipathic 
sexual instinct has not progressed far, can the fulfilment 
of 1 and 2 be sufficient, as a case fully reported by the 
author in the "Irrenfreund," 1885, No. 1, proves. Cf. 
case 128, ninth edition of this book. 

As a rule, physical treatment, even though it be rein- 
forced morally by good advice with reference to the avoid- 
ance of masturbation, the repression of homosexual feel- 
ings and impulses, and the encouragement of heterosexual 
desires, will not prove sufficient, even in cases of acquired 
sexual inversion. 

Here a method of mental treatment hypnotic sugges- 
tion is all that can really benefit the patient. 

I know of but one case in which auto-suggestion proved 
successful, cf. case 129, ninth edition. 

As a rule, only suggestion coming from a second per- 
son, and that by means of hypnosis, promises success. 

In such cases, the object of post hypnotic suggestion 
is to remove the impulse to masturbation and homosexual 
feelings, and to encourage heterosexual emotions with a 
sense of virility. 

A prerequisite is, of course, the possibility to induce 
hypnosis of sufficient intensity. It is, unfortunately, in" 
these very cases of neurasthenia that this proves impossi- 
ble, since the subject is often excited, embarrassed, and 
in no condition to concentrate the thoughts. 

By reason of the great benefit that can be given to 
such unfortunates, and with Ladame's case in view (v. 



ANTIPATHIC SEXUAL INSTINCT. 451 

infra), in all such cases, everything should be done to force 
hypnosis the only means of salvation. The result, in the 
three following cases, was satisfactory : 

Case 160. Antipathic sexual instinct acquired 
through masturbation. Mr. X., merchant, aged twenty- 
nine. Father's parents healthy. Nothing nervous in 
father's family. 

Father was an irritable, peevish old man. One brother 
of the father was a man-about-town, and died unmarried. 

Mother died in third confinement, when the patient was 
six years old; she had a deep, rough, masculine voice, and 
coarse appearance. Of the children, one brother is irri- 
table, "melancholic," and indifferent to women. 

When a child, patient had scarlet fever with delirium. 
Up to his fourteenth year he was light-hearted and social, 
but, after that, quiet, solitary, and "melancholic". The 
first trace of sexual feeling appeared in his tenth or elev- 
enth year, and at that time he learned masturbation from 
other boys, and practised mutual onanism with them. 

At the age of thirteen or fourteen, ejaculation for the 
first time. Patient had felt no evil results of onanism until 
the last three months. 

At school he learned easily, but was troubled with head- 
aches. After the age of twenty, pollutions, in spite of 
daily practice of onanism. With pollutions occurred "pro- 
creative" dreams, as man and wife might perform the act 
In his seventeenth year he was seduced into mutual onan- 
ism by a man having a love for men. He found satisfac- 
tion in this, inasmuch as he was always very passionate 
sexually. It was a long time before the patient again 
sought new opportunities for intercourse with males. He 
did it simply to rid himself of semen. 

He felt no friendship or love for the person with whom 
he had intercourse. Tie felt satisfaction only when he 
played the passive role when manustupration was prac- 
tised on him. When the act was once completed, he had 
no respect for the individual. If it happened that, later, 



452 PSYCHOPATHIA SEXUALIS. 

he came to respect the man, then he ceased to indulge in 
the act with him. Later it became indifferent to him 
whether he masturbated or had masturbation practised on 
him. When he himself practised onanism, he always 
thought of pleasing men practising onanism on him dur- 
ing the act. He preferred a hard, rough hand. 

The patient thought that, had he not been led astray, 
he would have arrived at a natural mode of satisfaction of 
his sexual desires. He never felt love for his own sex, 
though he had pleased himself with the thought of loving 
men. At first he had had sensual inclinations toward the 
opposite sex. He had taken pleasure in dancing, and he 
had been pleased with women, but he had taken more 
pleasure in the figure than the face. He had had erections 
at the sight of women that pleased him. He had never 
attempted coitus, for fear of infection; whether he was 
potent or not with women, he did not know. He thought 
he could be so no longer, because his feeling for women 
had grown cold, especially during late years. 

While previously, in his sensual dreams, he had had 
ideas of both men and women, of late years he had dreamed 
only of approaches to men; he could not remember that 
he had dreamed, in late years, of sexual relations with a 
woman. At the theatre, as well as in the circus and ballet, 
the feminine figure had always interested him. In mu- 
seums, masculine and feminjjia statues had affected him 
equally. ff 

Patient was a great smoker, a beer-drinker, loved male 
society, and was an athlete and skater. Anything dandi- 
fied was repugnant to him, and he had never felt any de- 
sire to please men; he would even have preferred to please 
women. 

He now felt his position to be painful, because onanism 
had obtained the upper hand. Masturbation, that had 
previously been practised without evil effects, now began 
to disclose its bad results. 

Since July, 1889, he had suffered with neuralgia of 
the testicles. Tlie pain occurred particularly at night; and 



ANTIPATHIC SEXUAL INSTINCT. 453 

tt night there was also trembling (increased reflex excita- 
bility). 

1> was not refreshing, and he would wake up with 
pain in the testicles. He was inclined, now, to indulge 
more frequently in onanism. lie was afraid of the con- 
sequences of the habit. He hoped that his sexual life 
might still be turned into normal channels. Now, he 
thought of the future; he had a relation with a girl, who 
was attractive to him, and the thought to possess her as 
a wife was pleasing. 

For five days he had abstained from onanism, but he 
could scarcely believe that he would be able, with his own 
strength, to overcome the habit. Of late he had been 
very much depressed, having lost all desire for work, and 
become tired of life. 

Patient was tall, powerful, well nourished, and had a 
thick growth of beard. Skull and skeleton normal. Knee- 
jerks very prompt ; deep reflexes in upper extremities much 
increased. Pupils dilated, equal, and acted promptly. 
Carotids of equal calibre; hyperaesthesia urethra; cords 
and testicles not sensitive ; genitals normal. 

The patient was calmed, and given hope for the future, 
provided that he gave up onanism and attempted to trans- 
fer his sexual desires from persons of his own sex to 
females. 

Hip-baths (24 to 20 R.^ ; extr. Secal. cornut. aquos., 
0.5; antipyrin, 1.0 (pro die) ; pot. brom. 4.0 (evenings), 
were ordered. H 

13th December. To-day the patient came, in a dis- 
t turbed condition of mind, complaining that, unaided, he 
was unable to resist the impulse to masturbate, and he 
' asked for help. 

A trial of hypnosis induced a condition of deep lethargy 
in the patient. 

He was given the following suggestions: 

1. I can not, must not, and will not masturbate again. 

2. I abhor the love of my own sex, and shall never 
again think men handsome. 



454 PSYCHOPATHIA SEXUALJ8. 

3. I shall and will become well again, fall in love with 
a virtuous woman, be happy, and make her happy. 

14th December. While out walking to-day, patient 
saw a handsome man, and felt himself powerfully drawn 
toward him. 

From this time there were hypnotic sittings every 
second day, with the above suggestions. 

18th December (fourth sitting), somnambulism oc- 
curred; the impulse to onanism and interest in men dis- 
appeared. 

At the eighth sitting "complete virility" was added to 
the above suggestions. The patient felt himself morally 
elevated and physically strengthened. The neuralgia of 
the testicles had disappeared. He now found that he was 
without sexual feeling. 

He now believed himself free from masturbation and 
inverted sexual inclination. 

After the eleventh sitting he thought further help was 
unnecessary. He wished to go home, and marry. He felt 
well and potent. Early in January, 1890, treatment 
ceased. 

In March, 1890, the patient wrote: "I have since had 
several occasions on which it has been necessary for me 
to use all my moral strength in order to overcome my 
habit, and, thank God, I have been successful in freeing 
myself from this vice. Several times I have had oppor- 
tunity for sexual intercourse, and I have found pleasure 
in it. I look calmly on my happy future." 

Other cases successfully treated by suggestion may be 
found in Wetterstrand, Der Hypnotismus und seine An- 
wendung in der praktischen Medicin, 1891, p. 52 u. ff. ; 
Berriheim, "Hypnotisme," Paris, 1891, etc., p. 38. 

The foregoing details of the successful results of hyp- 
notic suggestion, in cases of acquired sexual inversion, 
make it seem possible that those unfortunates who are 
afflicted with congenital perversion may be helped in some 
degree by the same means. 

Of course the proposition is different as regards cases 



ANTirvillH si.MM. INSTINCT. 455 

of a congenital anomaly. To correct a morbid psycho- 
sexual existence is a most ilitiinilt proMcm. 

The most favourable cases are those of psychosexual 
hermaphroditism in which at least rudimentary hetero; 
sexual feelings may be strengthened by suggestion and 
brought into active practice. 

Case 170. Mr. von X., aged twenty-five, landed 
proprietor, lit- came "I a neuropathic, irascible father, 
who was said to have been sexually normal. His mother 
was nervous, as were her two sisters. Maternal grand- 
mother was nervous, and maternal grandfather a roue, 
much given to venery. Patient was like his mother, and 
an only child. From birth ho was weak, suffered much 
with migraine, and was nervous. lie passed through sev- 
eral illnesses. At fifteen he began masturbation, without 
having been taught. 

Until his seventeenth year he never had feeling for 
men, or, in fact, any sexual inclination; but at this time 
desire for men arose. He fell in love with a comrade. 
His friend returned his love. They embraced and kissed 
and indulged in mutual onanism. Occasionally patient 
praetised coitus inter femora riri. He abhorred pederasty. 
Lascivious dreams were concerned only with men. In 
circus and theatre males alone interested him. The inclin- 
ation was for those of about twenty years. Handsome, tall 
forms were enticing to him. Given these conditions, he 
was quite indifferent to other characteristics of the men. 
In his sexual affairs with men his part was always that of 
a man. 

After his eighteenth year the patient was always a 
source of anxiety to his highly respected parents, for he 
then began a love-affair with a male waiter, who fleeced 
him and made him an object of remark and ridicule. He 
was taken home. He consorted with servants and hostlers. 
He caused a scandal. He was sent away to travel about. 
In London he iM into a "blackmailing scrape," but suc- 
ceeded in escaping to his home. 



456 PSYCHOPATHIA SEXUALIS. 

He profited in no way by this bitter experience, and 
again- showed disgraceful inclinations toward men. Pa- 
tient was sent to me to be cured of his fatal peculiarity 
(December, 1888). Tall, stately, robust, well-nourished, 
of masculine build ; large, well-formed genitals. Gait, 
voice, and attitude masculine. Pronounced masculine pas- 
sions. He smoked but little, and only cigarettes; drank 
little, and was fond of confectionery. He loved music, 
arts, aesthetics, flowers, and moved in ladies' society by 
preference. He wore a moustache, the face being other- 
wise cleanly shaved. His garments were in nowise re- 
markable. He was a soft, blase fellow, and a do-nothing. 
He would lie in bed mornings, and could scarcely be made 
to rise before noon. He said he had never regarded his 
inclination toward his own sex as abnormal. He looked 
upon it as congenital ; but, taught by his evil experiences, 
he wished to be cured of his perversion. He had little 
faith in his own will. He had tried to reform, but always 
lapsed into masturbation, which he found injurious, inas- 
much as it caused (slight) neurasthenic symptoms. There 
was no moral defect. Intelligence was a little below the 
average. Careful education and aristocratic manners were 
apparent. The exquisite neuropathic eye betrayed a ner- 
vous constitution. The patient was not a complete and 
hopeless urning. He had heterosexual feelings, his sen- 
sual inclinations toward the opposite sex, however, were 
manifested but weakly and infrequently. When nineteen, 
he was first taken to a brothel by friends. He experienced 
no horror femince, had efficient erections, and some pleas- 
ure in coitus, but not the instinctive delight he experienced 
while embracing men. 

Since then, patient asserted that he had had coitus six 
times, twice sua sponte. He gave the assurance that he 
was always capable of it, but he did it only faute de mieux, 
as he did masturbation, when the sexual impulse troubled 
him, as a substitute for intercourse with men. He had 
thought of the possibility of finding a sympathetic lady and 



ANTIPATHIC SIXUAL INSTINCT. 457 

marrying her. He would regard marital cohabitation and 
abstinence from intercourse with men as hard duties. 

Since there were rudiments of heterosexual feelings 
present, and the case could not be looked upon as hopeless, 
it seemed that treatment was indicated. The indications 
were clear enough, but there was no support for them in 
the will of the indolent patient, so unconscious of his own 
position. It lay near to seek support for the moral influ- 
ence in hypnosis. The fulfilment of this hope seemed 
doubtful, because the famous //onsen had tried several 
times, in vain, to hypnotise him. 

At the same time, by reason of the most important 
social interests of the patient, it was necessary to make 
another attempt. To my great surprise, Bernheim's pro- 
cedure induced immediately a condition of deep lethargy, 
with possibility of post-hypnotic suggestion. 

At the second sitting somnambulism was induced by 
merely looking at him. The patient easily yielded to sug- 
gestions of all kinds; indeed, contractures were induced 
by stroking him. He was awakened by counting three. 
Awakened, patient had amnesia for all the events of the 
hypnotic state. Hypnosis was induced every second or 
third day for the communication of hypnotic suggestions. 
At the same time, moral and hydro-therapeutic measures 
were employed. 

The hypnotic suggestions were as follows: 

1. I abhor onanism, because it makes me weak and 
miserable. 

2. I no longer have inclination toward men; for love 
for men is against religion, nature and law. 

3. I fool an inclination toward woman; for woman is 
lovely and desirable, and created for man. 

During the sittings the patient always repeated ver- 
batim these suggestions. After the fourth sitting it was 
noticeable, that, when taken into society, he paid court to 
ladies. Shortly aftor that, when a famous priraa-donna 
Bang, he was all enthusiasm for her. Some days later the 
jxatient sought the address of a brothel. 



458 PSYCHOPATHIA SEXUALIS. 

Yet he preferred the society of young gentlemen; but 
the most careful watching failecl-to reveal anything sus- 
picious. 

17th February. Patient asked to be allowed to in- 
dulge in coitus, and was very well satisfied with his expe- 
rience with one of the demi-mondes. 

16th March. Up to this time, hypnosis twice a week. 
The patient always passed into deep somnambulism by 
simply being looked at, and, at request, repeated the sug- 
gestions. He was susceptible to all kinds of post-hypnotic 
suggestion, and, in the waking state, knew not the least 
of the influences exerted on him in the hypnotic state. 
In the hypnotic condition he always gave the assurance 
that he was free from onanism and sexual feeling for men. 
Since he gave the same answers in hypnosis e.g., that on 
such and such a date he practised onanism for the last 
time, and that he was too much under the will of the 
physician to be able to lie his assertions deserved belief; 
the more, since he looked well and was free from all neu- 
rasthenic symptoms, and, in the society of men, not the 
slightest suspicion rested on him. An open, free, and 
manly bearing was developed. 

Moreover, since, of his own will, he now and then in- 
dulged in coitus with pleasure, and occasional pollutions 
were induced by lascivious dreams which concerned 
women, there could be no doubt of the favourable change 
of his vita sexualis; and it was presumable that the hyp- 
notic suggestions had developed into auto-suggestive in- 
clinations, which directed his feelings, thoughts and will. 
Probably the patient will always remain a natura frigida; 
but he more often spoke of marriage, and of his intention 
to win a wife as soon as he had become acquainted with a 
sympathetic lady. Treatment was stopped. (Author's own 
case, "Internat. Centralbl. fiir die Physiol. und Pathol. 
der Harn- und Sexualorgane" Band i.) 

In July, 1889, I received a letter from his father, tell- 
ing me of his son's good health and conduct. 

On 24th May, 1890, by chance, I met my former 



ANTir. \THIC SEXUAL INSTINCT. 459 

patient, while on a journey. His bright, healthful appear- 
ance allowed the most favourable opinion of his condition. 
He told me that he still had sympathetic feeling for some 
men, but never anything like love. He occasionally had 
pleasurable coitus with women, and now thought of mar- 
riage, 

I hypnotised him, in the former manner, to try him, 
and asked for the commands I had given him. In a deep 
condition of somnambulism, and in the same tone of voice 
as formerly, the patient repeated fte suggestions he had 
received in December, 1888 an excellent example of the 
possible duration and power of post-hypnotic suggestion. 

Other cases may be found in the eighth. edition, casea 
137, 138, 140, 141 ; and ninth edition, case 133, of thii 
book. 

The cases quoted by the author, as well as those given 
by Ladame, in which suggestion removed the homosexual 
instinct, or, at least, neutralised it (as a protection from 
shame and law), seem to afford a proof that even the 
gravest cases of congenital sexual inversion may be bene- 
fited by the application of hypnotism. 

Weiterstrand (cf. Schrenck, op. cit. t case 49) Bern- 
heim (cf. Schrenck, case 51), Muller (cf. Schrenck, case 
53), Schrenck (op. cit., cases 66, 67), report even complete 
success in displacing the homosexual by the heterosexual 
instinct coupled with virility. Schrenck (op. cit., cases 
62, 63) succeeded also in cases of effeminatio. 

But only when hypnotism produces deep somnambu- 
lism, decided and lasting results may be hoped for, which, 
after all, are nothing more than suggestive training, not 
a real cure. They are marvellous "artefacta" of hypnotic 
science practised on abnormal human beings, but by no 
means "transformations" (cf. Schrenck) of a psychosexual 
existence. 

Very instructive in this respect is a case related by 
Schrenok, the representative of which after effected "cure" 
says of himself: "I am ever conscious of a certain insu- 



460 PSYCHOPATHIA SEXUALIB. 

perable coercion winch does not rest upon moral principles, 
but must, as I believe, be referable directly to treatment". 
At any rate such "cures" afford no proof whatsoever 
against the assumption of original conditionality of sexual 
inversion. 

It is necessary here to warn the reader against illusions 
about the true value of hypnotic therapy. 

Attempts have been repeatedly made to question the 
right of the medical adviser to treat cases of antipathic 
sexuality. The advice given to the unfortunates so af- 
flicted was to become reconciled with their anomaly and 
to eschew homosexual intercourse. In some cases in which 
the libido was weak or the sense of morality was not en- 
tirely blunted, success has been achieved. It was pointed 
out to these unfortunate beings that there are many other 
dreadful afflictions, such as trigeminus neuralgia or malign 
tumours, which man must bear with resignation. This 
view involves, however, a defective knowledge of the 
meaning and bearing of antipathic sexual instinct, in so 
jfar as this affliction means nothing more or less than a 
[hopeless existence, a life without love, an undignified 
comedy before human society, and moral and psychical 
marasmus if the advice is adopted; on the other hand, 
eventual loss of social position, civic honour and liberty 
are involved. 

Castration is out of the question, because it is difficult 
to justify such an operation, for the antipathic sexual in- 
stinct with its psychical tortures, cannot be extirpated by 
this process even though the libido sexualis be diminished. 

To confine such people in an insane asylum is a mon- 
strous idea. Justification for it can only then exist if the 
perverse individual suffers also from a psychosis which 
renders confinement imperative. 

Another objection which has been made against treat- 
ment is that the weal and welfare of society is jeopardized 
in so far as an opportunity is given to tainted individuals 
to propagate their perversions. 

This objection appears comical in the face of the fact 



ANTIPATHIC SEXUAL INSTINCT. 461 

that no one has yet thought of prohibiting tin- marriage 
of the congenital libertine or habitual drunkard. M\ 
perience teaches me that the sexual perverts in general 
by no means constitute tin' worst type of degeneration. 
The progeny of individuals thus tainted, which 1 have had 
occasion to observe, has offered no pronounced manifesta- 
tions of neuropathic constitution or taint. 

Psychopathia sexualis is not often met with as a family 
failing or a mark of heredity. 

The number of cases which have been really cured of 
tin.- anomaly will always be limited, because many of these 
unfortunates refrain from taking into their confidence even 
the medical man. Others despair beforehand of the effi- 
ciency of treatment, whilst some who practise homosexual 
intercourse and find satisfaction in it, hesitate to exchange 
their method for something uncertain. Again others de- 
mur for fear of becoming potent, and thus transmitting 
their own weakness to the offspring. Others present psy- 
chical impedimenta which s<"'in insurmountable, or they 
do not react to hypnotic influence or suggestion, thus ren- 
dering treatment futile. 

If an individual afflicted with antipathic sexual in- 
stinct, for ethical, social or any other reasons, demands 
treatment, surely it cannot be denied him. It is the sacred 
duty of every medical man to give advice and aid to the 
best of his ability and knowledge whenever it is asked for. 
The health and welfare of the patient must ever be para- 
mount to that of society at large. Hygiene and prophy- 
laxis enable him at all times to recompense the community 
for any damage he may have done in an isolated case. 

Moreover in the majority of cases the patient is quite 
satisfied when he becomes sexually neutral, and under 
these circumstances medical skill has rendered a signal ser- 
vice to both society and the individual himself. 



IV. SPECIAL PATHOLOGY. 

THE MANIFESTATIONS OF ABNORMAL SEXUAL LIFE IN THE 

VABIOU8 FOBM8 AND STATES OF MENTAL 

DISTURBANCE. 

ABBEST OF MENTAL DEVELOPMENT. 

SEXUAL life in idiots is, generally speaking, but slightly 
developed. It is wanting entirely in idiots of high grade. 
In such instances the genitals are frequently small and 
deformed, and menstruation is late or does not occur at 
all. There is either impotence or sterility. Even in 
idiots of low grade, sexuality is not prominent. In rare 
cases it is manifested with a certain periodicity, and then 
with greater intensity. It may then find expression in 
sudden impulses, and be violently satisfied. Perversions 
of the sexual instinct do not seem to occur at the lowest 
levels of mental development. 

When the desire for sexual satisfaction is opposed in 
these cases, great passion is excited, with danger of mur- 
derous assault on the persons attacked. It is to be ex- 
pected that idiots should not exercise choice, and even 
attempt to satisfy the sexual instinct on their nearest 
relatives. 

Thus Marc-Ideler reports the case of an idiot who 
attempted to rape his sister, and had almost strangled 
her when he was discovered. 

Friedreich reports an analogous case ("Friedreich's 
Blatter," 1858, p. 50). 

I have repeatedly had occasion to give opinions in 
cases of attempts to rape little girls. 

462 



ARREST OF MENTAL DEVELOPMENT. 463 

Oiraud ("Annal. m6d. psych.," 1885, No. 7) also re- 
ports a case of this kind. Consciousness of the significance 
of the act is always wanting; but an instinctive know- 
ledge that such obscene acts are not publicly permitted 
is often present, and causes the act to be undertaken in 
a deserted place. 

In imbeciles the sexual instinct is usually developed 
as in normal individuals. The moral inhibitory ideas are 
cloudy, and, therefore, the sexual impulse is more or less 
openly manifested. For this reason imbeciles are sources 
of disturbance in society. Abnormal intensity and per- 
version of the sexual instinct are infrequent 

The most frequent manner of satisfying the sexual 
desire is onanism. The weak-minded seldom make sexual 
attacks on adults of the opposite sex. 

Sexual satisfaction with animals is frequently at- 
tempted. The great majority of cases of injury (sexual) 
to animals must be attributed to imbeciles. Children are 
quite often their victims. 

Emminghaus ("Maschka's Handb.," iv., p. 234) draws 
attention to the frequency of unrestricted manifestation 
of sexual instinct, which comprises open masturbation, 
exhibition of the genitals, attacks on children and those 
of the same sex, and sodomy. 

Oiraud ("Annal. med. psycho!.," 1855, No. 1) hag 
reported a whole series of immoral attacks on children* : 

1. H., aged seventeen, imbecile, enticed a little girl into 
a barn, by giving her nuts. There he exposed her genitals 
and showed his own, making movements of coitus on 
the child's abdomen. He had no idea of the moral sig- 
nificance of the act 

2. L., aged twenty-one; imbecile; degenerate. While 

1 For numerous case*, "r. Ufnkf'$ Zeitschr.," xxiii., "Erglnzungs- 
heft," p. 147; Combe*, "Annal. meU psychol.," 1866; Ltmow, 
" Zweifelh. Geisteazustlnde," p. 389 ; Ca*j>cr-IAman. " Lehrb., 7, 
Aufloge," Fall 295 ; Bartelt, " Fricdreich'i Blatter f. gerichtl. lied.," 
1890, Heft 1. 



464 PSYCHOPATHIA SEXUALI8. 

he was watching cattle, his sister of eleven years, with a 
playmate of eight years, came and told him how some 
unknown man had attempted to do them violence. L. 
led the children to a deserted house and attempted coitus 
with the younger child, but let her go because immission 
was unsuccessful, and because the child cried out. On 
the way home he promised to marry her if she would 
not say anything. At the trial he thought that by marriage 
he could right the wrong he had done. 

3. G., aged twenty-one, microcephalic, imbecile, had 
masturbated since his sixth year, and practised active 
and passive pederasty. He had repeatedly tried to per- 
form pederasty with boys, and attacked little girls. He 
was absolutely without an understanding of his acts. 
His sexual desires were manifested periodically and in- 
tensely, as in animals. 1 

4. B., aged twenty-one; imbecile. While alone in a 
forest with his sister of nineteen, he demanded that she 
allow coitus. She refused. He threatened to strangle 
her, and stabbed her with a knife. The frightened girl 
wrenched his penis, and he then left her and quietly 
went on with his work. B. had a deformed, microcephalic 
skull, and had no sense of the significance of his act. 

Emminghaus (op. cit., p. 234) reports the case of an 
exhibitionist : 

Case 171. A man, aged forty, married, had for six- 
teen years been accustomed to exhibit himself in parks, at 
dusk, to little girls and servants, and drew their atten- 
tion to himself by whistling. After having been frequently 
punished for it, he avoided the places, but he carried on 
his practice elsewhere. Hydrocephalus. Mental weakness 
of slight degree. Mild sentence passed. 

Case 172. X., of tainted family ; imbecile ; defective 

1 Other cases of pederasty, v. Catper, "Klin. Novellen," Fall 5; 
Combe*, "Annul. m6d. psychol.," July, 1866. 



ARREST OF MENTAL DEVELOPMENT. 465 

and pervertc'd in inirllivt, feeling and will. For help 
and protection lie was brought before an officer. It was 
complained that he had repeatedly exposed his genitals 
to servant-girls, and had shown himself at windows with 
the upper portion of his body naked. No other mani- 
festations of inverted sexual instinct No onanism re- 
ported (Sander, "Archiv f. Psych.," p. 655). 

Case 173. Pederasty with a child. On 8th April, 
1884, at ten o'clock, A. M., while X. was sitting in the 
street, holding a boy of eighteen months on her lap, a cer- 
tain Vallario approached and took the child from X., say- 
ing he was going to take it for a walk. He went the 
distance of half a kilometre, and returned, saying that the 
child had fallen from his arms, and thus injured its anus. 
The anus was torn, and blood was pouring from it At the 
place where the deed was done, traces of semen were 
found. V. confessed his horrible crime, and, at his final 
trial, he acted so strangely that an examination of his 
mental condition was made. He had impressed the . 
prison attendants as being an imbecile. V., aged forty- 
five, mason, defective morally and intellectually, dolicho- 
microcephalic ; narrow, deformed facial bones; the halves 
of the face and the ears asymmetrical ; brow low and re- 
treating; genitals normal. V. showed general diminution 
of cutaneous sensibility, was imbecile, and had no ideas. 
He lived in the present, had no ambition, and did nothing 
of his own will. He had no desires and no emotional feel- 
ing. ,He had never had coitus. Nothing more could be 
ascertained about his vita sexualis. Proofs of intellectual 
and moral idiocy, due to microcephaly; the crime was 
ascribed to a perverse, uncontrollable sexual impulse. Sent 
to an asylum (Virgilio, "II Manicomio," v: year, No. 3). 

A case mentioned by L. Meyer ("Arch. f. Psych.," Bd. 
i., p. 103) shows how female imbeciles may indulge in 
shameless prostitution and immorality. 1 

F. Bander, " Vierteljahrsschr. f. ger. ML," xriit, p. 11; 
Coiper, "Klin. Novellen," Fall 27. 

30 



466 PSYCHOPATHIA SEXUALIS. 

States of Acquired Mental Weakness. 

The numerous anomalies of the vita sexualis in senile 
dementia have been described in the section on "General 
Pathology". In other conditions of acquired mental 
weakness those due to apoplexy; trauma capitis; to the 
secondary stages of psychoses; or to inflammatory pro- 
cesses in the cortex (lues, paretic dementia), perversions 
of the sexual instinct seem to be infrequent; and here 
the immoral sexual acts seem to depend on abnormally 
increased or uninhibited sexual feeling, which, in itself, 
is not abnormal. 

I. Dementia Consecutive to Psychoses. 

Casper ("Klin. Novellen," Fall 31) reports a case that 
belongs here. It is that of a physician, aged thirty-three, 
who attempted rape on a child. He was weakened 
mentally, as a result of hypochondriacal melancholia. 
He excused his deed in a very silly way, and had no 
appreciation of the moral and criminal meaning of the 
act, which was apparently the result of a sexual impulse 
that could not be controlled on account of his mental 
weakness. 

Case 21, in Liman's, "Zweifelhafte Geisteszustande," 
is an analogous case (dementia after melancholia; offence 
against morals by exhibition). 

2. Dementia After Apoplexy. 

Case 174. B., aged fifty-two. He passed through a 
cerebral attack, and was no longer able to carry on his 
business as a merchant. 

One day, in the absence of his wife, he locked two 
girls in the house, gave them liquors to drink, and then 
carried out sexual acts with the children. He commanded 
them to say nothing, and went to his business. The 
medical expert established mental weakness, resulting 



STATES OP ACQUIRED MENTAL WKAKNXM. -M>7 

from repeated apoplexies. B., who, up to this time, 
had been well-behaved, Bays he committed the criminal 
act because of an uncontrollable and incomprehensible 
impulse; and that, when he came to himself, he was 
ashamed, and sent the girls away. Since his apoplectic 
attack, B. had been weak-minded, incapable of business, 
and hemiplegic; but, soon after arrest, he made an un- 
skilful attempt at suicide. He often cried childishly. 
His moral and intellectual energy in opposing his sexual 
impulses was certainly much weakene'd. No sentence 
(Qiraud, "Ann. med. Psychol.," March, 1881). 

3. Dementia After Apoplexy of Head. 

Case 175. K., when fourteen years old, was injured 
on the head by a horse. The skull was fractured in 
several places, and several pieces of bone required removal. 

From that time K. was weak mentally, irascible, and 
ill-tempered. Gradually he developed an inordinate and 
truly beastly sensuality, which drove him to the most 
immoral acts. One day he raped a girl of twelve, and 
strangled her for fear of discovery. Arrested, he confessed. 
The medical experts declared him responsible, and he 
was executed. 

The autopsy revealed ossification of almost all the 
sutures, remarkable asymmetry of the halves of the skull, 
and evidences of healed fractures. The affected hemi- 
sphere had bands of cicatricial tissue running through 
it, and was one-third smaller than the other (Friedreich'g 
"Blatter," 1885, Heft 6). 

4. Acquired Mental Weakness, Probably Resulting 
from Lues. 

Case 176. X., officer, had repeatedly committed 
immoral acts with little girls; among other things, he 
had induced them to perform manustupration on him, 
had exposed his genitals, and handled theirs. 



468 P8YCHOPATHIA SEXUALIS. 

X., formerly healthy, and of blameless life, was in- 
fected with syphilis in 1867. In 1879 paralysis of the 
left abducens occurred. Thereafter mental weakness was 
noticed, with a change of his disposition and character. 
Headache, occasional incoherence of speech, failure of 
power of thought and logic, occasional inequality of pupils, 
and paresis of the right facial muscles, were observed. 

X., aged thirty-seven, showed no trace of lues when 
examined. The paralysis of the left abducens was still 
present. The left eye was amblyopic. He was mentally 
weak. Concerning the trial that was before him, he said 
it was nothing but a harmless misunderstanding. Indi- 
cations of aphasia. Weakness of memory, particularly 
for recent events. Superficial emotional reaction; rapid 
exhaustion of memory and ability to speak. Proved: 
that the ethical defect and the perverse sexual impulse 
are the symptoms of an abnormal condition of brain 
induced by lues. 

Suspension of criminal proceedings (personal case, 
"Jahrbiicher fur Psychiatrie"). 

5. Paretic Dementia. 

Here the sexual life is usually abnormally affected ; in 
the incipient stages of the disease, as well as in episodical 
states of excitement, it is intensified, and sometimes per- 
verse. In the final stages libido and sexual power usually 
become nil. 

Just as in the prodromal stage of the senile forms, one 
sees here, in -connection with more or less evident losses 
in the moral and intellectual spheres, expressions of an 
apparently intensified sexual instinct (obscene talk, las- 
civiousness in intercourse with the opposite sex, thoughts 
of marriage, frequenting of brothels, etc.), which is char- 
acteristic of the clouding of consciousness. 

Seduction, abduction and public scandal are here the 
order of the day. At first there is still some appreciation 
of the circumstances, though the cynicism of the acts is 



EPILEPSY. 469 

striking enough. As the mental weakness increases, such 
patients become criminal by reason of exhibition, mastur- 
bation in the streets and attempts at immoral acts with 
children. 

If conditions of mental excitement come on, attempts 
at rape are commit tinl, or at least, grossly immoral acts, 
the patient attacks women on the street, appears in public 
in very imperfect dress; or, half-clothed, tries to force his 
way into strange houses, to cohabit with the wife of an 
acquaintance, or to marry the daughter on the spot 

Numerous cases belonging to this category are cited 
by Tardieu ("Attentats aux rnoeurs") ; Mendel ("Progres- 
sive Paralyse der Irren," 1880, p. 123) ; Westphal ("Arch, 
f. Psvrh., vii., p. 622) ; and a case by Petrucci ("Annal. 
med. Psychol.," 1875) shows that bigamy may also occur 
here. 

The brutal disregard of consequences with which the 
patients in the advanced stages attempt to satisfy their 
sexual needs is characteristic. 

In a case reported by Legrand ("La folie," p. 519), the 
father of a family was found masturbating in the open 
street. After the act he consumed his semen. 

A patient seen by me, an officer, of a prominent family, 
in broad daylight, made attacks on little girls at a water- 
ing-place. 

A similar case is reported by Dr. Regis ("De la 
dynamic ou exaltation fonctionnelle au debut de la paral. 
gen.," 1878). 

Cases reported by Tarnowsky (op. cit., p. 82) show that 
also pederasty find bestiality may occur in the prodromal 
stages and course of this malady. 

Epilepsy. 

Epilepsy is allied to the acquired states of mental 
weakness because it often leads to them, and then all the 
possibilities of reckless satisfaction of the sexual impulse 
that have been mentioned may occur. Moreover, iu 



4:70 PSYCHOPATIIIA SEXUALJS. 

many epileptics the sexual instinct is very intense. For 
the most part it is satisfied by -masturbation, now and 
then by attacks on children, and by pederasty. Perver- 
sion of the instinct with perverse sexual acts seems to be 
infrequent 

Much more important are the numerous cases in 
literature in which epileptics, who, during intervals, 
present no signs of active sexual impulse, but manifest it 
in connection with epileptic attacks, or during the time 
of equivalent or post-epileptic exceptional mental states. 
These cases have scarcely yet been studied clinically, and 
forensically not at all; but they deserve careful study. 
In this way certain cases of violence and rape would be 
understood, and legal murders prevented. 

From the following facts it will certainly be clear that 
the cerebral changes which accompany the epileptic out- 
break may induce an abnormal excitation of the sexual 
instinct. 1 Besides, in the exceptional mental states of 
epileptics, they are unable to resist their impulses, by 
reason t>f the disturbance of consciousness. 

For years I have known a young epileptic, of bad 
heredity, who, always after frequent epileptic seizures, 
attacks his mother and tries to violate her. After a time 
he comes to himself, and has no recollection of his acts. 
In the intervals he is very strict in morals, and has but 
slight sexual inclination. 

Some years ago I became acquainted with a young 
peasant, who, during epileptic attacks, masturbated shame- 
lessly, but during the intervals was above reproach. 

Simon ("Crimes et delits," p. 220) mentions an epilep- 
tic girl of twenty-three, well educated, and of the best 
morals, who, in attacks of vertigo, would shout out ob- 

*Arndt ("Lehrb. d. Psych," p. 410) especially emphasises the 
passionate element in epileptics : " I have known epileptics who 
behaved in a most sensual way toward their mothers, and others who 
were suspected by their fathers of sexual intercourse with the 
mothers." But when Arndt declares that, wherever there is a 
peculiarity of the sexual life, thought of an epileptic element should 
come into consideration, he is in error. 



EPILEPSY. 1 7 1 

scene words, then raise her dress, make lascivious move- 
ments, and try to tear open IUT undofgannentai 

Kiernan ("Alienist and Neurologist," January, 1884) 
reports the case of an epileptic who always had, as an 
aura, the vision of a beautiful woman in lascivious atti- 
tudes, which induced ejaculation. After some years, with 
treatment with potassium bromide, the vision was changed 
to that of a devil attacking him with a pitchfork. The 
instant this reached him, he became unconscious. 

The same author speaks of a very respectable man 
who had, two or three times a year, epileptic attacks of 
furor and dysthymia, with impulses to pederasty, which 
lasted a week or two ; and of a lady who, with epilepsy that 
came on during the climacterium, had sexual desire for 
boys. 

Case 177. W., of good heredity, previously healthy; 
before and after the attack, sound mentally, quiet, kind, 
temperate. On 13th April, 1877, he had no appetite. On 
the 14th, in the presence of his wife and children, he de- 
manded coitus, first of his wife's friend, who was present, 
then of his wife. Taken away, he had an epileptoid attack ; 
after this he became wildly maniacal and destructive, 
threw hot water on those that tried to approach him, and 
threw a child in the stove. Then he soon became quiet, 
but for some days remained confused, and finally came 
to himself with no recollection of the events of his attack 
(Kowalewsky, "Jahrbiicher f. Psych.," 1879). 

Another case, examined by Caspar ("Klin. Novellen," 
p. 267), may be attributed to epilepsy (latent). A respect- 
able man attacked four women, one after another, in the 
open street (one before two witnesses), and violated one 
of them, "notwithstanding that his young, pretty and 
healthy wife" lived hard by. 

The epileptic significance of the sexual acts in the 
following cases is unequivocal : 



472 PSYCHOPATHIA SEXUALIS. 

Case 178. L., an official, aged forty; a kind husband 
and father. During four years lie had offended public 
morals twenty-five times, for which he had to endure 
long imprisonment. 

In the first seven complaints he was accused of expos- 
ing his genitals to girls from eleven to thirteen years 
old, while passing them on horseback, and calling their 
attention by obscene words. While in confinement, he 
had exposed his genitals at a window which opened on 
a popular street. 

L.'s father was insane; his brother was once met on 
the street wearing only a shirt. During his military 
service L. had had two attacks of severe fainting. Since 
1859 he had suffered with peculiar attacks of vertigo, at 
such times becoming weak, tremulous, and deathly pale; 
it grew dark before his eyes, he saw bright stars, and was 
forced to get support in order to keep upright. After 
violent attacks, great weakness, profuse sweating. 

Since 1861 he had been very irritable, which, respected 
though he was as an official, caused him much trouble in 
his work. His wife noticed the change in him. He had 
days when he would run about the house as if insane, 
holding his head between his hands, striking the wall, and 
complaining of headache. In 1864 he fell to the ground 
four times, lying there stiff, with eyes open. Confused 
states of consciousness were also proved to have occurred. 

L. declared that he had not the slightest remem- 
brance of the crime of which he was accused. Observa- 
tion showed further and more violent attacks of epileptic 
vertigo. L. was not sentenced. In 1875 paretic dementia 
developed with rapidly fatal results (Westphal, "Arch. f. 
Psych.," vii., p. 113). 

Case 179. A rich man of twenty-six had lived for 
a year with a girl with whom he was very much in love. 
He cohabited but rarely, but was never perverse. 

Twice during the year, after excessive indulgence in 
alcohol, he had had epileptic attacks. One evening after 






EPILEPSY. 473 

dinner, at which he had taken much wine, he hurried to 
tin- house of his mistress, and into her sleeping-apartment, 
although the servant told him she was not at home. 
From there he hastened into a room where a boy of 
fourteen was sleeping, and began to violate him. At the 
cry of the child, whose prepuce and hand he had injured, 
the servant hurried to them. lie left the boy and raped 
the maid ; after that he went to bed and slept twelve 
hours. When he awoke, he had an indistinct remem- 
brance of intoxication and coitus. Thereafter there were 
repeated epileptic attacks (Tarnowsky, op. cit. t p. 52). 

Case 180. X., of high social position, led a dissolute 
life for some time, and had epileptic attacks. He be- 
came engaged. On his wedding day, shortly before the 
ceremony, he appeared on his brother's arm before the 
assembled guests. When he came before his bride, he 
exposed his genitals and began to masturbate. He was 
at once taken to an expert in mental disease. On the 
way he constantly masturbated, and for some days was 
actuated by this impulse, which gradually decreased in 
intensity. After this paroxysm the patient had only a 
confused remembrance of the events, and could give no 
explanation of his acts (Tarnowsky, op. cii., p. 53). 

Case 181. Z., aged twenty-seven; very bad heredity; 
epileptic. He violated a girl of eleven, and then killed her. 
He lied about the deed. Absence of memory, i.e., mental 
confusion at the time of the crime, was not proved. Pug- 
liese, "Arch, di Psich.," viii., p. 622). 

Case 182. V., aged, sixty; physician; violated chil- 
dren. Sentenced to imprisonment for two years. Dr. 
Marandon later on proved the existence of epileptoid 
attacks of apprehensiveness, dementia, erotic and hypo- 
chondriacal delusions and occasional attacks of fear (Lacas- 
sagne, "Lyon. med.," 1887, No. 51). 

Case 183. On 4th August, 1878, H., aged about 



474 PSYCHOPATHIA SEXUALI8. 

fifteen, was picking gooseberries with several little girls 
and boys as her companions. Suddenly she threw L., 
aged ten, to the ground and exposed her, and ordered A., 
aged eight, and O., aged five, to bring about conjunctio 
membrorum with the girl, and they obeyed. 

H. had a good character. For five years she had been 
subject to irritability, headache, vertigo and epileptic 
attacks. Her mental and physical development had been 
arrested. She had not menstruated, but she manifested 
menstrual molimena. Her mother was suspected to be 
epileptic. For three months H., after seizures, had 
frequently done strange things, and afterward had no 
remembrance of them. 

H. seemed to have been deflowered. Mental defect was 
not apparent. She said she had no remembrance of the 
act of which she was accused. According to her mother's 
testimony, she had an epileptic attack on the morning of 
4th August, and she had been, on that account, told by her 
mother not to leave the house (Piirkhauer ', "Friedreich's 
Blatter f. ger. Med.," 1879, H. 5). 

Case 184. Immoral acts of an epileptic in states of 
abnormal unconsciousness. T., revenue collector; aged 
fifty-two ; married. He was charged of being guilty of im- 
morality with boys for the past seventeen years, by practis- 
ing masturbation on them, and by inducing them to carry- 
out the act on himself. The accused, a respected officer, 
was overcome by the terrible crime attributed to him, and 
declared that he knew nothing of the deeds of which he 
was accused. His mental integrity was^ questionable. 
His family physician, who had known him twenty years, 
emphasised his peculiar, retiring disposition and his 
mercurial moods. His wife asserted that T. once tried 
to throw her in the water, and that he sometimes had 
outbreaks in which he tore off his clothing, and tried to 
throw himself out of window. T. knew nothing of these 
attacks. Other witnesses testified to strange changes of 
mood and peculiarities of character. A physician reported 



EPILEPSY. 475 

the observation of occasional attacks of vertigo and con- 
vulsions in him. 

TVs grandfather was insane; his father was affected 
with chronic alcoholism, and of late years had had epilep- 
tiform attacks. The father's brother was insane, and had 
killed a relative while in a delirious state. Another uncle 
of T. had killed himself. Of T.'s three children, one 
was weak-minded, another cross-eyed, and the third was 
subject to convulsions. The accused asserted that he had 
occasional attacks in which consciousness was so reduced 
that he did not know what he was about. These attacks 
were ushered in by an auro-like pain in the back of his 
neck. He was then impelled to go out in the air. He 
did not know where he went. His wife had perfectly 
satisfied him sexually. For eighteen years he had had 
chronic eczema (actual) of the scrotum, which had often 
caused him to have extraordinary sexual excitement. 
The opinions of the six experts were contradictory (sane, 
attacks of latent epilepsy) ; the jury disagreed, and he 
was dismissed. Dr. Legrand du Saulle, who was called as 
an expert witness, found that, until his twenty-second 
year, T. had urinated in bed from ten to eighteen times a 
year. After that time the enuresis nocturna had ceased; 
but, from that time, states of mental confusion, lasting 
from an hour to a day, had occurred occasionally, and they 
left the patient without any remembrance of them. Soon 
T. was arrested again for public immorality, and sentenced 
to imprisonment for fifteen months. In prison he grew 
sick, and apparently much weaker mentally. For this 
reason he was pardoned, but the mental weakness in- 
creased. T. was noticed to have repeated epileptoid con- 
vulsions (tonic convulsion with tremor and loss of con- 
sciousness) (Auzouy, "Annal. med. psychol., 1874, Nov.; 
Legrand du Saulle, "Etude mcd. legale," etc., p. 99). 

The following cases of immoral acts with children, ob- 
served by the author and reported in "Friedreich's Blat- 



476 PSYCHOPATHIA BEXUALIS. 

ter," will serve to conclude this group, 1 so important in its 
legal bearings. It is the more important, in that a state 
of unconsciousness was established at the time of the act, 
and because, for allied reasons, the facts related in Latin 
show how a complicated and refined act becomes possible 
in such a state of unconsciousness. 

Case 185. P., aged forty-nine; married, hospital 
beneficiary. He was accused of having committed the 
following terrible acts with two girls, D., aged ten, and 
G., aged nine, whom he had taken to his work-shop on 
25th May, 1883. 

D. testified: "I was in the meadow with G. and my 
sister J., aged three. P. called us into his shop and 
fastened the door. Turn nos exosculabatur, linguam in 
os meum demittere tentabat faciemque mihi lambebal ; 
sustulit me in gremium, bracas aperuit, vestes meas 
sublevavit, digitis me in genitalibus titillabat et merabro 
vulvam meam fricabat ita ut humida fierem. When I 
cried, he gave me twelve kreuzers, and threatened to shoot 
me if I exposed him. At last he tried to persuade me to 
come again the next day." 

G. testified : "P. nates et genitalia D . . se exosculatus, 
iisdem me conatibus aggressus est. Deinde filiolum 
quoque tres annos natum in manus acceptum osculatus 
est nudatumque parti suee virili appressit. Postea quae 
nobis essent nomina interrogavit ac censuit, genitalia 
D. .se meis multo esse majora. Quin etiam nos impulit, 
ut membrum suum intueremur, manibus comprehendere- 
mus et videremus, quantopere id esset erectum." 

At his examination, 29th May, P. said he had but an 
indistinct recollection of having fondled, caressed and 
made presents to a little girl a short time before. If he 
had done anything more, it must have been in an irre- 
sponsible condition. Besides, he had suffered for years 

l Cf. also Liman, " Zweifelhafte Geisteszustande," Fall 8; 
Lastgue, " Exhibitionists, Union mfid.," 1877 ; Ball and Chambard, 
"Art. Somnambulisme" ("Diet, des scienc. m6d.," 1881). 



EPILEPSY. 477 

with weakness in his bead as result of an injury. On 
22nd June he knew nothing of the events of 25th May, 
and nothing of his examination on 29th May. This 
amnesia was shown also on cross-examination. 

P. came of a family affected with cerebral disease; a 
brother was epileptic. P. was formerly a drinker. Years 
before he had actually received an injury to his head. 
Since then, from time to time, he had attacks of mental 
disturbance, introduced by moroseness, irritability, ten- 
dency to alcoholic excesses, apprehension, and delusions of 
persecution sufficient to induce threats and deeds of vio- 
lence. At the same time ho would have auditory hyperacs- 
thesia, vertigo, headache and cerebral congestion, all this, 
with great mental confusion and amnesia for the whole 
period of the attack, which sometimes lasted for weeks. 

During the intervals he was subject to headache, 
which started from the seat of injury on the head (a 
small scar in the skin over the right temple), which was 
painful on pressure. With exacerbation of the headache 
he became very irritable, morose to an extent that in- 
clined him to suicide, and mentally like one drunk. In 
1879, while in such a state, he made an impulsive attempt 
at suicide, of which he afterward had no remembrance. 
Soon after this, being sent to hospital, he gave the im- 
pression of being epileptic, and for a long time was treated 
with pot. bromide. At the end of 1879 he was taken 
to the infirmary, no actual epileptic attack having been 
observed. 

During his lucid intervals he was a virtuous, indus- 
trious, good-natured man, and had never shown any sex- 
ual excitement; and, until this time, never sexual incli- 
nations, even during his mental confusion. Moreover, 
until lately he had lived with his wife. At the time of 
the criminal act he had shown signs of an approaching 
attack, and had asked the physician to prescribe pot. 
bromide. 

P. asserted that, since the injury to his head, he had 
been intolerant of heat and alcohol, which immediately 



478 PSYCHOPATHIA SEXUALI8. 

brought on headache and confusion. The medical exami- 
nation proved the truth of his- assertions about mental 
weakness, irritability and poor sleep. 

If pressure were made at the seat of the trauma, P. 
became congested, irritable, confused and trembled all 
over; he appeared excited; consciousness was disturbed, 
and remained so for hours. 

At times, when he was free from the sensations that 
started from the scar, he seemed kind, free, willing and 
open, though he was mentally weak and cloudy. P. was 
not sentenced (vide "Friedreich's Blatter" for full report). 

Periodical Insanity. 

Just as in cases of non-periodical mania, an abnormal 
intensity or a noticeable prominence of the sexual sphere 
is very often manifested in the periodical attacks (v. infra, 
"Mania"). 

The following case, reported by Servaes ("Arch. . 
Psych."), shows that it then may also be perverted: 

Case 186. Catherine W., aged sixteen; she had 
not yet menstruated ; previously healthy. Father very 
irascible. 

Seven weeks before admission (3rd December, 1872), 
melancholic depression and irritability. 27th November, 
maniacal outbreak, lasting two days; thereafter, melan- 
cholic. 6th December, normal condition. 

24th December (twenty-eight days after the first 
maniacal attack), silent, shy, depressed. 27th December, 
exaltation (jolly, laughing, etc.), with violent love for an 
attendant (female). 31st December, suddenly melan- 
cholic catalepsy, which disappeared after two hours. 20th 
January, 1873, new attack like the previous one. A simi- 
lar one on 18th February, with traces of menses. The 
patient had no recollection whatever for what occurred in 
the paroxysms, and blushed scarlet with astonishment and 
shame when told about them. 



PERIODICAL INSANITY. 479 



Tin n-aftiT ilirru were abortive attacks, which entirely 
disappeared, to give place to the normal mental condition 
in . I une. 

In a case reported by Goclc ("Arch. f. Psych." v.), 
which was probably circular insanity, in a man of very 
bad heredity, during the state of exaltation there was 
manifestation of sexual feeling for men. In this case, 
however, the patient thought himself a girl, and it is ques- 
tionable whether the sexual inclination was induced by the 
delusion or by an antipathic sexual instinct 

In connection with these cases of abnormal manifesta- 
tion of the sexual instinct are those which, as a symptom 
of mania, manifest an abnormal and frequently a perverse 
sexual instinct in an impulsive way, analogous to dipso- 
mania, while in the intervals the sexual instinct is neither 
intense nor perverse. 

Quite a genuine case of such periodical psychopathia 
sexualis, connected with the process of menstruation, is 
the following reported by Anjel ("Arch. f. Psych." xv., 
Heft 2) : 

Case 187. A quiet lady, near the climacterium. 
Very bad heredity. In her youth attacks of petit mal. 
Always eccentric, quick-tempered; very moral; childless 
marriage. 

Several years ago, after a violent emotional disturb- 
ance, a hystero-epileptic attack, with post-epileptic insanity 
of several weeks' duration. Thereafter there was sleep- 
lessness for several months. Following this, there was 
always menstrual insomnia, and the impulse to embrace 
and kiss boys of ten, and fondle their genitals. During 
this excitement there was no desire for coitus; certainly 
not for intercourse with adults. 

The patient often spoke openly of this impulse, and 
asked to be watched, as she was not to be trusted. In the 
intervals she anxiously avoided all talk of it, was very 
modest, and in nowise passionate sexually. 



480 PSYCHOPATIIIA SEXUALI8. 

With reference to the still imperfectly known cases of 
periodical psychopathic, scxualis of this kind Tarnowsky 
(op. cit., p. 38) has made valuable contributions, though 
his cases were not all of a periodic nature. 

Tarnowsky reports cases where married, cultured men, 
the fathers of families, were, from time to time, compelled 
to perform the most terrible sexual acts, while during the 
intervals they were sexually normal, abhorred their parox- 
ysmal sexual acts, and shuddered before the expectation of 
their repetition. 

If a new paroxysm came on, the normal sexual instinct 
disappeared; a state of mental excitement arose with in- 
somnia, and thoughts and impulses to commit the perverse 
sexual acts, with anxious confusion and an increasing im- 
pulse to the abhorred indulgence. In this state the act 
was a relief, because it ended the condition. The analogy 
with dipsomania is complete. 

For other cases (of periodical pederasty), vide Tarnow- 
sky, op. cit., p. 41. The case there reported, on page 46 
belongs in the category of epilepsy. 

The following case, reported by Anjel (Arch. f. 
Psych.," xv., Heft 2), is one of the most topical of the 
convulsive-like occurrence of sexual excitement : 

Case 188. A gentleman of high social position, aged 
forty-five ; generally respected and beloved ; heredity good ; 
very moral; married fifteen years. Previously sexually 
normal, the father of several healthy children, and living 
in happy matrimony. Eight years ago he had a sudden 
fright. For some weeks thereafter he had a feeling of 
apprehension of cardiac attacks. Then came attacks, at 
intervals of several months or a year, of what the patient 
called his "moral catarrh". He became sleepless. After 
three days, loss of appetite, increasing irritability,. strange 
appearance; fixed stare, staring into space; paleness, 
changing with redness ; tremor of the fingers ; red, shining 
eyes, with peculiar glassy expression; and violent, quick 
manner of speech. There was a desire for girls of from 



MANIA. 481 

live- t. ti-n years, evrn for his own daughters. He would 

beg his wife to guard tin- children. For days at a time, 

while in this state, he would shut himself in his room. 

iously he was compelled to pass school-girls on the 

t, and he found a peculiar pleasure in exposing his 

genitals before them, by acting as if about to urinate. 

For fear of exposure, he shut himself in his room, 
morose, incapable of movement, and torn by feelings of 
fear. Consciousness seemed to" be undisturbed. The at- 
tacks lasted from eight to fourteen days. The cause of 
their return was not clear. Improvement was sudden; 
there was great desire for sleep, and, after this was satis- 
fied, he was well again. In the interval there was nothing 
abnormal. Anjel assumed an epileptic foundation, and 
considered the attacks to be the psychical equivalents of 
epileptic convulsions. 

Mania. 

With the general excitation that here exists in the psy- 
chical organ, the sexual sphere is likewise often implicat- 
ed. In maniacal individuals of the female sex, this is the 
rule. In certain cases, it may be questionable whether 
the instinct, which, in itself, is not intensified, is simply 
recklessly manifested, or whether it is present in actual 
abnormal intensity. For the most part, the latter is the 
true assumption certainly so where sexual delusions and 
their religious equivalents are constantly expressed. In 
accordance with the degrees of intensity of the disease, the 
intensified instinct is expressed in different forms. 

In simple maniacal exaltation in men, courting, frivol- 
ity, and lasciviousness in speech, and frequenting of 
brotln-ls, arc ohserved; in women, inclination for the so- 
ciety of men, personal adornment, perfumes, talk of mar- 
riage and scandals, suspicion of the virtue of other women ; 
or there is manifested the reli^i-ms equivalent pilgrim- 
ages, missionary work, desire to become a monk or the 

31 



482 PSYCHOPATIIIA SEXUALIS. 

servant of a priest; and in this case there is much talk 
about innocence and virginity. 

At the height of mania there may be seen invitations 
to coitus, exhibition, obscenity, great excitation at sight 
of women, tendency to smear the person with saliva, 
urine, and even faeces; religio-sexual delusions, to be 
under the protection of the Holy Ghost, to have given 
birth to Christ, etc. ; open onanism and pelvic movements 
of coitus. 

In maniacal men care must be taken to prevent shame- 
less masturbation and sexual attacks on women. 

Nymphomania and Satyriasis. 1 

The description of these conditions is simply an annex 
to the attempt made on page 69 to explain hypercesthesia 
sexualis, in so far as we take into consideration temporary 
sexual affects emanating therefrom, no matter whether they 
are occasioned by abstinence or are of a permanent char- 
acter. They may become so predominant that they com- 
pletely sway the field of imagination and desire, and im- 
peratively demand the relief of the affect in the correspond- 
ing sexual act. In acute and severe cases, ethics and will- 
power lose their controlling influence entirely, while in 
chronic and milder cases restraint is still possible to a 
certain degree. At the acme of paroxysm hallucinations, 
delirium and benumbed consciousness make* their appear- 
ance, and often continue during a prolonged period. 



Literature: Bienville, Traite" de la nymph., Amsterdam, 1771; 
Louyer-Villermay, art. nymphomanie, diet, des sciences med., xxx., 
p. 563; Magnet, diet, en 60 vol. (vol xxxvi., p. 580) ; Meyer Alexit, 
des rapporta conjugaux, Paris, 1882, 7 6d. ; Guibout, traite clinique 
des malad. des femmes, Paris, 1886; Icard, la femine pendant la 
pgriode menstruelle, 1890; Marc, die Geisteskrankheiten, (ibersetzt 
von Ideler, ii., p. 138; Ideler, Grundriss der Seelenheilkunde, ii., p. 
488; Foville, diet, de me'd. et de chirurch. pratique; Legrand du 
Saulle, la folie devant des tribun., 1864; Hall, la folie e"rotique, 1888; 
Moreau, aberrations du sens ggnlsique, 1884; Thoinot, attentats aux 
inoeurs, p. 487; Legrand du Saulle, les hyste'riques, 1883. 



NYMPHOMANIA AND 8ATTRIA8I8. 483 

Such cases have led to the classification of nympho- 
mania as a proper psychical disease. But this is an error, 
for nymphoinania is only a syndrome within the sphere of 
psychical degeneration. As such it may manifest itself 
as an acute paroxysmic condition, analogous to dipsomania, 
frequently coinciding with menstrual phases, recurring 
either in stated periodical cicles, or at irregular intervals. 
Or it may be a complication or combination of other condi- 
tions and appear episodically in dementia senilis, climac- 
teric psychosis, mania in degenerates, and delirium acutum 
("acute deadly nymphomania" ). 

Moreau (op. cit.) reports an interesting case. A young 
girl became suddenly a nymphomaniac when forsaken by 
her betrothed ; she revelled in cynical songs and expres- 
sions, and lascivious attitudes and gestures. She refused 
to put on her garments, had to be held down in bed by 
muscular men ( !) and furiously demanded coitus. In- 
somnia, congestion of the facial nerves, a dry tongue, and 
rapid pulse. Within a few days lethal collapse. 

Louyer-Villermay (op. cit.) : Miss X., aged thirty; 
modest and decent, was suddenly seized with an attack of 
nymphomania, unlimited desire for sexual gratification, 
obscene delirium. Death from exhaustion within a few 
days. Cf. three other cases with deadly result by Maresch, 
Psychiatr. Centralblatt, 1871. 

Chronic Nymphomania is more frequently met with, 
but seems to occur only in individuals psychically degener- 
ated. It is the result of sexual hyperaesthesia and exacer- 
bations thereof reaching even to the state of sexual affects 
which manifest themselves in impulsive acts, or, in milder 
cases, are complicated with delusions. These, however, 
need not by necessity lead to involuntary acts, in as much 
as ethical considerations may counterbalance the milder 
forms of sexual excitement and, moreover, recourse to soli- 
tary masturbation as a means of temporary relief is here 
always possible. 

Tlipso milder cases of nymphomania claim our sym- 
pathy not less that thoee unfortunate women who by lire- 



484 P8YCIIOPATHIA SEXUALIS. 

sistible impulses are forced to sacrifice feminine honour and 
dignity, for they are fully conscious of their painful situa- 
tion, they are a toy in the grip of a morbid imagination 
which revolves solely around sexual ideas and grasps even 
the most distant points in the sense of an aphrodisiac. 
Even in their sleep they are pursued by lascivious dreams. 
In the daytime the slightest cause will produce a crisis in 
which a veritable erithismus cerebralis sexnalis, coupled 
with painful sensations (pressure, vibration, pulsation, 
etc.,) in the genitals torments them. Temporary relief 
comes in time in the shape of neurasthenia gcnitalis, which 
reacts promptly on the centre of ejaculation and readily 
causes pollutions in lascivious dreams, or some erotic crisis 
when awake. Full gratification, however, they cannot find 
any more than those of their unfortunate fellow-sufferers 
who abandon themselves to men. This anaphrodisia ex- 
plains to a large extent the persistence of the sexual affect, 
i.e., that nymphomania which heaps crisis upon crisis. 

Neurasthenia sexualis, which inhibits orgasm and 
sensual gratification, no doubt, fully explains this anaphro- 
disia which restrains the beneficent assuagement of sexual 
emotions, yet maintaining an incessant craving (libido in- 
saiiata}, forces the woman, morally devoid of all power of 
resistance, to auto-masturbation or psychical onanism, and 
eventually as a Messalina to prostitution in which to find 
satisfaction and relief with one man after another. 

This neurasthenia is often caused by an abnormally 
early and powerful sexual instinct, which prescribes onan- 
ism; or it may be reduced to enforced continence with 
strong coexisting sexual appetite. 

Case 189. Mrs. V., from earliest youth mania for 
men.- Of good ancestors, highly cultured, good-natured, 
very modest, blushed easily, but always the terror of the 
family. Quando quidem sola erat cum homine sexus alte- 
rium, negligens, utrum infans sit an vir, an senex, utrum 
pulcher an teter, statim corpus nudavit et vehement or 
libidines suas satiari rogavit vel vim vel manus ei injecit. 



NYMPHOMANIA AND 8ATYRIA8I8. 485 

Marriage was resorted to as a cure. Maritum quam max- 
ime amavit, neque tanien sibi teinperare potuit quin a 
quolibet viro, si solura apprehenderat, seu verso, seu mer- 
cennario, seu discipulo coitum exposceret. 

Nothing could cure her of this failing. Even when 
she was a grandmother, she still remained a Messalina. 
Puerum quondam duodecim annos natum in cubiculum 
allectum stuprare voluit. He tore himself away and fled, 
and his brother gave her a severe punishment. But it 
was all in vain. When sent to a convent she was a model 
of good conduct and committed not the slightest act of 
indiscretion. But the moment she returned home, she 
resumed her perverse practices. The family sent her away, 
giving her a small allowance. She worked hard to earn 
the money she needed for "buying her lovers." In look- 
ing at the trim, neat matron of sixty-five years of age, with 
her modest manners and a most amiable disposition, no 
one could ever suspect how shamelessly needy in her sexual 
life she was even then. 

At last she was sent to an insane asylum, where she 
lived till May, 1858, when in her seventy-third year, she 
succumbed to a stroke of cerebral apoplexy. Her beha- 
viour at the asylum when under surveillance, was beyond 
reproach; but if left to herself she utilized every oppor- 
tunity in the same old fashion even to within a few daya 
before her death. No other signs of mental anomaly could 
be detected in her. (Trelat, "folie lucide.") 

Case 190. Chronic nymphomania. Mrs. E., age 
forty-seven. An uncle on father's side insane. Father 
Buffered from self-conceit and was given to sexual excess. 
A brother of the patient died from acute cerebral inflam- 
mation. Always nervous, eccentric, erotic, began coitus 
at the age of ten. Married at nineteen. Although her 
husband was virile, she maintained a number of male 
friends. Fully conscious of the abominable nature of her 
conduct, she was powerless in restraining her insatiable ap- 
petite. She kept up appearances, however. Later on she 



486 PSYCIIOPATHIA SEXUALJS. 

claimed that she had suffered from a "monomania for 
men." 

She had six confinements. One day she was thrown 
from a carriage and sustained concussion of the brain. 
This caused melancholia and paranoia persecutoria. With 
approaching climacterium the menses became frequent and 
very profuse, but the libido gradually disappeared. Slight 
degree of descensus uteri and prolapsus ani. 

Chronic conditions of nymphomania are apt to weaken 
public morality and lead to offences against decency. Woe 
unto the man who falls into the meshes of such an insatia- 
ble Messalina, whose sexual appetite is never appeased. 
Heavy neurasthenia and impotence are the inevitable con- 
sequences. These unfortunate women disseminate the 
spirit of lewdness, demoralize their surroundings, become 
a danger to boys, and are liable to corrupt girls also, for 
there are homosexual nymphomaniacs as well. 1 By expos- 
ing their feminine charms, even by exhibition, they lure 
men. Nymphomaniacs endowed with the world's riches 
purchase lovers. In many instances they resort to prosti- 
tution. 

The conditions of Satyriasis in men are analogous to 
nymphomania. It is a central disturbance, either of an 
acute character or chronic. In the acute stage it may lead 
to hallucinations of erotic content, and where compensa- 
tion of the sexual affect is rendered impossible, to furious 
mania, delirium acutum. 

This pathological sexual affect, stigmatised by abnormal 
intensity and duration, fills the whole psychical life. Oc- 
currences of the commonest and most indifferent nature 
are taken as sensual hints or suggestions. The lustful 
colouring of thoughts, ideas or natural perceptions by the 
senses is strongly exaggerated. At the acme of the crisis 
the patient is in a "rut-like" condition, in which conscious- 
ness is clouded and a general physical excitement, similar 
to that during coitus (cf. p. 40) pervades the whole 

1 Thoinot, attentats aux moeurs, p. 498. 



NTMPHOMANIA AND 8ATYBIA8I8. 487 

frame. Ejaculation may be concatenated with a renewed 
phase of orgasm in which the genital organs retain a per- 
manent turgescence (priapism). The individual afflicted 
with satyriasis is forever exposed to the peril of commit- 
ting rape, thus becoming a common danger to all persons 
of the opposite sex. Faute de mieux he resorts to mastur- 
bation and sodomy. Luckily satyriasis is a rare disease. 
It is not due to poisoning with cantharides, as some claim, 
which only produces priapism, that is to say, though at 
first causing erotic .-vn-ations and erection, after repeated 
doses it produces the opposite effect 

Analogous with nymphomania chronica mitis condi- 
tions of a mild satyriasis exist in men, (chiefly after Abusus 
Veneris) who suffer from neurasthenia sexualis ex mastur- 
batione and subsequent impotence, yet are the slaves of 
an insatiable libido. The imagination the same as in 
acute cases is highly excited and consciousness is com- 
pletely filled with obscene pictures and situations. The 
\vlnle train of thought, the entire realm of desire in these 
men is directed to sexual matters. Impotence and anaphro- 
disia assisted by perverse fancies lead them to the worst 
perversities possible in the sexual act and render them 
particularly dangerous to children. They give offence by 
exhibition, by masturbation and by sexual acts with per- 
sons of the other sex in public. They are lascivious in 
speech and revel in filthy language, etc. 

Satyriasis mitis is often observed in the incipient stages 
of dementia paralitica and senilis. 

Case 191. Satyriasis. Delir. acuium ex abstinentia. 
On the 29th of May, 1882, F., age twenty-three, unmar- 
ried, cobbler, was received at the psychiatric clinic at 
Graz. Father irascible, mother neuropathic, uncle on 
mother's side insane. 

Patient never had a severe illness, was not addicted to 
fir ink, but sexually very needy. Five days previously he 
was attacked with an acute psychical disease. In broad 
dajlight, and in the presence of two witnesses, he made 



488 PSYCHOPATIIIA SEXUALIS. 

two separate attempts at rape, went into a fit of delirium, 
raving about obscene matters when arrested, constantly 
masturbated, and became a raving maniac with violent 
motoric irritability and fever. Treatment with ergotine 
brought relief. 

On January 5th, 1888, he was again arrested in a fit 
of raving mania. On the 4th, he had been morose, irrita- 
ble, squeamish, sleepless. He became furious when he 
was foiled in two assaults on women. On the 6th his con- 
dition became very much aggravated, heavy delirium acu- 
tum (disturbance of consciousness, jactation, crinching of 
teeth, facial contortions and other motoric manifestations, 
temperature 40.7). Masturbation as if by instinct. Re- 
covery under treatment with ergotine till the llth of 
January. 

When restored to health again he gave some interesting 
details about his illness. 

His sexual needs were always very great. Coitus at 
sixteen. Continence caused headaches, great psychical 
irritability, dislike for work, laziness, sleeplessness. Hav- 
ing no opportunity for coitus he resorted to masturbation, 
once or twice daily. 

For two months he had had no sexual intercourse. 
As sexual excitement increased, masturbation failed as a 
means of compensation, but the desire for coitus became 
more vehement than ever. At the acme of the attack his 
memory failed him. - In his normal state he was a decent 
man and looked upon his state as a pathological condition 
which filled him with alarm for the future. 

Case 192. On the afternoon of 7th July, 1874, 
Clemens, engineer, being on his way, on business, from 
Trieste to Vienna, left the train at the town of Bruck, and, 
passing through the town to the neighbouring village of 
St. Ruprecht, attempted a rape on an old woman, aged 
seventy, whom he found alone in a house. He was seized 
by the neighbours and arrested by the local police. At his 
hearing he declared that he had tried to find the pound, 



HYMI'IIOMAXIA AND 8ATYRU8IB. 43d 

in order to satisfy his sexual desire with a bitch. Tie said 
that he often suffered with such sexual excitement. 1 It- 
did not deny his act, but excused it as the result of disease. 
The heat, the motion of the cars, and anxiety about his 
family, to whom he wished to go, had confused him and 
made him ill. Shame and remorse were not shown. Ilia 
conduct was open, his mien gay; eyes red and bright, head 
hot, tongue coated; pulse full, soft, beating over 100; 
fingers somewhat tremulous. The statements of the ac- 
cused were precise but hurried; his glance uncertain, and 
with an unmistakable expression of lasciviousness. To the 
medical expert summoned to examine him he gave the 
impression of one suffering with disease as if he were in 
the beginning of alcoholic insanity. 

( \ was forty-five years old, married, father of one child. 
He did not know what diseases his parents or other mem- 
bers of his family had. In childhood he was weak and 
neuropathic. At the age of five his head was injured by 
a blow with a hoe. A scar one-half cm. broad by one 
cm. long, situated on the right parietal and frontal bones, 
dated from that injury. The bone was here somewhat 
depressed. The overlying skin was united to the bone. 
Pressure at this point caused pain, which radiated along 
the lower branch of the trigeminus. This spot was also 
at times spontaneously painful. In his youth he suffered 
"fainting spells"; before puberty, pnefamonia, rheumatism 
and intestinal catarrh. At the age of seven he experienced 
a peculiar inclination for men i.e., for a certain superior. 
Whenever he saw this man he had a peculiar feeling in 
his heart ; kissed the ground he walked on. At ten he fell 
in love with a certain deputy. Later he had an enthusiasm 
f<>r men, though it was entirely platonic. He began to 
masturbate at the age of fourteen ; first intercourse at sev- 
enteen. Then the earlier manifestations of inverted sexual 
feeling disappeared entirely. At that time he passed 
through a peculiar acute j>-\vli<>pathic condition, which he 
ribed as a kind of clairvoyance. From fifteen, haemor- 
rhoids, with symptoms of abdominal plethora. When ho 



4dO PSYCHOPATHIA 8EXUALI8. 

had profuse hsemorrhoidal haemorrhage, which occurred 
usually every three or four weeks, he was better. At 
other times he was constantly in a condition of painful sex- 
ual excitement, which he satisfied partly by means of onan- 
ism and partly by coitus. Every woman he met excited 
him ; even when he was among female relatives he was im- 
pelled to make indecent proposals. Sometimes it was possi- 
ble for him to master his desire ; sometimes he was driven to 
indecent acts. If, after these, he was ejected from the 
house, it seemed perfectly right to him; for he thought 
that he needed such correction and support against his 
powerful impulse, which was a burden to him. No period- 
icity in this sexual excitement was recognisable. 

Until 1861 he committed excesses in venery and was 
several times infected with gonorrhoea and chancres. In 
1861, marriage. He was sexually satisfied, but became a 
burden to his wife on account of his great sensuality. In 
1864 he passed through an attack of mania in the hospital 
at Fiume, and in the same year he again fell ill, and was 
taken to the insane asylum at Ybbs, where he remained 
until 1867. There he suffered with recurrent mania, ac- 
companied by great sexual excitement. He said that in- 
testinal catarrh and anxiety were the cause of his illness 
at that time. 

Thereafter he was well, but he suffered much on ac- 
count of his excessive sexual desire. If he were absent 
from his wife but a short time the impulse became so 
powerful that man or animal was indifferent to him for 
the satisfaction of his lust. In summer these impulses 
were much stronger, and were always accompanied by ab- 
dominal plethora. Something that he remembered in 
medical reading made him think that in his case the gan- 
glionic system was more, powerful than the cerebral. In 
October, 1873, on account of business, he had to leave his 
wife. From that time until Easter, with the exception of 
occasional masturbation, there was no sexual indulgence. 
After that he made use of women as well as bitches. From 
the middle of June until 7th of July, he had no oppor- 



1TTMPHOMANIA AND 8ATYRIA8I8. 401 

tunity for sexual indulgence. He felt nervously excited, 
relaxed, and as if he were going crazy. Of late he had 
slept badly. A longing for his wife, who lived in Vienna, 
drove him to leave his business. He obtained leave of ab- 
sence. The heat and the noise of the train confused him, 
and he could no longer hold out against his sexual excite- 
ment and the pressure of blood in his abdomen. Every- 
thing danced before his eyes. He left the car at Bruck, 
and was absolutely confused, not knowing where he went; 
and for a moment the thought came to him to throw him- 
self in the water; everything appeared as in a mist before 
his eyes. Then he saw a woman, exposed his genitals, and 
tried to embrace her. She cried for help, and thus he was 
arrested. 

After the attempt it suddenly became clear to him 
what he had done. He openly confessed his crime, 
which he remembered in all its details, but which seemed 
to him to be something abnormal. He could not help it. 
For some days after this C. suffered with headache and 
congestions, and was now and then excited and restless, 
and slept badly. His mental functions were undisturbed, 
but he was, nevertheless, a congenitally peculiar man, 
with a character weak and devoid of energy. The facial 
expression had something lascivious and peculiar about 
it. He suffered with hemorrhoids. The genitals pre- 
sented nothing abnormal. The cranium was narrow and 
retreating at the forehead. Body large and well nourished. 
With the exception of diarrhrea, there was no disturbance 
of the vegetative functions. 

Case 193. For three years farmer D., universally 
respected, married, aged thirty-five, had manifested states 
of sexual excitement with increasing frequency and 
severity, which during the past year had become true 
paroxysms of satyriasis. It was impossible to discover 
hereditary or other organic causes. D. was compelled a* 
times, when his sexual excitement was excessive, to per- 
form the sexual act from ten to fifteen times in twenty- 



492 PSTCHOPATHIA SEXUALIS. 

four hours, without deriving any feeling of satisfaction. 
Gradually he developed a condition of general nervous 
hyper-irritability (erethisme general) with increased emo- 
tional irritability to the extent of pathological outbreaks 
of anger, and impulse to over indulgence in alcohol, which 
induced symptoms of alcoholism. His attacks of satyri- 
asis became