III. Cerebral Neuroses (part 1)

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

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

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

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

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

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

1. Sexual Instinct Manifested in Childhood.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

B. Anæsthesia Sexualis (Absence of Sexual Feeling).

1. As a Congenital Anomaly.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

2. Acquired Anæsthesia.

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

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

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

C. Hyperæsthesia (Abnormally Increased Sexual Desire).

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

Since woman has less sexual need than man, a predominating sexual desire in her arouses a suspicion of its pathological significance; and the more, when this finds expression in desire for adornment, coquetry, or male society, which, passing beyond the limits set by good breeding and manners, becomes quite noticeable.

The constitution, in both sexes, is of the greatest significance. An abnormally strong sexual instinct is frequently accompanied by a neuropathic constitution; and such individuals pass a great part of their lives heavily burdened with the weight of this constitutional anomaly of their sexual life. The power of the sexual impulse in such cases may at times rise to the importance of an organic necessity, and really endanger the freedom of the will. The want of satisfaction of this impulsive desire may, under such conditions, induce a condition allied to actual rutting, or a psychical condition, accompanied by emotions of fear, in which the individual gives up to the impulse, and responsibility becomes doubtful. If the individual does not give up to his powerful impulse, he is in danger, by reason of his enforced abstinence, of ruining his nervous system by inducing a neurasthenia, or seriously increasing such a condition if it be already present. In normally constituted individuals, too, the sexual instinct is an inconstant quantity. Aside from the temporary indifference following satisfaction, and the diminution of sexual desire in long-continued continence after a certain reactionary stage of sexual desire is overcome, the manner of life has a great influence. Those living in large cities, who are constantly reminded of sexual things and incited to sexual enjoyment, certainly have more sexual desire than those living in the country. A dissipated, luxurious, sedentary manner of life, preponderance of animal food, and the consumption of spirits, spices, etc., have a stimulating influence on the sexual life. In woman the sexual inclination is post-menstrually increased. At this time, in neuropathic women, the excitement may reach a pathological degree.

The great libido of consumptives is remarkable. Hofmann tells of a consumptive peasant who satisfied his wife sexually on the evening before his death.

The sexual acts are coitus (eventually rape) and, faute de mieux, masturbation; and, with defective moral sense, pederasty or bestiality. If sexual power is diminished or extinct, with excessive sexual desire, all manner of perversity of sexual acts becomes possible.

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, sexual excitement occurs, occasioned by pruritus; and also in cases where there is neuropathic taint. Magnan (Annales médico-psychol., 1885, p. 157) reports the case of a lady who was afflicted mornings with attacks of frightful erethismus genitalis, and the case of a man, aged 55, who was tormented at night by unbearable priapism. In each case there was a neurosis.

The central origin of sexual excitement is of frequent occurrence in persons having neurotic taint or hysteria, and in conditions of psychical exaltation. Here, where the cortex and the psycho-sexual centre are in a condition of hyperæsthesia (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 concepts.

Magnan (op. cit.) reports the case of a young woman who had an increasing sexual desire from puberty, and satisfied it by masturbation. Gradually she grew to become 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 für Psychiatrie, vii, 2); Cases 3 and 5 are given here.

Case 11. On the afternoon of July 7, 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 neighboring village of St. Ruprecht, attempted a rape on an old woman, aged 70, whom he found alone in a house. He was seized by the neighbors and arrested by the local police. At his hearing he declared that he had tried to find the pound, in order to satisfy his sexual desire with a bitch. He said that he often suffered with such sexual excitement. He did not deny his act, but excused it as the result of disease. The heat, the motion of the cars, and anxiety about his family, to which he wished to go, had confused him and made him ill. Shame and remorse were not shown. His conduct was open, his mien gay; eyes red and bright, head hot, tongue coated; pulse full, soft, beating over 100; fingers somewhat tremulous. The statements of the accused were precise, but hurried; his glance 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.

C. is forty-five years old, married, father of one child. He does not know what diseases his parents or other members of his family have had. In childhood he was weak and neuropathic. At the age of five his head was injured by a blow with a hoe. A scar one-half cm. broad by one cm. long, situated on the right parietal and frontal bones, dates from that injury. The bone is here somewhat depressed. The overlying skin is united to the bone. Pressure at this point causes pain, which radiates along the lower branch of the trigeminus. This spot is also frequently spontaneously painful. In his youth he had frequent attacks of “fainting”; before puberty, pneumonia, rheumatism, and intestinal catarrh. At the age of seven he experienced a peculiar inclination for men,—i.e., for a certain superior. Whenever he saw this man he had a peculiar feeling in his heart; kissed the ground he walked on. At ten he fell in love with a certain deputy. Later he had an enthusiasm for men, though it was entirely platonic. He began to masturbate at the age of fourteen; first intercourse at seventeen. Then the earlier manifestations of contrary sexual feeling disappeared entirely. At that time he passed through a peculiar acute psychopathic condition, which he described as a kind of clairvoyance. From fifteen, hæmorrhoids, with symptoms of plethora abdominalis. When he had profuse hæmorrhoidal hæmorrhage, which occurred usually every three or four weeks, he was better. At other times he was constantly in a condition of painful sexual excitement, which he satisfied partly by means of onanism and partly by coitus. Every woman he met excited him; even when he was among female relatives he was impelled to make indecent proposals. Sometimes it was possible for him to master his desire; sometimes he was driven to indecent acts. If, after these, he was kicked out-of-doors, it seemed perfectly right to him; for he thought that he needed such correction and support against his powerful impulse, which was a burden to him. No periodicity in this sexual excitement was recognizable.

Until 1861 he committed excesses in venery and was several times infected with gonorrhœa and chancres. In 1861, marriage. He was sexually satisfied, but became a burden to his wife on account of his great sensuality. In 1864 he passed through an attack of mania in the hospital at Fiume, and in the same year he again fell ill, and was taken to the insane asylum at Ybbs, where he remained until 1867. There he suffered with recurrent mania accompanied by great sexual excitement. He says that intestinal catarrh and anxiety were the cause of his illness at that time.

Thereafter he was well, but he suffered much on account of his excessive sexual desire. If he were 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 abdominal plethora. Something that he remembered in medical reading, made him think that in his case the ganglionic system was more powerful than the cerebral. In October, 1873, on account of business, he had to leave his wife. From that time until Easter, with the exception of occasional masturbation, there was no sexual indulgence. After that he made use of women and bitches. From the middle of June until July 7, he had no opportunity 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 absence. The heat and the noise of the train confused him, and he could no longer hold out against his sexual excitement and the pressure of blood in his abdomen. Everything danced before his eyes. He left the car at Bruck, and was absolutely confused, not knowing where he went; and for a moment the thought came to him to throw himself in the water; all was like a mist before his eyes. Then he saw a woman, exposed his genitals, and tried to embrace her. She cried for help, and thus he was arrested.

After the attempt it suddenly became clear to him what he had done. He openly confessed his crime, which he remembered in all its details, but which seemed to him to be something abnormal. He could not help it. For some days after this, C. suffered with headache and congestions, and was now and then excited and restless, and slept badly. His mental functions are undisturbed, but he is, nevertheless, a congenitally peculiar man, with a character weak and devoid of energy. The facial expression has something lascivious and peculiar about it. He suffers with hæmorrhoids. The genitals present nothing abnormal. The cranium is narrow and retreating at the forehead. Body large and well nourished. With the exception of diarrhœa, there is no disturbance of the vegetative functions.

Case 12. Mrs. E., aged 47. Uncle on father’s side was insane; father was sanguine, and given to excess in venery. Patient’s brother died of an acute cerebral affection. Patient from childhood has been nervous, eccentric, and romantic; and while little more than a child manifested excessive sexual desire, and at ten began sexual indulgence. At nineteen, marriage. Unhappy married life; her husband, who was normal, did not satisfy her, and until recent years she constantly had other friends besides her husband. She was well aware of the immorality of her life, but felt her powerlessness against her insatiable desire, which she sought to keep, at least outwardly, a secret. Later she thought that she had suffered with a “mania for men.” Patient has borne six children. Six years ago she was thrown from a wagon and received a severe cerebral concussion. Following this there was melancholia, with delusions of persecution, which sent her to the asylum. She is approaching the climacterium, and of late the menses have been profuse and too frequent. Since this period she is pleased to note that the previously powerful sexual impulse has declined. Proper behavior. Slight degree of descensus uteri and prolapsus ani.

Hyperæsthesia sexualis may be continuously present with exacerbations, or it may be intermittent or periodic. In the latter case it is a cerebral neurosis per se (vide “Special Pathology”), or an accompanying symptom of a condition of general psychical excitement (mania; episodically in dementia paralytica, dementia senilis, etc.).

Lentz has published a remarkable case of intermittent satyriasis (Bulletin de la société de méd. légale de Belgique, Nr. 21):—

Case 13. For three years the generally respected farmer D., married, aged 35, has manifested states of sexual excitement, with increasing frequency and severity, which, during the past year, have become true paroxysms of satyriasis. It was impossible to discover hereditary or other organic cause. D. was compelled, at times when his sexual excitement was excessive, to perform the sexual act from ten to fifteen times in twenty-four hours, without deriving any feeling of satisfaction. Gradually he developed a condition of general nervous hyper-irritability (éréthisme général) with increased emotional irritability to the extent of pathological outbreaks of anger, and impulse to over-indulgence in alcohol, which induced symptoms of alcoholism. His attacks of satyriasis became so violent that consciousness was interfered with, and the patient raged about in blind impulse to sexual acts. He demanded that his wife give herself to other men or to animals in his presence; that she allow copulation with him, presentibus filiabus, because this would afford him greater enjoyment. Memory for the events at the height of these attacks, in which the extreme irritability even led to outbreaks of maniacal rage, was entirely wanting. D. himself thought that he must have had moments in which he no longer had control of his senses, and without satisfaction from his wife would have been compelled to seize the next best female. After an attack of violent emotion, these attacks of sexual excitement suddenly disappeared entirely.

The two following cases show how powerful, dangerous, and painful sexual hyperæsthesia may become in those afflicted with this anomaly:—

Case 14. Hyperæsthesia Sexualis—Delirium Acutum ex Abstinentia.—On May 29, 1882, F., aged 29, single, shoemaker, was received at the clinic. Father was of passionate temper; mother neuropathic, and had an insane brother. Patient had never been seriously ill previously, and was not a drinker, but had always been sexually very passionate. Five days before, he was taken acutely ill mentally. He made two attempts at rape in broad daylight, before witnesses, and when arrested talked in delirium only of obscene things, and masturbated without stint, and for three days had been raving mad. On admission he presented the picture of a severe acute delirium, with violent motor symptoms of irritation, and fever. Under treatment with ergotin a cure was effected.

On January 5, 1888, second admission, in a state of violent mania. On January 4, he had become morose, irritable, whining, and sleepless; and then, after vain assaults on women, had manifested symptoms of increasing angry excitement.

On January 6, progress of the condition to severe acute delirium (great disturbance of consciousness, jactation, grinding of the teeth, grimacing, and other motor symptoms of irritation; temperature as high as 40.7° C.); impulsive masturbation. Recovery was complete by January 11, under energetic treatment with ergotin.

After his recovery the patient gives an interesting account of the cause of his illness. Always very passionate sexually; first coitus at the age of sixteen. Continence caused headache, great psychical irritability, lassitude, great loss of pleasure in work, and sleeplessness. Since he had few opportunities in the country to satisfy his desire, he had recourse to masturbation. It was necessary for him to masturbate once or twice daily. No coitus in two months. Increasing sexual excitement; could think of nothing save means for the gratification of his impulse. Masturbation was not sufficient to banish the constantly increasing torment ex abstinentia. During the last four days violent impulse to coitus; increasing sleeplessness and irritability. There was only a summary recollection of the height of the illness. Patient recovered in December. A very respectable man; he considers his inordinate desire decidedly pathological, and is anxious about his future.

Case 15. On July 11, 1884, R., aged 33, 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 indulgences. Later, abusus coitus in marriage cum uxore. Now and then even perverse impulse to commit cunnilingus and to administer cantharides to his wife, because her libido did not equal his own. His wife died after a short period of married life. Patient’s circumstances became straightened, and he had no means to indulge himself sexually. Then masturbation again; employment of lingua canis to induce ejaculation. At times, priapism and conditions approaching satyriasis. He was then driven to masturbate, in order not to become stuporous. Beneficial diminution of the libido nimia, with the gradually predominating sexual neurasthenia and hypochondria.

The following case, valuable for an understanding of many Messalinas, some of whom are historically celebrated, is a classical example of pure hyperæsthesia sexualis, which I take from Trelat’s “Folie lucide”:—

Case 16. Mrs. V. has suffered with a passion for men since her earliest youth. Of good family, well bred, of pleasant disposition, exceedingly modest, she was, as a little girl, a terror to her family, because she could scarcely be alone with a person of the opposite sex, no matter whether it was with child or man of any age, without exposing herself immediately and demanding satisfaction for her sexual passion, even going so far as to lay hold of him. An attempt was made to cure her by marriage. She loved her husband passionately, but even with him she could not keep from demanding coitus of every one with whom she could be alone, no matter whether it was servant, laborer, or school-boy.

Nothing could cure her of this impulse. Even when she became a grandmother, she was still a Messalina. One day she locked a twelve-year-old boy in her room and tried to seduce him. The boy defended himself and escaped. She was severely punished by his brother. All was in vain. She was put in a cloister. There she was an example of morality, and gave not the slightest cause for blame. Immediately after her return the scandal began again. The family banished her, and set aside money to support her. She earned by her own hand-work enough to buy herself lovers. Any one seeing this neatly dressed matron, of good manners and amiable disposition, would never suspect how recklessly passionate she still was at the age of sixty-five. On January 7, 1854, her family, in despair at new scandals, placed her in an asylum. She lived there until May, 1858, when she died of apoplexia cerebri, in her seventy-third year. Her conduct in the asylum was exemplary. Left to herself, and under favorable conditions, her sexual impulses manifested themselves shortly before her death. With the exception of this, during an observation of four years by physicians of the asylum, she never showed a sign of mental abnormality.

D. Paræsthesia of Sexual Feeling (Perversion of the Sexual Instinct).

In this condition there is perverse emotional coloring of the sexual ideas. Ideas physiologically and psychologically 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 opposing ideas with corresponding feelings of disgust; or the influence of such opposing concepts may be impossible on account of the absence or loss of all ideas of morality, æsthetics, and law. This loss, however, is only too frequently found where the spring of ethical ideas and feelings (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 correspond with the purpose of nature,—i.e., propagation,—must be regarded as perverse. The perverse sexual acts resulting from paræsthesia are of the greatest importance clinically, socially, and forensically; and, therefore, they must here receive careful consideration; all æsthetic and polite disgust must be overcome.

Perversion of the sexual instinct, as will be seen from what follows, is not to be confounded with perversity in the sexual act; since the latter may be induced by conditions which are not psychopathology. The concrete perverse act, monstrous as it may be, is not decisive. In order to differentiate between disease (perversion) and vice (perversity), one must investigate the whole personality of the individual and the original impulse leading to the perverse act. Therein will be found the key of diagnosis (v. infra).

Paræsthesia may occur in combination with hyperæsthesia. This association seems to be frequent clinically. Sexual acts are then confidently to be expected. The perverse direction of sexual activity may be toward sexual satisfaction with the opposite or the same sex. Thus two great groups of perversions of the sexual life may be distinguished.

1. Sexual Inclination toward Persons of the Opposite Sex, with Perverse Activity of the Instinct.

1. Association of Active Cruelty and Violence with Lust—Sadism.—That lust and cruelty frequently occur together is a fact that has long been recognized and not infrequently observed. Writers of all kinds have called attention to this phenomenon. The not infrequent cases where individuals of very excitable sexual natures bite or scratch the companion in intercourse fall within physiological limits. The older authors have called attention to the relation between lust and cruelty.

Blumröder (“Ueber Irresein,” Leipzig, 1836, p. 51) saw a man who had several wounds bitten into the pectoral muscle, which a woman, in great sexual excitement, had given him at the acme of lustful feeling during coitus. Blumröder (“Ueber Lust und Schmerz,” Friedreich’s Magazin für Seelenkunde, 1830, ii, 5) calls especial attention to the psychological connection between lust and murder. In relation to this, he especially refers to the Indian myths of Siva and Durga (Death and Lust); to human sacrifice with sensual 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, 1874) also cites numerous examples of the occurrence of a desire to murder with greatly increased lust.

On the other hand, when murderous lust has been excited, lust itself often follows. Lombroso (op. cit.) alludes to the fact, mentioned by Mantegazza, that, with fear of being plundered by bandits, there was always a dread of brutal lust. These examples form transitions to the pronounced pathological cases.

The examples of the degenerate Cæsars (Nero, Tiberius) are also instructive. They took delight in having youths and maidens slaughtered before their eyes. Not less so is the history of that monster, Marschalls Gilles de Rays (Jacob, “Curiosités de l’histoire de France,” Paris, 1858), who was executed in 1440, on account of mutilation and murder, which he had practiced for eight years on more than eight hundred children. As the monster confessed it, it was from reading Suetonius and the descriptions of the orgies of Tiberius, Caracalla, etc., that the idea was gained of 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 children were burned, and only a number of heads of particularly beautiful children were preserved—as memorials.

In an attempt to explain the association of lust and cruelty, it is necessary to return to a consideration of the quasi-physiological cases, in which, at the moment of most intense lust, very excitable individuals, who are otherwise normal, commit such acts as biting and scratching, which are usually the result of anger. It must further be remembered that love and anger are not only the most intense emotions, but also the only two forms of active (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 stand-point it is clear how lust impels to acts that otherwise are expressive of anger. The one, like the other, is a state of exaltation, an intense excitation of the whole psycho-motor sphere. Thus there arises an impulse to react on the object that induces the stimulus, in every possible way, and with the greatest intensity. Just as maniacal exaltation easily passes to furibund destructiveness, exaltation of the sexual emotion often induces an impulse to expend itself in senseless and apparently harmful acts. To a certain extent these are psychical accompaniments; but it is not simply an unconscious excitation of innervation of muscles (which also sometimes occurs as blind violence); it is a true hyperbulia, a desire to exert the most intense effect on the individual giving rise to the stimulus. The most intense means, however, is the infliction of pain.

Through such cases of infliction of pain, during the most intense emotion of lust, we approach the cases in which a real injury, wound, or death, is inflicted on the victim. In these cases, the impulse to cruelty, which may accompany the emotion of lust, becomes unbounded in a psychopathic individual; and, at the same time, owing to defect of moral feeling, all normal inhibitory ideas are absent or weakened. Such monstrous, sadistic acts have, however, in men, in whom they are much more frequent than in women, another source in physiological conditions. In the intercourse of the sexes, the active or aggressive rôle belongs to man; woman remains passive, defensive. It affords a man great pleasure to win a woman, to conquer her; and in the ars amandi, the modesty of a woman who keeps herself on the defensive until the moment of surrender, is an element of great psychological significance and importance. Under normal conditions a man meets obstacles which it is his part to overcome, and for which nature has given him an aggressive character. This aggressive character, however, under pathological conditions, may likewise be excessively developed, and express itself in an impulse to subdue absolutely the object of desire, even to destroy or kill it.

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

Sadism is thus nothing else than an excessive and monstrous pathological intensification of phenomena,—possible, too, in normal conditions in rudimental forms,—which accompany the psychical vita sexualis, particularly in males. It is, of course, not at all necessary, and not even the rule, that the sadistic individual should be conscious of his instinct. What he feels is, as a rule, only the impulse to cruel and violent treatment of the opposite sex, and the coloring of the idea of such acts with lustful feelings. Thus arises a powerful impulse to commit the imagined deeds. When the actual motive of this instinct is not comprehended by the individual, the sadistic acts have the character of impulsive deeds.

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

A differentiation of original and acquired cases of sadism is scarcely possible. Many individuals, tainted ab origine, for a long time do everything to conquer the perverse instinct. If they are potent, at first they are able to lead a normal vita sexualis, often with the assistance of subjective ideas of a perverse nature. Later, after the opposing motives of an ethical and æsthetic kind have been gradually overcome, and after the constantly repeated experience that the natural act does not bring complete satisfaction, the abnormal instinct bursts forth. Owing to this late expression, in acts, of an originally perverse disposition, the appearances are those of an acquired perversion. As a rule, it may be safely assumed that this psychopathic state exists ab origine.

Sadistic acts vary in monstrousness with variation in the power of the perverse instinct over the individual afflicted, and with variation in the strength of opposing ideas that may be present, which almost always are more or less weakened by original ethical defect, hereditary degeneracy, or moral insanity. Thus there arises a long series of forms which begins with capital crime and ends with silly acts which afford the perverse desires of the sadistic individual merely symbolic satisfaction.

Sadistic acts may be further differentiated with reference to their nature: either as they are indulged in after consummated coitus by which the libido nimia remains unsatisfied; or, with diminished virility, as they are used to stimulate the diminished power; or, finally, where virility is absolutely wanting, as they become an equivalent for the impossible coitus, for the induction of ejaculation. In the last two cases, notwithstanding the impotence, there is still intense libido; or there was, at least, intense libido in the individual at the time when the sadistic acts became habitual. Sexual hyperæsthesia is always to be regarded as the basis of sadistic inclinations. The impotence which occurs so frequently in the psychopathic and neuropathic individuals here considered, as a result of excesses indulged in from early youth, is usually dependent upon spinal weakness. Often, too, there is a kind of psychical impotence, induced by concentration of thought on the perverse act with simultaneous fading of the idea of normal satisfaction. No matter what the external form of the act may be, the mentally perverse predisposition and instinct of the individual are essential to an understanding of it.

(a) Lust-Murder (Lust Potentiated as Cruelty, Murderous Lust Extending to Anthropophagy).—The most horrible example, and one which most pointedly shows the connection between lust and a desire to kill, is the case of Andreas Bichel, which Feuerbach published in his “aktenmässige Darstellung merkwürdiger Verbrechen.”

B. puellas stupratas necavit et dissecuit. With reference to one of his victims, at his examination he expressed himself as follows: “I opened her breast and with a knife cut through the fleshy parts of the body. Then I arranged the body as a butcher does a beef, and hacked it with an axe into pieces of a size to fit the hole which I had prepared 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 choking prostitutes, post-actum, and said: “I am fond of women, but it is sport for me to choke them after having enjoyed them.”

A certain Grassi (Lombroso, op. cit., p. 12) was one night seized with sexual desire for a relative. Irritated by her remonstrance, he stabbed her several times in the abdomen with a knife, and also stabbed her father and uncle who attempted to hold him back. Immediately thereafter he hastened to visit a prostitute in order to cool his sexual passion in her arms. But this was not sufficient. He then murdered his father and slaughtered several oxen in the stable.

It cannot be doubted, from what has gone before, that a great number of so-called lust-murders depend upon a combination of hyperæsthesia and paræsthesia sexualis. As a result of this perverse coloring of the feelings, further acts of bestiality with the body 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’hygiène publique), who was examined by Lasègue, Brouardel, and Motet, declared to be mentally sound, and executed.

Case 17. A four-year-old girl was missing from her parents’ home, April 15, 1880. On April 16th, Menesclou, 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-burned condition, were taken from the stove. Parts of the body were found in the water-closet. The genitals could not be found. M., when asked their whereabouts, became embarrassed. The circumstances, as well as an obscene poem found on his person, left no doubt that he had violated the child and then murdered her. M. expressed no remorse, asserting that his deed was an accident. His intelligence is limited. He presents no anatomical signs of degeneration; is somewhat deaf, and scrofulous.

M., aged 20; convulsions at the age of nine months. Later, he suffered from poor sleep (enuresis nocturna); was nervous, and developed tardily and imperfectly. From the time of puberty he was irritable, showed evil inclinations; was lazy; could not be taught, and in all trades proved, to be of no use. He grew no better even in the House of Correction. He was made a marine, but there, too, he proved useless. When he returned home he stole from his parents, and spent his time in bad company. He did not run after women, but gave himself up passionately to masturbation, and occasionally indulged in sodomy with bitches. His mother suffered with mania menstrualis periodica. An uncle was insane, and another an inebriate. 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 convolutions.

Case 18. Alton, a clerk in England, goes out of town for a walk. He lures a child into a thicket, and returns after a time to his office, where he makes this entry in his note-book: “Killed to-day a young girl; it was fine and hot.” The child was missed, searched for, and found cut into pieces. Many parts, and among them the genitals, could not be found. A. did not show the slightest trace of emotion, and gave no explanation of the motive or circumstances of his horrible deed. He was a psychopathic individual, and occasionally subject to states of depression with tædium vitæ. His father had had one attack of acute mania. A near relative suffered from mania with homicidal impulses. A. was executed.

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

Case 19. Leger, vine-dresser, aged 24. From youth moody, silent, shy of people. He starts out in search of a situation. He wanders about eight days in the forest, there catches a girl twelve years old, violates her, mutilates her genitals, tears out her heart, eats of it, drinks the blood, and buries the remains. Arrested, at first he lied, but finally confessed his crime with cynical cold-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 (Gorget, “Darstellung der Prozesse Leger, Feldtmann,” etc., Darmstadt, 1827).

Case 20. Tirsch, hospital beneficiary of Prag, aged 55, always silent, peculiar, coarse, very irritable, grumbling, revengeful, was sentenced to twenty years’ imprisonment, on account of violating a girl ten years old. He had attracted attention on account of outbursts of anger from insignificant causes, and also on account of tædium vitæ. 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 July 8th he went about with the intention of killing one of this hated sex. Vetulam occurentem in silvam allexit, coitum poposcit, renitentem prostravit, jugulum feminæ compressit “furore captus.” Cadaver virga betulæ desecta verberare voluit neque tamen id perfecit, quia conscientia sua hæc fieri vetuit, cultello mammae et genitalia desecta domi cocta proximis diebus cum globis comedit. On September 12th, when he was arrested, the remains of this meal were found. He gave as the motive of this act “inner impulse.” He himself wished to be executed because he had always been persecuted. In confinement there were great emotional irritability and occasional outbursts of fury, preceded by refusal of food, which made isolation, lasting several days, necessary. It was authoritatively established that the most of his earlier excesses were coincident with outbreaks of excitement and fury (Maschka, Prager Vierteljahrsschrift, 1866, i, p. 79).

The Whitechapel murderer, who still eludes the vigilance of the police, probably belongs in this category of psycho-sexual monsters. The constant absence of uterus, ovaries, and labia, in the victims (ten) of this modern Bluebeard, allows the presumption that he seeks and finds still further satisfaction in anthropophagy.

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 prototype 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 January 11, 1872, in prison; is 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 27; (3) of an attempt to strangle a married woman, Gala, by grasping her throat while kneeling on her body; (4) on suspicion of the following murders:—

In December a fourteen-year-old girl, Johanna Motta, set out for a neighboring village between seven and eight o’clock in the morning. Since 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 opened 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 neighborhood 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 August 28, 1871, a married woman, Frigeni, aged 28, set out in the fields early in the morning. Since 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 slit open, and the intestines were hanging out.

On August 29, at noon, as Maria Previtali, aged 19, 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 there were any one near, the girl got up and, by her supplicating entreaty, induced Verzeni to let her go, after he had pressed her hands together for some time.

Verzeni was brought before a court. He is twenty-two years old. His cranium is of more than average size, but asymmetrical. The right frontal bone is narrower and lower than the left, the right frontal prominence being less developed, and the right ear smaller than the left (by 1 centimetre in length and 3 centimetres in breadth); both ears are defective in the inferior half of the helix; the right temporal artery is somewhat atheromatous. Bull-necked; enormous development of the zygomæ and inferior maxilla; penis greatly developed, frænum wanting; slight divergent alternating strabismus (insufficiency of the internal rectus muscle, and myopia). Lombroso concludes, from these signs of degeneration, that there is a congenital arrest of development of the right frontal lobe. As seemed probable, Verzeni has a bad ancestry,—two uncles are cretins; a third, microcephalic, beardless, one testicle wanting, the other atrophic. The father shows traces of pellagrous degeneration, and had an attack of hypochondria pellagrosa. A cousin suffered from cerebral hyperæmia; another is a confirmed thief.

Verzeni’s family is bigoted and low-minded. He himself has ordinary intelligence; knows how to defend himself well; seeks to prove an alibi and cast suspicion on others. There is nothing in his past that points to mental disease, but his character is peculiar. He is silent and inclined to be solitary. In prison he is cynical. He masturbates, and makes every effort to gain sight of women.

Verzeni finally confessed his deeds and their motive. The commission of them gave him an indescribably pleasant (lustful) feeling, which was accompanied by erection and ejaculation. As soon as he had grasped his victim by the neck, sexual sensations were experienced. It was entirely the same to him, with reference to these sensations, 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. His satisfaction in this garroting was greater than in masturbation. The abrasions of the skin on Motta’s thighs were produced by his teeth, while sucking her blood in most intense lustful pleasure. He had torn out a piece of flesh from her calf and taken it with him to roast at home; but on the way he hid it under the straw-stack, for fear his mother would suspect him. He also carried pieces of the clothing and intestines some distance, because it gave him great pleasure to smell and touch them. The strength which he possessed in these moments of intense lustful pleasure, was enormous. He had never been a fool; while committing his deeds he saw nothing around him (apparently as a result of intense sexual excitement, annihilation of apperception—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 inclinations 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, experiencing during the act erections and real sexual pleasure. It was even a pleasure only to smell female clothing. The feeling of pleasure while strangling them was much greater than that which I experienced while masturbating. I took great delight in drinking Motta’s blood. It also gave me the greatest pleasure to pull the hair-pins out of the hair of my victims.

“I took the clothing and intestines, because of the pleasure it gave me to smell and touch them. At last my mother came to suspect me, because she noticed spots of semen on my shirt after each murder or attempt at one. I am not crazy, but in the moment of strangling my victims I saw nothing else. After the commission of the deeds I was satisfied and felt well. It never occurred to me to 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 entirely independently, after having noticed, when he was twelve years old, that he experienced a peculiar feeling of pleasure while wringing the necks of chickens. After this he had often killed great numbers of them, and then said that a weasel had been in the hen-coop (Lombroso, Goltdammer’s Archiv, Bd. xxx, p. 13).

Lombroso mentions an analogous case (Goldtdammer’s Archiv) which occurred in Vittoria (Spain):—

Case 22. A certain Gruyo, aged 41, 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 the preceding horrible group of perversions of the sexual instinct, which arise from hyperæsthesia and paræsthesia sexualis with retained virility, come naturally the necrophiles; for 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 healthy person would shudder, is accompanied by lustful feelings, and thus leads to the impulse to indulge in acts of necrophilia.

The cases of mutilation of bodies mentioned in literature seem to be pathological; but, with the exception of the celebrated one of Sergeant Bertrand (v. infra), they come far from being described and observed with exactness. 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 is perhaps such a one:—

A man, aged 23, attempted to rape a woman, aged 53. Struggling, he killed her and then violated 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 adherent to the cortex.

French writers have recorded numerous examples of necrophilia. Two cases concerned monks, where they were 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, and there mutilated female bodies in the mortuary.

In other cases, however, there is undoubtedly direct preference of a corpse to the living woman. When no other act of cruelty—cutting into pieces, etc.—is practiced 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 subjugation, without possibility of resistance.

Brierre de Boismont (Gazette médicale, July 21, 1859) relates the history of a corpse-violator who, after bribing the watchman, had gained entrance to the corpse of a girl of sixteen, who belonged 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 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 was afterward ascertained that the culprit, a man of good family, had often violated the bodies of young women. He was sentenced to imprisonment for life.

The story of a prelate, reported by Taxil (“La prostitution contemporaine,” p. 171), is of great interest as an example of necrophilia. From time to time he would visit houses of prostitution in Paris and order a prostitute, dressed in white like a corpse, to be laid out on a bed. 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 on the girl, who, during the whole time, was compelled to play the rôle of a corpse.

The cases in which the perpetrator injures and cuts up the corpse are clearer. Such cases come next to those of lust-murder, in that, in these individuals, 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 rôle.

Case 23. Sergeant Bertrand, a man of delicate physical constitution and of peculiar character; from childhood silent and inclined to solitude.

The details of the health of his family are not satisfactorily known; but the occurrence of mental diseases in his ancestry is ascertained. It is said that while he was a child he was affected with destructive impulses, which he himself could not explain. He would break whatever was at hand. In early childhood, without teaching, he learned to masturbate. At nine he began to feel inclinations toward 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 thereafter he would think of them as corpses, and of how he defiled them. Occasionally, in such situations, the thought of carrying out a similar act with male corpses would come up, but it was always attended with a feeling of disgust.

In time he felt the impulse to carry out such acts with actual corpses. For want of human bodies, he obtained those of animals. He would cut open the abdomen, tear out the entrails, and masturbate during the act. He declares that in this way he experienced inexpressible pleasure. In 1846 these bodies no longer satisfied him. He now killed dogs, and proceeded with them as before. Toward the end of 1846 he first felt the desire to make use of human bodies. At first he had a horror of it. In 1847, being by accident in a grave-yard, he ran across the grave of a newly-buried corpse. Then this impulse, with headache and palpitation of the heart, became so powerful that, although there were people near by, and he was in danger of detection, he dug up the body. In the absence of a convenient instrument for cutting it up, he satisfied himself by hacking it with a shovel.

In 1847 and 1848, during two weeks, as reported, the impulse, accompanied by violent headache, to commit brutalities on corpses, actuated him. Amidst the greatest dangers and difficulties, he satisfied this impulse some fifteen times. He dug up the bodies with his hands, in nowise sensible, in his excitement, to the 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 ascertained that this modern vampire had dug up more female than male corpses. During these acts he declares himself to have been in an indescribable state of sexual excitement. After having cut them up, he had sometimes reinterred the bodies.

In July, 1848, he accidentally came across the body of a girl of sixteen. Then, for the first time, he experienced a desire to carry out coitus on a cadaver. “I covered it with kisses and pressed it wildly to my heart. All that one could enjoy with a living woman is nothing in comparison with the pleasure I experienced. After I had enjoyed it for about a quarter of an hour, I cut the body up, as usual, and tore out the entrails. Then I buried the cadaver again.” Only after this, as B. declares, had he felt the impulse to use the bodies sexually before cutting them up, and thereafter he had done it in three instances. The actual motive of the exhuming of 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; therefore, he had always cut up the body afterward or mutilated another body. The medico-legal examiners gave an opinion of “monomania.” Court-martial sentence to one year’s imprisonment. (Michéa, Union méd., 1849; Lunier, Annal. méd.-psychol., 1849, p. 153; Tardieu, “Attentats aux moeurs,” 1878, p. 114; Legrand, “La folie devant les tribun.,” p. 524.)

(c) Injury of 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 for degenerate men. The notorious Marquis de Sade, after whom the combination of lust and cruelty has been named, was such a monster. Coitus only excited him when he could prick the object of his desire until the blood came. His greatest pleasure was to injure prostitutes and then bind their wounds.

Here also belongs the case of a captain mentioned by Brierre 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 anæmic and, as a result of this, insane.

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

Case 24. Mr. X., aged 25; father syphilitic, died of paretic dementia; mother hysterical and neurasthenic. He is a weak individual, constitutionally neuropathic, and presents several anatomical signs of degeneration. When a child, hypochondria and imperative conceptions; later, constant alternation of exaltation and depression. While yet a child of ten, the patient felt a peculiar lustful desire to see blood flow from his fingers. Thereafter he 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 saw a servant-girl cut her finger it gave him an intense lustful feeling. From this time his vita sexualis became more and more powerful. Without any teaching he began to masturbate, and always during the act there were memory-pictures of bleeding girls. 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. Often he could scarcely overcome the impulse to injure two cousins and a certain servant. But also young women that were in themselves not attractive induced this impulse when they excited him by some peculiarity of dress or adornment, especially coral jewelry. It was necessary for him to overcome these desires; but in his imagination bloody thoughts were constantly present, and induced lustful excitement. There was an inner relation existing between both thoughts and feelings. Often there were other cruel fancies. He imagined himself in the rôle of a tyrant who had the people shot in crowds with grape-shot. He was compelled to fancy a scene as it would be if enemies were to take a city and mutilate, torture, kill, and rape the young women. In times of quiet this patient, who had a mild disposition and was not morally defective, was shamed and horrified by such cruel, lustful fancies, and they always became immediately latent as soon as his sexual excitement had been satisfied by masturbation.

After a few years the patient became neurasthenic. Then simple imaginary representation of blood and scenes of blood was sufficient 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 assistance of this idea no erection was possible. The cruel thought of cutting was limited to the woman’s hand. At times of greatest sexual excitement, simply the sight of the hand of an attractive woman was sufficient to induce 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 tædium vitæ. Careful and watchful medical treatment cured the patient after a few months. He has remained mentally well three years; but now, as before, he is very sensual, though it is very seldom that he is troubled by his earlier bloody ideas. X. has given up masturbation entirely. He finds satisfaction in natural sexual indulgence, is virile, and it is no longer necessary for him to call up ideas of blood.

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

Case 25. Z., physician; neuropathic constitution, reacting badly to alcohol. Under ordinary circumstances capable of normal coitus, as soon as he has indulged in wine he finds that his increased libido is no longer satisfied by simple coitus. In this condition he is compelled to prick the nates puellæ or to make stabs with the lancet, to see blood, and feel the entrance of the blade into the living body, in order to have ejaculation and experience complete satiety of his lust.

The majority of those afflicted with this form of the perversion seem insensible to the normal stimulus of woman. In the first case (24), the assistance of the idea of blood was necessary in order to obtain erection. The following case 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 26. The girl-stabber of Bozen (reported by Demme, “Buch der Verbrechen,” Bd. ii, p. 341). In 1829, H., aged 30, soldier, became the subject of legal investigation. At different times and in different places, he had wounded girls with bread-knives or pocket-knives, by stabbing them in the abdomen, probably in the region of the genitals. He gave, as a motive for these acts, heightened sexual impulse, 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 had a satisfaction like that of completed coitus, which was increased by the sight of the blood that ran from the knife. In his tenth year the sexual instinct became powerfully manifest. At first he gave himself up 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 to practice masturbation on him, and by sodomy. Gradually the thought came to him of how pleasurable it would be to stab a young and pretty girl in the region of the genitals, and take delight in the sight of the blood running from the knife.

Among his effects were found copies of objects of art and obscene pictures, painted by himself, of Mary’s conception, and of the “congealed thought of God” in the lap of the Virgin. He was considered a peculiar, very irritable man, shy of people, given to women, moody, and glum. He was apparently a person that had become impotent through earlier sexual excesses, and who was thus predisposed, by the continuance of intense libido sexualis, and heredity, to perversion of the sexual life.

Case 27. In the “sixties” the inhabitants of Leipzig were frightened by a man who was accustomed to attack young girls on the street and stab them in the upper-arm with a dagger. Finally arrested, he was recognized 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. (Wharton, “A Treatise on Mental Unsoundness,” § 623. Philadelphia, 1873.)

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

Case 28. The girl-cutter of Augsburg (reported by Demme, “Buch der Verbrechen,” vii, p. 281). Bartle, wine-merchant. He was subject to lively sexual excitement at the age of fourteen, though decidedly opposed to its satisfaction by coitus, his aversion going so far as disgust for the female sex. At that time he already had the idea to cut girls, and thus satisfy his sexual desire. He refrained from it, however, on account of lack of opportunity and courage. He practiced masturbation, and now and then had pollutions with erotic dreams of girls that had been cut. At the age of nineteen he first cut a girl. During the act he had a seminal emission, and experienced intense pleasure. From that time the impulse became 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. Until thirty-two years old he carried on this process of cutting, but always with care 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 and not to ejaculation. Then he sought to attain his object by pricking the girls with a knife 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 had more pain than one that was merely, cut. In his thirty-seventh year he was detected and arrested. In his dwelling was found a collection of daggers, sword-canes, and knives. He said that the mere sight of these weapons, and still more the grasping of them, gave him an intense feeling of sensual pleasure, with violent excitement. According to his confession he had injured, in all, fifty girls. His external appearance was rather pleasing. He lived in very good circumstances, but was peculiar and shy.

Case 29. J. H., aged 25, in 1883 came for consultation concerning severe neurasthenia and hypochondria. Patient confesses that he has practiced onanism since his fourteenth year, infrequently up to his eighteenth year; but since that time he has been unable to resist the impulse. Up to that time he had no opportunity to approach females, for he had been anxiously cared for and never left alone, on account of his invalidism. He had had no real desire for this unknown pleasure; but he accidentally learned what it was when one of his mother’s maids cut her hand severely on a pane of glass she had broken while washing windows. While helping to stop the blood he could not keep from sucking up the blood that flowed from the wound, and in the act he experienced extreme erotic excitement, with complete orgasm and ejaculation.

From this time, in every possible way, he sought to see, and if possible 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 success frequently enough, though with some difficulty. In the intervals he practiced onanism and manustupration per feminam, which, however, never afforded him complete satisfaction, but, on the contrary, caused listlessness and self-reproach. On account of his nervous difficulties he visited many sanitariums, and he was twice a voluntary patient in institutions. He used hydrotherapy, electricity, and strengthening cures, without particular success. For a time it was possible, by means of cold sitz-baths, monobromate of camphor, and bromides, to diminish his sexual excitability and onanistic impulse. However, when the patient felt himself free again, he would immediately fall into his old passions and spare no pains or money in order to satisfy his sexual desire in the abnormal manner described.

Case 30 (communicated by Dr. A. Moll, Berlin). L. T., aged 21; merchant in a Rhenish city. He belongs to a family in which there are several nervous and psychopathic members. A sister suffers with hysteria and melancholia.

The patient was always of quiet disposition and timid. At school he frequently kept apart from other pupils, particularly when they talked about girls. In the presence of ladies he thought every expression he made was an offense against decency. Thus, for example, he thought it very improper, in the presence of ladies, married or unmarried, to speak of going to bed, rising, etc. In the elementary classes the patient learned well. Later he became more indolent and did not make good progress.

August 17, 1890, the patient visited Dr. Moll on account of abnormal symptoms of a sexual kind. He did this on the advice of a physician, X., a relative, in whom he had previously confided. The patient conveys the impression of being very apprehensive and shy, and in answer to questions says that he is very timorous, and that particularly in the presence of others all his self-confidence and assurance leave him. Dr. X. confirmed this statement.

The beginning of his sexual life the patient was able to refer to his seventh year. At that age he frequently played with his genitals, and was often punished for it. In this onanism, in which he said he had erection, he constantly thought of whipping a woman on the naked nates with a rod until the skin raised in weals. “It delighted me,” said the patient, “when I thought that she was a proud, beautiful lady, and that I performed the act in the presence of others, especially women, particularly with the idea that she might feel the power I had over her. For this reason I early sought reading about punishment, e.g., about the abuse of Roman slaves. However, I had erections only when the conceived abuse consisted of blows delivered on the back or nates. At first I thought this kind of excitement would disappear in time, and said nothing about it to any one.”

Masturbation, early indulged in, the patient continued to practice, and always with the same thought. After his thirteenth or fourteenth year he had ejaculation with the act. Decimum septimum annum agens primum feminam adiit coëundi causa neque coitum perficere potuit libidine et erectione deficientibus. Mox autem iterum apud alteram coitum conatus est nullo succesu. Tum feminam per vim verberavit. Tantopere erat excitatus ut mulierem dolore clamantem atque lamentantem verberare non desierit. He never thought of any legal punishment for his acts, and, in fact, escaped it. In this procedure erection, orgasm, and ejaculation occurred. The patient performed the act in such a way that he took the woman between his knees, with the penis in contact with her body, but without emissio penis in vaginam, which seemed entirely superfluous to him.

But the patient afterward experienced such a feeling of shame about the beating, and was overcome with such great depression, that he often contemplated suicide. In the following three years he still visited women occasionally. But he never again asked one to allow him to beat her. He sought to obtain erection by thinking of the beating; but this was without result, and manustupration by the woman did not induce erection. Finally, after an unsuccessful attempt of this kind, the patient determined to give his confidence to a physician.

The patient made several other statements concerning his vita sexualis. His abnormal sexual desire had troubled him by its intensity. He went to sleep with sexual thoughts; they troubled him through the night and were still with him when he awoke. He was never safe for any length of time from the impulsion of the abnormal ideas that excited him; to which, indeed, he gave himself up willingly, and from which he could free himself for a short time only by onanism.

In response to my question, the patient stated that any other means of punishment of women than beating the back, and nates particularly, had no charm for him. Neither binding them, walking on them, nor striking them, gives him such pleasure. This is to be emphasized the more, since the whipping given the woman affords him sexual pleasures because its effect on her is “humiliating, mortifying,” and because she should “feel that she is completely in his power.” Too, it would give the patient no pleasure to beat a woman on any other part of her body than those mentioned, or to cause her pain in any other way than by blows. Multum minorem ei affert voluptatem si nates suæ a muliere verberantur; tamen ea res sæpe ejaculationem seminis effecit, sed hæc fieri putat erectione deficienti. Inter verbera autem penem in vaginam immittendo nullam voluptatem se habere ratus qualibet parte corporis feminæ pene tacte semen ejaculat. Just as in beating the woman his pleasure lay in humiliating her, so with the relations reversed he was sexually excited by the fact that the beating humiliated him and he felt himself to be completely in the woman’s power. No other personal humiliation than a beating on his nates could excite him. To allow himself to be bound or walked on by a woman is repugnant to him.

The patient’s dreams, as far as they were of an erotic nature, were directed in the same way as his sexual inclinations while awake; actual ejaculation also often took place in dreams. Whether the perverse sexual thoughts first occurred in dreams or the waking state, the patient is not able to state, owing to the fact that his memory goes back so far,—to his seventh year. But he thinks that these thoughts first occurred to him while awake. In his dreams it frequently seemed to him that he was striking a man, which also caused ejaculation. In the waking state it excited him but very little to think of striking a man. The nude form of a man had no attraction whatever for him, while the nude form of a woman had a decided charm for him, though his libido found its real satisfaction only when the acts previously described took place; and, as he states, he feels no desire for coitus in vaginam.

The treatment of the patient is directed to the attainment of normal coitus with normal desire, where possible; for it may be assumed that, with success in making his sexual life normal, the patient’s shyness and apprehensiveness, which cause him great annoyance, may be much easier removed. The treatment followed by me (Dr. Moll) during three months and a half was as follows:—

1. The patient, who had a great desire to be cured, was most strictly forbidden to give himself up to the perverse thoughts. Of course, I did not give him the foolish advice not to think of blows at all. The patient could not follow such advice, since the thoughts come to him without any act of his own, even when he accidentally reads the word “blow” (schlagen). I forbade him only ever to voluntarily give himself to such thoughts. I advised him more particularly to do everything in order to turn his ideas in another direction.

2. I allowed him, commanded him even, to think of nude women, because many nude females interested him, even though, as he thought, they did not excite him sexually.

3. I sought, by means of hypnosis—which was hard to induce—and suggestion, to fortify the patient in this as far as possible. All attempts at coitus were forbidden in order to save the patient from a discouraging result.

Within two months and a half this treatment led to the result that, as the patient stated, the perverse ideas occurred much less frequently and were constantly retreating to the background; indeed, according to the patient’s statement, erections occurred with the thoughts of nude women, became more frequent, and often induced him to masturbate with the thought of coitus without the occurrence of any idea of blows. Erotic dreams occurred but infrequently. These were concerned sometimes with normal coitus, sometimes with blows.

After two months and a half of the treatment I advised the patient to attempt coitus. Since then he has tried four times. I advised him to choose always a woman who pleased him, and sought to increase his sexual excitement before coitus by means of tincture of cantharides. The four attempts, the last of which took place on November 29, 1890, resulted as follows: At the first, prolonged manipulation of the penis by the woman was necessary in order to induce erection. Then immisio in vaginam and ejaculation with orgasm took place. During the whole act there occurred no thought of beating the woman or being beaten, but the woman in herself excited him sufficiently for the performance of coitus. At the second attempt the result was better and more quickly attained; manipulation ad genitalia by the woman was not long required. In the third attempt coitus was attained only after the patient had thought of beating for a long time, and had thus induced erection; but beating was not indulged in. At the fourth attempt coitus was attained without any thought of beating and without any manipulation ad genitalia.

Of course, the case described cannot yet be regarded in any way as cured. Though the patient were able to perform coitus in a normal or nearly normal way, that does not mean that he will always be able to do it in the future; moreover, the thought of beating still affords him great pleasure, even though it occurs much less frequently than formerly. Yet there is a possibility that the abnormal desire, which has been weakened, will remain weakened in the future, and perhaps disappear.

This carefully observed case is, for several reasons, particularly interesting. 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 decidedly timid, and in other respects modest and even apprehensive. The case also shows clearly that powerful libido, which even impels the individual to overcome all obstacles, may be present, while at the same time coitus is not desired, because the principal intensity of feeling is, ab origine, connected with the cruel part of the sadistic (lustful and cruel) circle of ideas. This case also contains weak elements of masochism (v. infra).

Cases are by no means infrequent in which men with perverse inclinations induce prostitutes, by paying them high prices, to allow themselves to be whipped and even wounded by them. Works on prostitution contain reports of them (vide Coffignon, “La Corruption à 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 (Vierteljahrsschr. f. ger. Medicin, N. F. xvii, H. 1), belongs here:—

Case 31. A., medical student at Greifswald, accusatus quod iterum iterumque puellis honestis parentibus natis in publico genitalia sua e bracis dependentia plane nudata quæ antia summo amiculo (overcoat) tecta erant, ostenderat. Nonnunquam puellas fugientes secutus easque ad se attractas urina oblivit. Hæc luce clara facta sunt; nunquam aliquid hæc faciens locutus est.

A. is twenty-three years old, powerfully built, neat in dress, and decent in manners. Indication of cranium progeneum; chronic pneumonia of the apex of the right lung; emphysema. Pulse, 60; in excitement, not more than 70 to 80. Genitals normal. Complaints of occasional disturbances of digestion and hardness of the abdomen, vertigo; excessive excitement of the sexual desires, which early led to onanism. The sexual desire has never been directed toward a natural method of satisfaction. Complaints of occasional attacks of depression, or thoughts of deprecation of self, and of perverse impulses, for which he 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 is of a nervous temperament; his mother is subject to nervous headache. A brother suffered with epileptic convulsions.

From his youth the culprit presented a nervous temperament, was inclined to convulsions and attacks of syncope, and when he was severely scolded would fall into a state of momentary stiffness. In 1869 he studied medicine in Berlin. In 1870 he went to the war as a hospital-assistant. His letters at this time betray a peculiar torpidity and weakness. On his return home, in 1871, his emotional irritability was noticed by those about him. Thereafter frequent complaints of bodily ailments; unpleasantness resulting from a love affair. In November, 1871, he pursued his studies diligently in Greifswald. He was considered very gentlemanly. In confinement he is quiet, calm, and sometimes self-absorbed. His acts he attributes to painful sexual excitement, which of late had become excessive. He declared that he had been fully conscious of his perverse acts, and had afterward 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,—fallen a victim to an evil power. Presumption of irresponsibility, as a result of absence of free will.

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

Case 32. I knew such a patient, who had a woman dressed in a décolleté ball-dress lie down on a low sofa in a brightly lighted room. Ipse apud januam alius cubiculi obscurati constitit adspiciendo aliquantulum feminam, excitatus in eam insiluit excrementa in sinus ejus deposuit. Hæc faciens ejaculationem quandam se sentire confessus est.

An officer of Vienna informs me that men, by means of large sums of money, induce prostitutes to suffer ut illi viri in ora earum spuerent et fæces et urinas in ora explerent.

The following case by Dr. Pascal (“Igiene dell’amore”) seems also to belong here:—

Case 33. A man had an inamorata. His relation with her was that he had her allow him to blacken her hands with coal or soot, and then she had to sit before a mirror in such a way that he could see her hands in it. While conversing with her, which was often for a long time, he looked constantly at her mirrored hands, and finally, after a time, he would take his leave, fully satisfied.

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

An officer was known in a brothel in K. only by the name of “Oil.” “Oil” induced erection and ejaculation only by having puell. 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 of females (e.g., sprinkling with sulphuric acid, ink, etc.) depend upon a perverse sexual impulse; at least, here it is a kind of injury, and those injured are always females, and the perpetrators males. At least in the future, in crimes of this kind, pains should be taken to examine the vita sexualis of the culprits.

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

(e) Other Attacks 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 there is yet sufficient moral resistance, it may happen that the perverse inclination is satisfied by an act that is apparently quite senseless and silly, but which has a symbolic meaning for the perpetrator. This seems to be the meaning of the two following cases:—

Case 34. (Dr. Pascal, “Igiene dell’amore.”) A man was accustomed to go, on a certain day once a month, to an inamorata and cut her “bang.” This gave him the greatest pleasure. He made no other demands on the girl.

Case 35. A man in Vienna regularly visits several prostitutes only to lather their faces and then to remove the lather with a razor, as if he were shaving them. He never hurts the girls, but becomes sexually excited and ejaculates during the procedure.

The significance of the following cases, in which a sadistic comedy is played, is clearer:—

Case 36. A man always announces to a puella publica his intended visits. She must stand at the window, awaiting him, with her face done up, and, on his entrance into the room, complain of severe toothache. He is sorry for her, asks particularly about the pain, takes the cloth off and puts it on again; but he never has coitus, and finds his satisfaction simply in this act.

The following case, which, unfortunately, was not carefully examined scientifically, is peculiar to itself:—

In an examination before a criminal court in Vienna, the following facts were brought to light: Count N., accompanied by a young girl, appeared in the public garden of an hotel, and, by his actions there, gave public offense. He demanded of his companion that she kneel down before him and implore him with folded hands. Then she was compelled to lick his boots. Finally, he demanded of her, publicly, “an unheard-of thing” (osculum ad nates, or the like), and only desisted after she had sworn to do it at home.

In this case, the most remarkable thing was the desire of the perverse individual to humiliate the woman before witnesses (comp. the fancies of sadists, Case 29); further, that the desire to humiliate the woman came entirely into the foreground, and acts of a purely symbolic nature were undertaken. Of course, with these, in this imperfectly-observed case, acts of cruelty were probable.

(f) Sadism with Other Objects—Whipping of Boys.—Besides the sadistic acts with females described, others occur with other living, sensitive objects,—children and animals. There may be a full consciousness that the impulse is really directed toward women, and that only faute de mieux the next attainable objects (pupils) are abused. But the condition of the perpetrator may be such that the impulse to cruel acts enters consciousness accompanied only by lustful excitement, while its real object (which alone can explain the lustful coloring of such acts) remains in the dark.

The first alternative suffices as an explanation of the cases which Dr. Albert describes (Friedreich’s Blätter f. ger. Med., p. 77, 1859),—cases in which lustful teachers whipped their pupils on the naked nates without cause. We must think of the second alternative, the sadistic impulse with unconsciousness of its object, when boys are immediately excited sexually at the sight of punishment of their companions, and are thus determined in their later vita sexualis, as in the following cases:—

Case 37. K., aged 37, 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; he later became strong.

At the age of eight, while at school, he saw how the teacher punished the boys 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, during which he always called 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 frightened, and tried to overcome his impulse to masturbate; but he fell into the practice of psychical onanism, which he regarded as innocuous and morally defensible, and for which he made use of the memory-pictures of boys being whipped, previously mentioned.

Patient now became neurasthenic, suffered with pollutions, 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 recognized that he was entirely insensible to the charms of the fair sex.

The patient is an intelligent man, normally developed, and of æsthetic taste. There is no inclination to persons of his own sex. My advice consisted of means to combat the neurasthenia and pollutions; interdiction of psychical and manual onanism; avoidance of all sexual excitants; and, possibly, hypnotic treatment to ultimately induce a return of the vita sexualis to its normal condition.

Case 38. Abortive sadism. N., student, came under observation in December, 1890. He had practiced masturbation from early youth. According to his statements, he became sexually excited when he saw his father whip the children, and, later, when he saw the teacher whip his companions. 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 masturbate, but he stated with certainty that his sexual instinct was first awakened by the punishment of others, and thus he unconsciously came to practice onanism. 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. He found great sexual pleasure in it. When, however, his companion beat him in return, he experienced nothing but pain.

The impulse to beat others was never very strong. The patient experienced more satisfaction in filling his imagination with scenes of whipping. He never indulged in any other sadistic acts, and never had any desire to see blood, etc. Until his fifteenth year his sexual indulgence consisted of onanism, indulged in after such fancies. After that (dancing lessons, association with girls), the early fancies disappeared almost entirely, and were accompanied by but weak lustful feelings; so that the patient gave them up entirely. In their place came thoughts of coitus in a natural way, without anything sadistic.

The patient indulged in coitus for the first time “on account of his health.” He then tried to abstain from onanism, but was not successful, though he often indulged in coitus, and with more pleasure than he had in onanism. He wished to be freed from onanism as something vicious. He had coitus once a month, but masturbated once or twice every night. He was normal sexually, with the exception of the onanism. There was no neurasthenia; genitals normal.

Case 39. 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 childhood, of convulsions. The patient is talented, virtuous, and quiet; but at times he is very disobedient, stubborn, and passionate. He has epilepsy, and practices onanism. One day it was learned that P., with money, induced a comrade of fourteen, B., to allow himself to be pinched on the arm, back, and thigh. 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. Gyurkovechky, “Pathol. und Therapie der männl. Impotenz.,” p. 80, 1889.)

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

(g) Sadistic Acts with Animals.—In numerous cases, sadistically perverse men that are afraid of criminal acts with human beings, or that care only for the sight of the suffering of a sensitive being, make use of the sight of dying animals, or torture animals, to stimulate or excite their lust.

The case of a man in Vienna, which is reported by Hofmann in his “Text-Book of Legal Medicine,” is noteworthy in relation to this. According to the evidence of several prostitutes, before the sexual act he was accustomed to excite himself by torturing chickens and pigeons and other birds, and, therefore, was called “Hendlmann” (chicken).

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 powerfully excited sexually whenever he saw calves slaughtered, and also at the sight of bloody flesh.

According to Mantegazza (op. cit., p. 114), among degenerate Chinamen, a horrible sport consists of committing sodomy with geese, and cutting their necks off tempoire ejaculationis!

Mantegazza (“Fisiologia del piacere,” 5th ed., pp. 394, 395) mentions the case of a man who once saw chickens killed, and from that time had a desire to wallow in their warm, steaming entrails, because he experienced a feeling of lust while doing it.

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

Case 40. C. L., aged 42, 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 abnormal 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 killed in the battle of Königgrätz.

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

Case 41. (Dr. Pascal, “Igiene dell’ amore.”) A gentleman visited prostitutes, had them purchase a living fowl or rabbit, and required them to torture the animal. He had in mind the head 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.

The last two sections 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, in the innumerable cruelties, as they here and there occur in history or in certain psychological manifestations among the people at the present time, it would be erroneous to assume sadism as a motive.

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 prehistoric conditions, is long afterward operative; and, in the ideas engendered by civilization, like that of “the criminal,” it finds new objects, even though 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 cruelty and all historical enormities may be explained without recourse to sadism (which may often have been in operation, but which cannot be assumed, since it is relatively an infrequent perversion).

At the same time, there is still another powerful psychical element to take into consideration, which explains the attraction that is still exerted by executions, etc.; and that is, the pleasure there is in intense and unusual impressions and rare sights, in contrast with which, in coarse and blunted beings, pity is silent.

But undoubtedly there are individuals for whom, in spite of, 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 following a dark impulse, occupy themselves with such things, or at least with pictures and notices of them. Still, this is not sadism, as long as no sexual element enters into consciousness; and yet it is possible that, in unconscious life, slender threads connect such manifestations with the hidden depths of sadism.

(h) Sadism in Woman.—That sadism—a perversion, as we have seen, frequent in men—is much less frequent in women, is easily explained. In the first place, sadism, in which the need of subjugation 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 a woman than for a man. Yet sadism occurs in women; and it can only be explained by the primary constituent element,—the general hyper-excitation of the motor sphere. Only two cases have thus far been scientifically studied.

Case 42. 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 wide-spread legend of the vampires, the origin of which may perhaps be referred to such sadistic facts.

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

Case 43. Mrs. H., of H., aged 26, comes of a nervous family, in which nervous or mental diseases are said not to have occurred; but the patient herself presents signs of hysteria and neurasthenia. Although eight years married, and the mother of a child, Mrs. H. never had desire to perform coitus. Very strictly educated as a young girl, until her marriage she remained almost innocent of any knowledge of sexual matters. She has menstruated regularly since her fifteenth year. There does not seem to be any essential abnormality of the genitals. To the patient coitus is not only not a pleasure, but even an unpleasant act; and repugnance to it has constantly increased. The patient cannot understand how any one can call such an act the greatest delight of love, which, to her, is something far higher and unconnected with such a sensual impulse. At the same time, it should be mentioned that the patient really loves her husband. In kissing him, too, she experiences a decided pleasure, which she cannot exactly describe. But she cannot conceive how the genitals can have anything to do with love. In other respects Mrs. H. is a decidedly intelligent woman, of feminine character.

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

In other cases of sadism which history and literature afford, we are compelled to think of a reversal of the feminine sexual character,—a partial viraginity,—in order to explain the sadistic acts.

In history there are examples of famous women who, to some extent, had sadistic instincts. These Messalinas are particularly characterized 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 found in having the ladies of her court whipped before her eyes, etc.

The gifted Henry von Kleist, who was undoubtedly mentally abnormal, gives a masterly portrayal of complete feminine sadism in his “Penthesilea.” In scene xxii, Kleist describes his heroine with Achilles, whom she had been pursuing in the fire of love, betrayed into her hands, as, overcome with lustful, murderous fury, she tears him in pieces and sets her dogs on him: “She strikes, tearing the armor from his body; they set their teeth in his white breast,—she and her dogs, the rivals, Oxus and Sphynx,—they on the right side, she on the left; and as I approached blood dripped from her hands and mouth.” And later, when Penthesilea becomes satiated: “Did I kiss him to death? No. Did I not kiss him? Torn in pieces? Then it was a mistake; kissing rhymes with biting, and one who loves with the whole heart might easily mistake the one for the other.”

2. The Association of Passively Endured Cruelty and Violence, with Lust—Masochism.—Masochism is the opposite of sadism. While the latter is the desire to cause pain and use force, the former is the wish to suffer pain and be subjected to force.

By masochism I understand a 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 colored by lustful feeling; the individual affected lives in fancies, in which he creates situations of this kind, and often attempts to realize them. By this perversion his sexual instinct is not infrequently made more or less insensible to the normal stimulus of the opposite sex,—incapable of a normal vita sexualis,—psychically impotent. But this psychical impotence does not in any way depend upon a horror sexus alterius, but upon the fact that this perverse instinct finds an adequate satisfaction differing from the normal,—in woman, to be sure, but not in coitus.

But cases also occur, in which, with the perverse impulse, there is also sensibility, in a measure, 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 perversions of the sexual instinct, is developed only on the basis of a psychopathic and, for the most part, hereditarily predisposed individuality; and, as a rule, such individuals give themselves up to excesses, particularly masturbation, to which the difficulty of attaining what their fancy creates, drives them again and again.

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, and to what extent, the individual subject to this perversion strives to realize his peculiar fancies or not; whether he has thus more or less diminished his virility or not,—depends upon the degree of intensity of the perversion in the single case, and upon the strength of the opposing ethical and æsthetic motives, as well as the relative power of the physical and mental organization, of the affected individual. The essential thing, from the psychopathic point of view, and the 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.

What has been said with reference to the impulsive 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 also a gradation of the acts from the most repulsive and monstrous to the silliest, in accordance with the degree of intensity of the perverse instinct, and the power of the remnants of moral and æsthetic motives that oppose it. The ultimate consequences of masochism, however, are opposed by the instinct of self-preservation, and, therefore, murder and serious injury, which may be committed in sadistic excitement, have here, as far as known, no passive equivalent in reality; but the perverse desires of masochistic individuals may, in imagination, attain these extreme consequences (v. infra, Case 54).

Moreover, the acts to which masochists give themselves up, are performed in some cases in connection with coitus, i.e., as preparatory measures; in others, as substitutes for coitus when that is impossible. Here, too, this 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.—The following detailed autobiography of a masochist, gives an exhaustive description of a typical case of this remarkable perversion:—

Case 44. I come of a neuropathic family, in which, with all kinds of peculiarities of character and manner of life, there are several abnormalities of a sexual nature. My imagination has always been very lively, and was very early directed to sexual matters. As far as I can remember, I was much given to onanism long before puberty. Even at that time my thoughts were, for hours at a time, directed to intercourse with females. But the relations in which I placed myself with the opposite sex were entirely peculiar. I fancied that I was a prisoner and absolutely in a woman’s power, and that this woman used her power to hurt and abuse me in every way possible. In this, whipping and blows played an important part in my fancy, and there were many other acts and situations which all expressed the condition of vassalage and subjection. I saw myself constantly kneeling before my ideal, trod upon, loaded with chains, and imprisoned. Severe punishments of all kinds were inflicted on me, to test my obedience and please my mistress. The more severely I was humiliated and abused, the more I indulged in these thoughts. (At the same time I developed a great preference for velvet and fur, which I liked to touch and smooth, and which likewise excited me sexually.)

I remember well that when a child I received many actual whippings at the hands of females. They never caused me any other feeling than pain and shame; never have I thought to connect such realities with my fancies. A threat to punish me severely and correct me agitated me painfully; but in my fancy I assumed a desire on the part of my “mistress” to enjoy my suffering and humiliation, which entranced me. Too, I have never brought into relation with my fancies the acts and orders of the females that have taken care of me. I was early able to discover the truth about the relation of the sexes; but this knowledge made no impression on me. The idea of sensual pleasure remained connected with the fancies with which it was originally associated. I also had the desire to touch females, to embrace and kiss them, but I looked for the greatest delight only in their maltreatment, and in situations in which they would cause me to feel their power. I soon came to realize that I differed from other men, and preferred to be alone and absorbed in my dreams. In my boyhood, real girls and women had but little interest for me; for I saw no possibility of having them act in the way I desired. On lonely paths in the forest I whipped myself with branches that had fallen from the trees, and allowed my imagination to play in the habitual way. I reveled in the sight of pictures of commanding women, particularly if, like queens, they wore furs. I read everything related to my cherished ideas. “Rousseau’s Confessions,” which then fell into my hands, was a great discovery. I found a condition described that resembled mine in essentials. I was still more astonished at the similarity of my ideas to those I read of in the writings of Sacher-Masoch. I devoured them all with avidity, though the blood-curdling scenes often far outdid my imagination, and then excited my aversion. Later, in order to supply new food for my fancy, I began to write descriptions of erotic scenes to my taste, and to make drawings of situations which, up to this time, I had painted only in imagination. In this, reality was entirely an indifferent matter to me. In the presence of a woman I was devoid of every sensual feeling; at most, at the sight of a feminine foot, there would come a fleeting wish to be trod upon by it.

This indifference, however, was only in relation to pure sensuality. In late boyhood and early youth I was subject to an enthusiastic partiality for young girls of my acquaintance, with all the extravagances common to this youthful enthusiasm. But it never occurred to me to connect the world of my sensual thoughts with these pure ideals. I never had to overcome such a thought; one never came to me. This is the more remarkable, since to me my lustful fancies seemed very strange and unattainable in reality, but in no wise vile or obnoxious. This, too, was a kind of poetry with me; but it was divided into two worlds,—on the one hand was my heart, or, rather, my æsthetically excited fancy; on the other, my sensually inflamed imagination. While my “elevated” feeling always had a certain young girl for its object, at other times I saw myself at the feet of a mature woman, who treated me as previously described. I never placed any lady of my acquaintance in this rôle. In dreams the two spheres of my erotic ideas occurred alternately, but never combined. Only the images of the sensual sphere induced pollutions.

In my nineteenth year I allowed myself, with outward reluctance, but with inward desire, to be taken by friends to visit prostitutes. But there I experienced nothing but repugnance and aversion, and left as soon as possible, without having felt the faintest trace of sensual excitement. Later, on my own initiative, I repeated the attempt, in order to convince myself as to whether I was impotent or not; for I was much troubled by my unexpected failure in the first instance. The result was always the same,—I felt no excitement at all, and had not the slightest erection. In the first place, it was not possible for me to regard a real woman as an object of sensual gratification; and, furthermore, I could not renounce the conditions and situations which were the principal things in sexualibus for me, and about which nothing could induce me to speak a word. Imissio penis—the act to be undertaken by me—seemed to me absolutely senseless and unclean. Again, in the second place, there was also my repugnance for common women, and fear of infection.

In the meantime, in secret, my sexual life went on in the old fashion. Whenever my old fancies came to mind, violent erection occurred, and I provoked ejaculations almost daily. I began to suffer with all kinds of nervous troubles, and now regarded myself as impotent, in spite of powerful erections and intense desire when I was alone. Nevertheless, from time to time I continued my experiments with prostitutes. In time I overcame my timidity, and in part my aversion to contact with common women; but I remained absolutely cold.

After I had, with advancing years, overcome to some extent my shyness and my inclination to indulge in dreams, in my sexual thought there was an approach to the normal, as I began to direct my interest to real persons. I was even successful in directing sensual thoughts to women of my acquaintance, without carrying over any of my peculiar ideas from the other sphere. Thus I had some affairs with respectable girls. Embracing and kissing occurred; desire was excited, but not the power,—at least, it was too weak to allow me to think that under normal circumstances I should be virile. Of course, the attention I gave to the excitation of my sexual power was not calculated to favor this. Thus, always greatly ashamed, I broke off the relations.

With this, my old habit continued. I was still a great onanist, even though with lessened power. But my fancy no longer satisfied me entirely. I now began to follow both respectable women and others on the street; in winter, particularly those wearing velvet and furs. I often followed prostitutes to their homes, and had them perform manustupration. I always thought I should find more real pleasure in that than in my fancies; but it was always less. When the woman took off her garments, my interest followed them. The empty clothing has never attracted me very strongly, but more than the nude female. The real object of my interest was the attired woman. In this, velvet and furs play the most important part; but also all other articles of attire attracted me, and particularly the form as brought out by lacing and padding. I had scarcely any other interest in the nude female form than an æsthetic one. I have always had a very great interest in the shoes of women, particularly in slippers with high heels, which is always connected with the thought of being trod upon, or of submissively kissing the foot.

At last I overcame the last vestige of my shyness, and one day, to realize my dreams, had myself whipped, trod upon, etc., by a prostitute. The result was a great disappointment. What was done to me I felt to be rough, repugnant, and silly. The blows caused me nothing but pain; the situation, repugnance and shame. Nevertheless, I induced an ejaculation mechanically, with which, with the help of my imagination, I transformed the real situation into that for which I longed. This—the really desired situation—differed from the actual essentially in that I created in imagination a woman who abused me with the same pleasure that I experienced in her maltreatment of me.

All my sexual fancies were erected on the assumption in the woman of a tyrannical, cruel disposition, to which I wished to be subject. The act expressing the relation was a secondary matter to me. After the first attempt at an impossible realization, it was perfectly clear to me toward what my longing was directed. To be sure, in my lustful dreams, I had often passed beyond all ideas of abuse, and conceived a commanding woman, with an imperious mien, a word of command, a kiss on the foot, etc; but now I fully realized what it was that attracted me, and that flagellation was only the strongest means of expressing the principle, and in itself secondary.

In spite of this disappointment, after the first step, I did not abandon my efforts to realize my erotic ideas. I was confident that, when once accustomed to the new reality, my fancy would find food in it for more intense activity. For my purpose I sought the most suitable women, and instructed them carefully in a complicated comedy. In this I occasionally found that the way had been prepared for me by predecessors of like disposition. The value of these comedies, for the effect of my fancy on my sensuality, remained problematical. What these acts and scenes did for me, in the way of intensifying the subsidiary circumstances of the desired situation, caused a diminution of the intensity of the principal element, which my unaided fancy, without the consciousness of planned, coarse deception, could more easily bring up before me. My physical sensations, under the various punishments, were changeable. The more perfect the self-deception, the more perfectly the pain was felt as pleasure.

Or, more correctly, the punishment was then conceived as a symbolic act. From this arose the illusion of the desired situation, which was then accompanied by an intense psychical feeling of pleasure. The lustful feeling then spread out over the whole body in lustful physical sensations, and thus the perception of the painful quality of the punishment was overcome. The process in the moral punishments—the humiliations to which I subjected myself—was similar, but simpler; because it was confined to the mental sphere. These were also attended with pleasurable feeling when the self-deception succeeded. It was seldom, however, that it succeeded well, and never perfectly; there always remained a disturbing element in consciousness. Therefore, in the intervals, I returned to solitary onanism. Moreover, in the other case, the conclusion of the act was usually an ejaculation provoked by onanism; often an ejaculation without the aid of mechanical means.

Thus I went on for many years, with diminishing power, but with slightly diminished desire, and with the power of my peculiar sexual idea over me unchanged. And at present the condition of my vita sexualis is the same. Coitus, which I have never performed, still seems to me a strange and unclean act. I learned about it from descriptions of sexual dissipations. My own sexual ideas seem natural, and do not in the least offend my sensitive taste. Their realization, as previously mentioned, for various reasons, leaves me unsatisfied. I am pleased with pretty girls and women of respectability, but for a long time I have ceased to approach them. I have never attained, not even partially, a direct, actual realization of my sexual fancy. As often as I have come into close relation with females, I have felt the woman’s will to be beneath mine, never vice versâ. I have never met a woman manifesting a desire of mastery in sexual things. Women who wish to rule in the household and exercise petticoat sovereignty are entirely different from my erotic ideals.

My whole personality presents many abnormalities besides the perversion of my vita sexualis; my neuropathic condition is expressed in many mental and physical symptoms. Besides, I think I recognize in myself an original abnormality of character in the nature of a resemblance to the feminine type; at least, I regard as of this nature my great weakness of will, and my great lack of courage in the presence of men and animals, which is in contrast with my coolness in the face of peril. My external appearance is entirely masculine.

The author of this autobiography also made me the following communication:—

“I always sought to find out whether the peculiar ideas that ruled me sexually were entertained by other men. Since the first stories about it accidentally came to my ears, I have sought everywhere to learn of it. Since it is really a process of inner consciousness, it is, of course, not easy to identify it, and it cannot always be done with certainty; but I assume the existence of masochism where I find perverse sexual acts that cannot be explained except by this dominating idea. I look upon this anomaly as wide-spread.

“I have heard numerous stories about it from prostitutes here in Berlin, and in Vienna; and I thus learned how numerous my fellow-sufferers are. I am always careful not to describe my own experiences, or ask whether they know of such; but I allow these persons to relate their experiences just as they will.

“Simple flagellation is so common that almost every prostitute is familiar with it; but cases of real masochism are very frequent. The men subject to this perversion submit themselves to the most refined cruelties. In this they always act the same farce with the instructed prostitutes,—humiliating subjection of the man, treading upon him, commands, threats, and scoldings that have been committed to memory; then flagellation, blows on various portions of the body, and all kinds of punishment, pricking with needles, etc. The scenes often end with coitus, but more frequently with ejaculation without it. Twice prostitutes have shown me heavy iron chains with handcuffs, which their patrons had made for them to put on them; and the dried peas, on which they kneeled; the seat set with needles, on which they sat at command; and many other similar things. Often the perverted man wishes the woman to tie his penis so tightly as to cause pain; to prick it with needles, make cuts in it with a knife, or beat it with a stick. Even the act of hanging is indulged in, it being cut short at just the right moment. Others have themselves scratched with a knife or dagger, but in the act the woman must threaten them with death. In all these things the symbolism of subjection is the most important factor. The woman is usually called ‘mistress’; the man, ‘slave.’

“A man of high social standing, dressed as a servant, sat on the box of a carriage and drove his mistress about. Here there may have been a conscious imitation of the ‘Venus in Furs.’ It seems to me that the writings of Sacher-Masoch have done much to develop this perversion in those predisposed. It is peculiar that the inexplicable enthusiasm for furs is so frequently combined with this perversion. It, as well as that for velvet, has been peculiar to me from my earliest youth.

“All these comedies with prostitutes are for masochists only troublesome substitutes. Whether there is such a thing as a realization of masochistic dreams in love relations or not, I do not know. If it occur, it is certainly very infrequent; for this taste in women (sadism in women, as described by Sacher-Masoch) is very difficult to find; and, too, the expression of sexual abnormalities finds greater obstacles in the modesty of women, etc., than in men. I myself have never noticed the slightest indications of anything of this kind, and have never been able to attempt an actual realization of my fancies. Once a man confidingly told me of his masochistic perversion, and said he had found his ideal.”

The two following cases are similar to the foregoing:—

Case 45. Mr. Z., aged 29, technicist, came for consultation because of a fear of tabes. Father was nervous and died tabetic. Father’s sister was insane. Several relatives are very nervous and peculiar. On closer examination the patient is found to have sexual, spinal, and cerebral asthenia. He presents no symptoms of tabes dorsalis, nor does he give a history of them. Questions concerning abuse of the sexual organs bring out a confession of masturbation practiced since youth. In the course of the examination the following interesting psycho-sexual anomalies came out: 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 one sex or the other. Faute de mieux he practiced flagellation on himself and, in time, this induced ejaculation. Long before this he had begun to satisfy himself with masturbation, and always during the act reveled in imaginary scenes of whipping. After growing up he twice visited brothels to have himself flogged by prostitutes. For this purpose he chose the prettiest girl he could find; but he was disappointed, and did not even have an 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 important thing. He realized this on the second trial. When he had the “thought of subjection,” he was perfectly successful. In time, by straining his imagination with masochistic ideas, he performed coitus without flagellation; but he found little satisfaction in it; so that he performed sexual intercourse in a masochistic way. He found pleasure 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 a pretty girl told stories of such scenes. 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 does not know how he arrived at this fetichistic idea. Boys’ legs with high heels also pleased him, but this charm was purely æsthetic, without any sensual coloring; and he said he had never noticed anything homo-sexual in himself. The patient referred his fetichism to his partiality for calves (legs). He is charmed by ladies’ calves only when elegant shoes are on the feet. Nude legs—feminine nudity in general—do not in the least affect him sexually. A subordinate fetichistic idea for the patient is the masculine ear. It is a lustful pleasure for him to pet the ears of handsome men, i.e., men having beautiful ears. With men this pleasure is slight, but with women it gives him great enjoyment.

He also has a weakness for cats. He thinks them simply beautiful; and their movements are very attractive to him. The sight of a cat can raise him from a feeling of the deepest depression. Cats seem to him sacred; he sees something divine in them! He does not know the reason for this idiosyncrasy.

Of late he has also frequently had sadistic ideas about punishing boys. In these imaginary flagellations both men and women play a part, but particularly the latter; and then his enjoyment is much more intense.

The patient finds that, with that which he recognizes and feels as masochism, there is something else which he prefers to designate “pageism.”

While his masochistic fancies and acts are entirely of a coarse, sensual nature, his “pageism” consists of the idea of being a page to a beautiful girl. He conceives her as perfectly chaste, but piquant; his relation to her, that of a slave, but perfectly chaste,—a purely platonic submission. This reveling in the idea of serving such a “beautiful creature” as a page, is colored by a pleasurable feeling; but this is in no way sexual. He experienced in it an exquisite feeling of moral satisfaction, in contrast with the sensually-colored masochism; and, therefore, he could but regard it as something of a different nature.

At first sight there was nothing remarkable in the patient’s appearance; but his pelvis is abnormally broad, the ilia are flat, and the pelvis, as a whole, tilted and decidedly feminine. Eyes, neuropathic. He also mentions that he often has itching and lustful irritation at the anus, and that there (“erogenous” area), ope digiti, he can satisfy himself.

The patient is 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 designates 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 consideration 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 46. X, writer, aged 28, predisposed. Sexually hyperæsthetic from childhood. At the age of six he had dreams of being whipped ad nates by a woman. After them he would awake in intense lustful excitement; and thus he came to practice 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 waking fancies, and indulged in onanism. Three years ago he had an impulse to have himself whipped by a puella. The patient was undeceived, for neither erection nor ejaculation occurred. At twenty-seven, another effort, with the thought to enforce erection and ejaculation. This was finally made possible by the following artifice: While coitus was attempted, the puella had to tell him how she had mercilessly flogged 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, helpless, 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 (infrequently) dreamed that he was abused, or that he looked on while a puella whipped others. He never had an intense, lustful pleasure in coitus. The only things in women that interest him are the hands. Powerful women with big fists are his preference. At the same time, his desire for flagellation is only ideal; for with his great cutaneous sensitiveness, at the most, a few strokes are sufficient. Blows from men were repugnant to him. He wishes to marry. From the impossibility of asking a decent woman to perform flagellation, and the doubt about being potent with such a woman, spring his embarrassment and desire to recover.

In the foregoing three cases, for the most part, passive flagellation serves the individual subject to this perversion of masochism as an expression of the desired situation of subjection to the woman. The same means is needed by a large number of masochists. But passive flagellation is a process which, as is known, has a tendency to induce erection reflexly by irritation of the nerves of the nates. 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 these dissipated individuals who are not psychically perverse, but physically weakened.

It is not difficult to show that masochism is something essentially different from flagellation, and more comprehensive; that flagellation is rather a by-play,—one of the many means used for the purpose of masochistic gratification in the sense of subjection to the woman. 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 satisfaction of his peculiar desires. The essential thing is the desire for ill-treatment, as a sign of this subjection. Besides flagellation, and often without it, there are many other things which serve to express this subjection; as is shown by the following series of cases. This fact establishes a presumption of the existence of an original anomaly of sexual feeling,—a paræsthesia sexualis. On the other hand, the individual that is weakened and not a subject of masochism, and who has himself flagellated, desires only a mechanical irritation of his spinal centre.

Whether, in a given case, it is simple (reflex) flagellation or masochism, is made clear by the individual’s statements, and often by the secondary circumstances. The determination depends upon the following facts:—

In the first place, the impulse to passive flagellation exists ab origine in the masochist. The desire is felt before there has been any experience of the reflex effect, often first in dreams; as, for example, in Case 48. Secondly, with the masochist, as a rule, the flagellation is only one of many and various punishments which come into his mind as fancies and are often realized. In these other punishments, and the frequent acts expressing purely symbolic humiliations, which occur by the side of flagellation, 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 perfect disappointment; in fact, always, if the masochist is not successful in his desire to create, by means of the pre-arranged programme, the illusion 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. If one cannot tickle one’s self, no more can one feel one’s self subject to a woman directed by one’s own will. In reference to this important point, compare the three foregoing cases and Case 50.

Between masochism and simple (reflex) flagellation, there is a relation somewhat analogous to that existing between contrary sexual instinct and acquired pederasty. It does not lessen the value of this opinion that, in the masochist, the flagellation may also have the known reflex effect; or that a whipping received in childhood may have aroused lust for the first time, and thus simultaneously excited the latent masochistically-constituted vita sexualis. In this event, the case must be characterized by the conditions 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 circumstances, such as those mentioned above under “secondly,” would make it clearly masochistic. This is illustrated in the two following cases:—

Case 47. A patient of Tarnowsky’s had a person in his confidence rent a house during his attacks, and instruct its personnel (three prostitutes) in what was to be done with him. He would come there, and was there 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 submit. 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 48. X., aged 34, greatly predisposed, suffers with contrary sexual instinct. For various reasons 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 a thing), and have her tread upon him, whip, and beat him. Qua re summa libidine affectus pedem feminæ lambit quod solum eum libidinosum facere potest: tum ejaculationem assequitur. Then disgust at the morally-debasing situation occurred, and he retired as quickly as possible.

Cases occur, however, in which passive flagellation alone constitutes the entire content of the masochistic fancies, without other ideas of humiliation, etc., and without any clear 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 makes the differential diagnosis certain; taken with the circumstance that genuine masochists are perverse in their youth, and that the realization of their desires usually comes late, or undeceives them (v. supra, under “thirdly”); for the whole thing, for the most part, belongs to the sphere of the imagination.

The following case is of this nature:—

Case 49. Autobiography.—In January, 1891, I received the following letter from a gentleman in Hungary: “In depression and despair of a life that shuts me out from all that makes human happiness, I come to you with the last gleam of hope of rescue from a condition which, if it continue, can end only tragically.

“I am thirty years old, and come of a mother who suffered with periodical insanity. As early as my fourteenth year abnormal sexual tendencies were noticeable in me. It always gave me a certain lustful pleasure to be whipped by boys of my own age, particularly when I was taken over the knee and spanked. It particularly delighted me when this was done by handsome young persons or boys having well formed legs and closely-fitting trousers. By means of such ideas I also came to masturbate; and I practiced onanism quite frequently,—almost daily, and, in fact, in absolute ignorance of the terrible results of the vice. Thus it continued until my eighteenth year, when, thus far absolutely unsuspecting, I was made aware of the vicious results of the practice.

“From this time began the terrible struggle with the desire to give it up, which I only too often abandoned. The fancies mentioned did not leave me; I longed to be whipped by handsome young persons aged from twenty to twenty-two years, wearing tight trousers. My fancy was filled especially with young soldiers and hussars. At times I was able to repress my imagination and avoid onanism; but I then had pollutions with dreams of the same nature.

“After my twentieth year, to my astonishment, the sexual inclination toward women, which I had noticed in comrades of my own age, and the occurrence of which I expected in myself, did not appear. I was cold toward women, and embarrassed in their presence. At the same time, feminine nudity was not unpleasant; on the contrary, there was something attractive about it, but my sensuality was not excited.

“I twice attempted coitus; I was not troubled about being in bed with the girl, but rather kissed and embraced her with pleasure, and even had traces of erection, but that was all. Since then I have had no hope, and occasionally returned to onanism, which I had avoided for some months previously. Nevertheless, I cultivated social intercourse with ladies, and particularly young girls; and I was esteemed in society, and liked for my graceful dancing. I was always hoping that in this way my unhappy tendency would be overcome successfully, but in vain; it grew constantly stronger. Thus I have lived hours of wretchedness; and the ghost of suicide has passed before me. I once confided in a physician in Pesth, but he had only the usual remedies for persons suffering with sexual weakness,—cold baths, quieting medicines, intercourse with women, etc.

“I tried everything in vain, until by accident a book on contrary sexual instinct fell into my hands, and gave me the last ray of hope. I have a respected position as a merchant, and appreciate thoroughly the joys of family life; and I have an opportunity to marry, under the most favorable circumstances, a young girl whom I love, and who loves me. But I feel the cruel impossibility of this step. I suffer terribly in thinking about these repulsive abnormalities. My only hope lies in a cure by means of hypnosis. May it not be in vain!”

Pity and a scientific interest induced me to invite the writer of the preceding lines to come to see me. Early in February Mr. D. came. He was distinguished, pleasing, and masculine in appearance. Examination of the case showed it to be one of masochism. He distinctly remembered that, when he once saw fellow-pupils whipped by the teacher, it gave him a feeling of lustful pleasure. He cannot remember that he was ever whipped by a teacher. His masochism had been an absolutely primary manifestation, and incomprehensible to him. Only gradually and faute de mieux had he come to practice onanism, during which ideas of flagellation, in which he played the passive rôle, filled his mind. He had never had desire to be whipped by the teacher; he always wished to be flogged by fellow-pupils and well-grown young persons. Since maturity he had never been able to induce himself to satisfy his masochistic inclinations.

In intercourse with puellis he had repeatedly had the thought to have himself whipped by them; but since this was not accompanied by sensual feeling, it was not carried out. The patient declares that his inclinations toward persons of his own sex are purely masochistic. In other respects he finds nothing interesting in men. Until his eighteenth year the patient had also sadistic tendencies. He was enthusiastic about the position of the pedagogue and wanted to be a teacher in order to be able to flog boys. This ideal sadism later disappeared entirely. The patient complains that he feels alone in the world, like a pariah, and that he is different from other men. But his libido toward women had much diminished, possibly as a result of his masturbation. He had no erection at the sight of feminine charms, but the sight of a riding-whip or a cane excited him powerfully sexually. When he attempted coitus, no masochistic ideas occurred. Such ideas arose, however, whenever he saw attractive young men. He believed that if he were freed from his ideas of flagellation, he would be helped; for his sensuality would then direct itself in a normal path.

The patient has neuropathic eyes, but is free from all degenerative signs. In the direction of hereditary taint, it is noteworthy that his maternal grandfather was peculiar, and shot himself while in a psychopathic condition. The patient feels well, save for slight neurasthenic troubles. Patellar reflex increased. The genitals are perfectly normal. His dreams with pollutions are exclusively about flagellation by young persons, particularly soldiers with tight trousers.

The principles of treatment laid down were: 1. Removal of the symptoms of neurasthenia. 2. Suggestive treatment looking to (a) avoidance of onanism; (b) indifference toward his own sex and the disappearance of thoughts of flagellation, both while awake and asleep; (c) libido exclusively toward persons of the opposite sex, the occurrence of erections at sight of beautiful women, complete power with women, and dreams of women exclusively. At the first sitting, by means of Bernheim’s method, the patient passed quickly into a state of deep lethargy. At the second sitting (February 5) a cataleptic condition of the muscles was induced. Sittings almost daily. It was seen that stroking the brow induced deeper hypnosis with catalepsy, which, however, did not go beyond deep lethargy. Suggestion was begun in the third sitting.

February 10. The patient says that he has no longer any interest in men, but a growing interest in women. He begins to dream of women.

February 13. He feels himself free from masochism during the day, and canes and whipping do not interest him any more. At night he still has “weak” dreams of flagellation concerning men, but without lustful feeling or pollution. A short time ago he had had a dream that was entirely strange, and without erotic coloring, to the effect that he whipped himself.

February 19. The patient attempted coitus with a puella pleasing to him. Erection was incomplete, and ejaculation did not occur; so he gave up the attempt. The patient finds that his libido toward women is still very slight. He was not discouraged by his failure, and expected ultimate success; for he felt free from his abnormal tendencies, and like another man. On February 20, unfortunately, the patient had to discontinue treatment, being called home by duties there.

The fact that traces of sadism (v. infra), were simultaneously present, lends certainty to the diagnosis of this rudimentary case as one of masochism. The purely psychical character of this latter perversion is unquestionable. At the same time, the case is combined with incompletely developed contrary sexual instinct, an association not infrequent in masochists and sadists.

In contrast with this case of rudimentary masochism, in which there is some difficulty of diagnosis, follows a typical case of 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 44 only in that here there is no thought of a realization of the perverse fancies; and that, notwithstanding the perversion of the vita sexualis, normal stimuli are so far effectual that sexual intercourse is possible under normal conditions.

Case 50. 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 disease. 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, and alike whether from the stand-point of master or servant. That one man could possess, sell, or whip another, caused me intense excitement; and in reading “Uncle Tom’s Cabin” (which I read at about the beginning of puberty), I had erections. Particularly exciting for me was the thought of a man’s being hitched up before a wagon 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 instinct,—i.e., on the way in which it was expressed. Though these ideas caused erections, yet I have never masturbated in my life; and from my nineteenth 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 powerful. 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 before a carriage, and made me take her for a drive; whom I must follow like a dog; at whose feet I must lie naked, and be punished—i.e., whipped—by her. This was the constant element in my ideas, around which all others were grouped. In these fancies I always found endless pleasure, which caused erection, but never ejaculation. As a result of the induced sexual excitement, I would immediately seek a woman, preferably one corresponding exteriorly with my ideal, and have coitus with her without any actual imitation of my fancies, and sometimes also without any thought of them during the act. At the same time, I also had inclination toward women of a different kind, and had coitus with them without being impelled to it by my fancy.

Notwithstanding all this, my life was not exceedingly abnormal sexually; yet these ideas were certain to occur periodically, and they have remained essentially unchanged. With growing sexual desire, the intervals constantly grew shorter. At the present time the ideas come every two or three weeks. If I have had coitus, the occurrence of the fancies is perhaps postponed. I have never attempted to realize my very definite and characteristic ideas,—i.e., to connect them with the objective world,—but I have contented myself with reveling in the thoughts; because I was convinced that my ideal would not allow even an approach to realization. The thought of a comedy with paid prostitutes always seemed to me silly and purposeless; for a person hired by me could never take the place in my imagination of a “cruel mistress.” I doubt whether there are sadistically 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 always seem only like 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 try to obtain my freedom at all hazards.

Yet I have found a way in which to induce, in a certain sense, a realization. After my sexual desire has been intensely excited by reveling 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 rôle. After thinking of such a situation for about half an hour, with a constantly resulting 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 no sympathy whatever with masochistic ideas. But the next attack is sure to come sooner or later. I must, however, state that I also have coitus without being prepared by such ideas, especially, 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 æsthetic, and despise anything like maltreatment of a human being. Finally, I will not leave unmentioned the fact that the form of address is of importance. In my fancies it is essential that the “mistress” 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 inclined, 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 ideal. She is gentle, but proud; 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 realization of the masochistic ideas (i.e., passive flagellation, etc.) be the desired end, then it is in opposition with the fact that the majority of masochists never attempt realization; or, when this is attempted, great disappointment occurs, or at least the desired satisfaction is not obtained.

Thus the reveling in imagination is the principal thing; and, in fact, this gives an unspeakable delight that takes its subject beyond external things, beyond all troubles and cares.

It is an astonishing fact that there is an author, who, instead of keeping them to himself, as others do, discloses his imaginary ideals to the world in novels and romances. In “Venus in Furs,” we find those that are like us in feeling,—word for word, line for line, are expressed the ideas so familiar to us, which we believe to be our own exclusive discovery.

Until then I did not think it possible that there could be, in any other brain than mine, the lustful thought of being harnessed to a plow and made to work like a draught-horse.

And the ill-temper of the mistress to be served at the toilet and bath; the imprisonment,—ah, how familiar such ideas are to us from childhood!

Therefore, perhaps by reason of this open disclosure of things that should be secret, the reading of this book shocks masochists, undeceives them, and exerts a curative influence.

Finally, I should mention that, according to my experience, the number of masochists, especially in large cities, seems to be quite large. The only sources of such information are—since men do not reveal these things—words of prostitutes; and, since they agree on the essential points, it may be concluded that certain facts are proved.

Thus there is the fact that every experienced prostitute is accustomed to keep 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; who, 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, reading the “New Investigations” made a great 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 guérir.” (To understand all is to cure all.)

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 overcome; they come like a stroke of lightning, are there, and one does not know whence or how.

But this 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 æsthetic sense of others, but also your own, disapproves? You regard that as beautiful and desirable which, in your own judgment, is at once ugly, coarse, silly, and impossible? You long for a situation which in reality you can never obtain? This opposing idea has an immediate inhibitory and undeceiving effect, and takes the edge off the fancy. Too, since reading the “New Investigations” (early this year), I have actually not reveled in my fancy once, though the masochistic tendency has occurred with regularity.

I must also confess that, in spite of its marked pathological 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 condition as well as ever.

The author of the foregoing lines also sends me the following notes:—

1. 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 thinking, I have had such thoughts. If the origin of them had been the result of a particular event, especially of a beating, I should certainly not have forgotten it. It is characteristic that the ideas were present before there was any libido. At that time the ideas were absolutely sexless. I remember that, when a boy, it affected (not to say excited) me intensely when an older boy addressed me in the second person (Du), while I spoke to him in the third (Sie). I would keep up a conversation with him, and have the exchange of address take place as often as possible. Later, when I had become more mature sexually, such things affected me only when they occurred with a married woman, and one relatively old.

2. Physically and mentally I am in all respects masculine. I have a superabundant growth of beard, and my whole body is very hairy. In my relations to the female sex that are not masochistic, the dominating position of the man is an indispensable condition, and any attempt to change it would meet with my energetic opposition. I am energetic, if not over-courageous; but the want of courage is not manifest when my pride is injured. I am not sensitive to events in nature (thunder-storms, storms at sea, etc.).

Too, my masochistic tendencies have nothing feminine 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 end and aim of all masochistic ideas.

3. 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 by no means excessively sensual naturally. 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 masochistic,—e.g., kissing). In spite of its manner of origin, this libido, by virtue of the masochistic ideas it engenders, is soon transformed into a masochistic and impure libido.

Moreover, there is no doubt that external, accidental impressions, particularly loitering in the streets of a large city, greatly intensify the desire. The sight of beautiful and imposing female forms, in nature as well as in art, is exciting. For those subject to masochism,—at least during the attacks,—the whole external world becomes 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 masochistic state.

4. An example of masochistic ideas follows: “She” is a peasant woman,—a rough, tall, large-boned woman of forty or fifty years. She is the possessor of a small, remote farm, which she works with the help of her slave alone. The work begins before sunrise. At four o’clock in the morning she opens the shed where she has kept me shut up over night, and wakens me, as I lie on the ground, with a kick; then she leads me out and harnesses me to a milk-cart bound for town. She leads me by a halter, and urges me along. On the road she gets on the heavily-loaded wagon, and sleeps until the destination is reached. There, in the open market-place of the town, still harnessed to the wagon, I lie down on the bare ground to rest. Those passing knock against me or step on me, without giving me any attention. After the stock is sold, we start homeward. After a short rest the work begins again, always under the direction of the mistress, who holds me by the halter and urges me on. At seven or eight o’clock at night I am put up to rest, and sleep until the next morning, when the same thing begins again. Work and blows, blows and work; no pleasure, no recreation, day in and day out!

Another time I fancy myself in the rôle of a paid lover of an elderly female roué, who makes use of me, sexually, in the most reckless manner; and in this direction makes the most shameful demands on me. If I do not submit to these willingly, I am beaten and punished; and, at the same time, she despises me unspeakably; gives me the lowest housework to do; and on every occasion shows me how low an opinion she has of my manhood.

I cannot clothe the character of masochism in any better formula than the following: A real masochist, without reflection, prefers the kick of a low woman to the embrace of a Venus.

5. In reading Sacher-Masoch, it struck me that in masochists, now and then, there was also an undercurrent of sadistic feeling. Too, I have now and then discovered in myself sporadic feelings of sadism. I must remark, however, that the sadistic feelings are not so marked as the masochistic; and that, aside from the fact that they are infrequently accessory, the sadistic fancies never leave the sphere of abstract feeling, and, above all, never take the form of concrete, connected ideas (like those above mentioned). The effect on libido, however, is the same with both.

If this case is remarkable on account of the complete development of the psychical state that constitutes masochism, the following one is noteworthy because of the great extravagance of the acts resulting from the 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 coloring of the resulting situations:—

Case 51. Masochism.—Mr. Z., official, aged 50; tall, muscular, healthy. He is said to come of healthy parentage, but his father was thirty years older than his mother. A sister, two years older than Z., suffers with delusions of persecution. There is nothing remarkable in Z.’s external appearance. Skeleton entirely masculine; abundant beard, but no hair on trunk. He characterizes himself as a man of sanguine temperament, whom no one can depress; though irascible and quick-tempered, he is quick to regret outbursts.

Z. says he has never masturbated. From his youth there have been nightly pollutions, in which girls play a part; but the sexual act, never. For example, he dreams that a pleasing woman lies heavily on him, or that, as he lies sleeping on the grass, she playfully walks up his back. Z. had always been averse to coitus with a woman. This act seemed animal to him. Nevertheless, he was drawn to women. It was only in the society of beautiful women and girls that he felt well and in his place. He was very gallant without being forward.

A voluptuous woman of beautiful form, and particularly with a pretty foot, when seated, had the power to throw him into intense excitement. He was impelled to offer himself as a chair, in order “to offer so much devotion.” 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 the woman. He thought how ladies liked to ride. He reveled in the thought of 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 colors; thought of the beautiful foot armed with spurs, the beautiful legs, and 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 abnormal, and was able to control himself. But he felt no need to fight against them; on the contrary, it would have hurt him had he been compelled to give up the feelings that had become so dear to him.

At the age of thirty-two Z. happened to make the acquaintance of an attractive woman, aged twenty-seven, who had been separated from her husband, and whom he found in need. He took her, and worked for her, without any selfish motive, for months. One evening she impatiently demanded sexual satisfaction from him, and almost used violence. Coitus was successful. Z. took the woman, lived with her, and indulged in coitus moderately; but coitus was more a burden than a pleasure; erections became weak, and he could no longer satisfy the woman. She finally declared that she would not have intercourse with him, because he only excited without satisfying her. Though he loved the woman very much, he could not give up his peculiar fancies. After this he lived with her only in friendly relations, and deeply regretted 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. At other times be dreamed that he was a small, weak horse. Then a large, heavy woman came and mounted the horse, and set off on a long journey in the mountains. Recklessly, and without mercy, she allowed the poor animal to feel her weight; she made herself comfortable on his back; while he threatened to give out under her, she had the greatest enjoyment, and with calm mind enjoyed the beautiful scenery. Under the influence of such dreams, seven years ago Z. overcame his reluctance, in order to experience such things in reality. He was successful in creating suitable opportunity. He speaks of it as follows: “I knew how to arrange it so that on an occasion she would, of her own will, seat herself on my back. Then I endeavored to make this situation as pleasant as possible, and easily made it so that on the next occasion she said, spontaneously: ‘Come, give me a little ride!’ Swelling with pride, and with 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 movements of a horse, and loved to have her treat me like a horse, without any thought of me. She could beat, prick, scold, or caress me, just as she felt inclined. I could carry on my back persons weighing from sixty to eighty kilos, for half or three-quarters of an hour, without interruption. 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 always rested, and placed myself at the disposal of the mistress again. When time and circumstances allowed it, I did this three or four times in succession. It sometimes happened that I practiced it both in the morning and afternoon. After it I never felt weary or had any uncomfortable feeling; but on such days I had very little appetite. When possible, I liked best to bare my trunk, that I might feel the rider more perfectly. The mistress had to be decent. I liked her best in pretty shoes and stockings, with short, closed drawers, reaching to the knee; with the upper portion of her person completely dressed, and with hat and gloves.”

Mr. Z. further says that he has not performed coitus in seven years; but he thinks he is potent. The riding was a perfect substitute for that “animal 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 half-way pretty were to address him directly, and say, “Come, I want to ride you,” he would not be strong enough to withstand the temptation. Z. wishes to know whether his abnormality is curable; whether he is unworthy as a vicious man, or an invalid deserving pity.

The following case seems very similar:—

Case 52. A man finds satisfaction in the following manner: Occasionally he goes to a puella publica. Here he has a porcelain ring, like those used in hanging curtains, put on his penis. Two cords are attached to the ring and drawn backward between his legs and attached to the bedstead. Then he tells the woman to beat him mercilessly with a whip and cry “whoa” to him constantly, and treat and abuse him as if he were an unruly horse. The more the woman spurs him on to pull, with shouts and blows, the greater his sexual excitement becomes. Erection occurs (probably mechanically favored by compression of the dorsal vein of the penis, which, when the cords are strained, must be closed by the pressure of the hard ring). With increasing erection, the whole member is compressed by the ring, and finally ejaculation occurs, with lustful feeling.

Even in the foregoing series of cases, with other things, the act of being walked upon has played a rôle 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 is shown in the following classical case of masochism, which Hammond reports (op. cit., p. 28) from an observation by Dr. Cox, of Colorado:—

Case 53. X., a model husband, very moral, the father of several children, has times—i.e., attacks—in which he visits brothels, chooses two or three of the largest girls, and shuts himself up with them. He bares the upper portion of his body, lies down on the floor, crosses his hands on his abdomen, closes his eyes, and then has the girls walk over his naked breast, neck, and face, urging them at every step to press hard on his flesh with the heels of their shoes. Sometimes he wants a heavier girl, or some other act still more cruel than this procedure. After two or three hours he has enough. He pays the girls with wine and money, rubs his blue bruises, dresses himself, pays his bill, and goes back to his business, only to give himself the same strange pleasure again after a few weeks.

Occasionally it happens that he has one of the girls stand on his breast; and the others then turn her around until his skin is torn and bleeding from the turning of the heels of her shoes. Frequently one of the girls has to stand on him in such a way that one shoe is over the eyes, with its heel pressing on one eye, while the other rests across his neck. In this position he endures the pressure of a person weighing about one hundred and fifty pounds for four or five minutes. The author speaks of dozens of similar cases that are known to him. Hammond presumes, with reason, that this man had become impotent for intercourse with women; that, in this strange procedure, he found an equivalent for coitus; and that, when the heels drew blood, he had pleasant sexual feelings, accompanied by ejaculation.

The ten 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 masochism the same effect is sought in the passive reception of similar abuse. 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 54. A middle-aged man, married and the father of a family, who has always led a normal vita sexualis, but who says he comes of a very nervous family, makes the following communication: In his early youth he was powerfully excited sexually at the sight of a woman slaughtering an animal with a knife. From that time, for many years, he had reveled in the lustfully-colored idea of being stabbed and cut and even killed by women with knives. Later, after the beginning of normal sexual intercourse, these ideas lost completely their perverse stimulus for him.

This case should be compared with the statements made under Case 44, according to which men find sexual pleasure in being lightly pricked with knives in the hands of women, who, at the same time, threaten them with death.

Such fancies, perhaps, give the key to an understanding of the following strange case, for which I am indebted to a communication from Dr. Körber, of Rankau:—

Case 55. A lady makes me the following communication: While still a young and innocent girl, she was married to a man of about thirty years. On their wedding-night he forced a towel and soap into her hands, and, without any other expression of love, wanted her to lather his chin and neck (as if for shaving). The inexperienced 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 is industrious and reliable, but a moody man, with little perseverance; 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 realization of ideas of injury or death, or of fancies about knives; like those the man previously mentioned had had in his youth, and by means of which he had been sexually excited and satisfied. The perfect sadistic counterpart to this case, looked upon in this light, is offered by Case 35, which is a case of symbolic sadism.

At any rate, there is a whole group of masochists who satisfy themselves with the symbolic representations of situations corresponding with their perversion; a group that corresponds with group “e” of “symbolic” sadists, just as the previously mentioned cases of masochism correspond with the groups “c” and “a” of sadism. Thus, just as the perverse longings of the masochist may, on the one hand, advance to “passive lust-murder” (to be sure, only in imagination); so, on the other hand, they may be satisfied with simple symbolic representations of the desired situations, which otherwise are expressed in acts of cruelty (this, of course, taken objectively, goes much further than the idea of being murdered, but in fact not so far, owing to the determining subjective conditions).

With Case 55, other similar cases should be here described, in which the acts desired and planned by the masochist have a purely symbolic character, and, to a certain extent, serve to indicate the desired situation.

Case 56. (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 following act. The puella had to undress him, tie his hands and feet, bandage his eyes, and draw the curtains of the windows. Then she would have her guest sit down on a sofa, and had to leave him there alone. 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, further in imagination. The following case, in which again a complicated comedy, in the sense of masochistic desires, is played, is still more peculiar:—

Case 57. (Dr. Pascal, ibid.) A gentleman in Paris was accustomed to call on certain evenings at a house where a woman, the owner, acceded to his peculiar desire. He entered the salon in full-dress, and she, likewise in evening toilette, had to receive him with a very haughty manner. He addressed her as “Marquise,” and she had to call him “dear Count.” Then he spoke of his good fortune in finding her alone, of his love for her, and of a lover’s rendezvous. At this the lady had to feel insulted. The pseudo-count grew bolder and bolder, and asked the pseudo-marquise for a kiss on her shoulder. There is an angry scene; the bell is rung; a servant, prepared for the occasion, appears, and throws the count out of the house. He departs well satisfied, and pays the actors in the farce handsomely.

In connection with this case of symbolic masochism, two more are here given, in which the psychical perversion was entirely confined to the sphere of thought and imagination, and no realization was attempted. The first is that of an individual, mentally and physically predisposed, bearing degenerative signs, in whom mental and physical impotence occurred early:—

Case 58. Mr. Z., aged 22, single, was brought to me by his father for medical advice, because he was very nervous and apparently abnormal sexually. Mother and maternal grandmother were insane. His father begat him at a time when he was suffering severely nervously.

Patient is said to have been a very lively and talented child. At the age of seven he was noticed to practice 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-mindedness, and various foolish acts.

Consultation was occasioned by an occurrence on 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 characterizes him as a man of perfectly good disposition, moral, but lazy, and dissatisfied with himself; as one often in despair about his want of success in life; as indolent, and interested in nothing but music, for which he possesses great talent.

The patient’s exterior—his plagiocephalic head; his large, prominent ears; the deficient innervation of the right facialis about the mouth; the neuropathic expression of the eyes—indicates a degenerate, neuropathic individual.

Z. is tall, of powerful frame, and, in all respects, of masculine appearance. Pelvis masculine; testicles well developed; penis remarkably large; mons veneris with abundant hair. The right testicle hangs much lower than the left; the cremasteric reflex is weak on both sides. The patient is below the average intellectually. He feels his deficiency, complains of his indolence, and asks to have his will strengthened. His awkward, embarrassed manner, timid glances, and relaxed attitude, point to masturbation. The patient confesses that from his seventh year, until a year and a half ago, he practiced it, years at a time, from eight to ten times daily. Until a few years ago, when he became neurasthenic (cephalic pressure, loss of mental power, spinal irritation, etc.), he says he always found great sensual pleasure in it. Since then this had been lost, and the desire to masturbate had disappeared. He had constantly grown more bashful and indolent, less energetic, and more cowardly and apprehensive. He had lost interest in everything, and did his business only from a sense of duty, feeling very low-spirited. He had never thought of coitus, and, from his stand-point as an onanist, he could not understand how others could find pleasure in it.

Investigations in the direction of contrary sexual instinct gave a negative result. He says he never was drawn toward persons of his own sex; he rather thinks that he has now and then had a weak inclination for females. He asserts that he came to masturbate independently. In his thirteenth year he first noticed ejaculations as a result of masturbatic manipulations.

It was only after long persuasion that Z. consented to entirely unveil his vita sexualis. As his statements, which follow, show, he may be classified as a case of ideal masochism, with rudimentary sadism. The patient distinctly remembers 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 feeling, and became the cause of masturbatic manipulations. Later the patient called them up voluntarily, in order to incite himself to masturbation. They also played a part in his dreams; but they never induced pollution, apparently because the patient masturbated excessively during the day.

In time, to these masochistic “ideas of violence,” others of a sadistic nature were added. At first they were scenes in which boys forcibly practiced onanism on one another, or cut off the genitals. He often imagined himself such a boy, now in an active, now in a passive, rôle. Later he busied himself with mental pictures of girls and women that exhibited themselves to one another. He reveled 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 passive. It satisfied him to use them for masturbation. Since a year and a half ago, with diminishing sexual imagination and libido, these ideas and impulses had become infrequent, but their content remained unchanged. The masochistic “ideas of violence” predominated over the sadistic. Now, when he sees a lady, he has the thought that she has sexual ideas like his own. In this way, in part, he explains his embarrassment in social intercourse. Owing to the fact that he had heard that he would get rid of his burdensome sexual ideas, if he were to accustom himself to natural sexual indulgence, during the last year and a half he has twice attempted coitus though he only 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 one, placed at my disposal by a colleague. Even though it be aphoristic, it seems particularly suited to throw a clear light on the distinctive element of masochism,—the consciousness of subjection, in its peculiar psycho-sexual effect:—

Case 59. Masochism.—Z., aged 27, artist. He is powerfully built, of pleasing appearance, and is said to be free from hereditary taint. Healthy in youth, since his twenty-third year he has been nervous and inclined to be hypochondriacal. Though inclined to indulgence sexually, he is not very virile. In spite of associations with females, his relations with them are limited to innocent attentions. At the same time, his desire to devote himself to women that are cold toward him is remarkable. Since his twenty-fifth year he has noticed that females, no matter how ugly, always excite him sexually, whenever he discovers anything domineering in their character. An angry word from the lips of such a woman is sufficient to give him the most violent erections. Thus, one day, he sat in a café and heard the (ugly) female cashier scold the waiters in a loud voice. This threw him into the most intense sexual excitement, which soon induced ejaculation. Z. requires the women, with whom he is to have sexual intercourse, to repulse and annoy him in various ways. He thinks that only a woman like the heroines of Sacher-Masoch’s romances could charm him.

Cases like this, in which the whole perversion of the vita sexualis is confined to the sphere of imagination,—to the inner world of thought and instinct,—and only accidentally comes to the knowledge of others, do not seem to be infrequent. Their practical significance, like that of masochism in general (which has not the great forensic importance of sadism), is confined to the psychical impotence to which such individuals, as a rule, become subject; and to the intense impulse to solitary indulgence, with adequate imaginary ideas, and its results.

That masochism is a perversion of uncommonly frequent 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.

Léo 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 à Paris”) has a chapter in his book entitled “Les Passionels,” which contains contributions to this subject.

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 Confessions” it is evident that he was affected with masochism.

Rousseau, with reference to whose life and malady Möbius (“J. J. Rousseau’s Krankengeschichte,” Leipzig, 1889) and Chatelain (“La folie de J. J. Rousseau,” Neuchatel, 1890) 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 punish him if he did not learn well, made the deepest impression on him. When, one day, he had blows at her hands, with the feeling of pain and shame, he also experienced sensual 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, however, he unintentionally gave cause for a whipping at Miss Lambercier’s hands. This was the last; for Miss Lambercier must have noticed something of the peculiar effect of the punishment; and from this time on she did not allow the eight-year-old boy to sleep in her room. From this time Rousseau felt a desire to have himself punished by ladies pleasing to him, a la Lambercier; but he asserts that until his youth he knew nothing of the relation of the sexes to each other. As is known, Rousseau was first introduced to the real mysteries of love in his thirtieth year, and lost his innocence through Madame de Warrens. Until that time 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 sensuality, which had undoubtedly been awakened by his whippings; for he reveled in desire, and could not disclose his longings. It would be erroneous, however, to suppose that Rousseau was concerned merely with flagellation. Flagellation 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 emphasizes that “Etre aux genoux d’une maitresse impérieuse, obéir à ses ordres, avoir des pardons à lui demander,—etaient pour moi de très douces jouissances.”

This passage proves that the consciousness of subjection and humiliation before the woman was the most important element.

To be sure, Rousseau was himself in error in supposing that this impulse to be humiliated before a woman had arisen by association of ideas from the idea of flagellation:—

“N’osant jamais déclarer mon goût, je l’amusais du moins par des rapports qui m’en conservaient l’idée.”

It is only in connection with the numerous cases of masochism, the existence of which has now been established, and among which there are so many that are in nowise connected with flagellation, showing the primary and pure 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 detected into which he necessarily fell in the analysis of his own condition.

Binet (Revue Anthropologique, xxiv, p. 256), who analyzes Rousseau’s case in detail, also justly calls attention to its masochistic significance, when he says: “Ce qu’aime Rousseau dans les femmes, ce n’est pas seulement le sourcil froncé, la main levée, le regard sévère, l’attitude impérieuse, c’est aussi l’état émotionnel, dont ces faits sont la traduction extérieure; il aime la femme fière, dédaigneuse, l’écrasant à ses pieds du poids de sa royale colère.”

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 manifested in ordinary fetichism.

This deduction is acute, but it gives only a word with which to designate a fact, not a solution of it. Whether an explanation is possible will later occupy our attention.

There were also elements of masochism (and sadism) in the celebrated, or notorious, French writer, C. P. Baudelaire, who died insane.

Baudelaire came of an insane and eccentric family. From his youth he was mentally 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 glowing poems as the equivalent of sexual indulgence. 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 dementia. (Lombroso, “The Man of Genius.”)

In scientific literature, the conditions that constitute masochism have not received attention until recently. All there is to mention is that Tarnowsky (“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, in Tarnowsky’s observation, in certain cases blows, even when they draw blood, do not bring the result desired (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 fancies that he makes opposition, scolds, and pretends to resist. Only under such circumstances do the blows induce excitement that leads to ejaculation.”

O. Zimmermann’s work, “Die Wonne des Leids,” Leipzig, 1885, also contributes much to this subject, taken from the history and literature.

Of late the subject has been given much attention.

A. Moll, in his work, “Die Conträre Sexualempfindung,” pp. 133 and 141 et seq., Berlin, 1891, gives a number of cases of complete masochism in individuals of contrary sexuality, and among them the case of a man suffering with contrary sexual instinct, who sent written instructions, containing twenty paragraphs, to a man engaged for his 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 me that, about three years before, he had given his attention to the perversion of the vita sexualis, designated “masochism” 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 Legal Society of Moscow (printed in the Juridischen Boten, the organ of the society, in numbers 6 to 8).

In later fiction the psycho-sexual perversion which forms the subject of this study has been treated by Sacher-Masoch, whose writings, already frequently alluded to, afford typical pictures of the perverse mental life of men of this kind. Many affected with this perversion refer directly to the writings of Sacher-Masoch, as is seen from the foregoing cases, as typical descriptions of their own psychical condition.

In “Nana,” Zola has a masochistic scene, and likewise in “Eugène Rougon.” The latest “decadent” literature of France and Germany is also largely concerned with the themes of sadism and masochism. According to von Stefanowsky’s statement, the modern Russian novel frequently treats the subject; but the statements of the writer of travels, Johann Georg Forster (1754–1794), show that this subject also played a rôle in Russian folk-songs.

(b) Foot-and Shoe-Fetichists—Larvated Masochism.—Following the above-mentioned group of “symbolic” masochists, who do not exactly desire abuse by women as the means of expression of subjection, but all kinds of silly acts that can be understood only through an acquaintance with the masochistic circle of ideas, comes the very numerous class of foot- and shoe-fetichists.

By fetichists (v. infra, 3) I understand individuals whose sexual interest is confined exclusively to parts of the female body, or to 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 53) the satisfaction of a masochist was found in being trod upon. In Cases 44 and 48, they also had themselves trod upon; in Case 51, equus eroticus, the person loved a woman’s foot, etc. In the majority of cases of masochism, the act of being trod upon with feet plays a part as an easily accessible means of expressing the relation of subjection.

Of the numerous established cases of shoe-fetichism, the following one, reported by Dr. A. Moll, of Berlin, which corresponds in many respects with Hammond’s case, but which is described in more detail and more carefully observed, seems especially suited to show the connection between masochism and shoe-fetichism:—

Case 60. O. L., aged 31, book-keeper in a city of Wurtemburg; comes of a tainted family.

The patient is a large, powerful man, of ruddy appearance. In general he is of a quiet temperament, but may become very violent on occasion; he says himself that he is quarrelsome and inclined to assert himself. L. is of a kindly disposition and generous; easily made to weep. At school he passed for a talented pupil, with good powers of comprehension. The patient at times has congestion of the head, but is otherwise healthy, except that he is much depressed and melancholic as a result of his sexual perversion, here to be described.

But little can be learned of any hereditary taint.

The following facts concerning the development of his sexual life are gathered from the patient’s own statements:—

In very early youth—in fact, when he was eight or nine years old—L. had the desire to lick his teacher’s boots like a dog. L. thinks it possible that this thought was excited in him by his once seeing a dog actually do this, but he cannot state this with certainty; and it seems much more certain to the patient that the first ideas of this kind came in a waking state, not in dreams.

From his tenth to his fourteenth year he constantly sought to touch the shoes of his fellow-pupils, and also those of little girls; but for this purpose he always chose boys who had wealthy and prominent parents. One of these, the son of a rich landed proprietor, had riding-boots; in the boy’s absence L. took these in his hands, struck himself with them, and pressed them against his face. L. did the same thing with the elegant boots of an officer of dragoons.

After the beginning of puberty the desire was transferred exclusively to the boots of females. Thus, while skating, the patient’s attention was entirely occupied with putting on and taking off skates for ladies; but he always chose only such women as were rich and prominent socially, wearing elegant boots. In the street and everywhere L. constantly looked for elegant boots. His love for them went so far that he often put in his purse, and even in his mouth, the sand and mud that bore their imprints. As a boy of fourteen L. visited brothels; and he often visited a café chantant solely to excite himself with the sight of elegant boots (low shoes were less attractive). In his school-books and on the walls of closets, L. drew boots. In the theatre he saw nothing but the shoes of the ladies. For hours at a time, in the street and on board steam-boats, L. would run after ladies wearing elegant boots; and he thought with delight of how he might get a chance to touch the boots. This peculiar love for boots remains unchanged. The thought to have himself trod upon by ladies in their boots, or to kiss the boots, gives L. the most intense sensual delight. Before shoe-stores he will stand and stand, merely to look at the boots. He is particularly excited by their elegance.

The patient prefers high-buttoned or laced boots with high heels; but less elegant boots, even with low heels, also excite him, if their wearer is a wealthy, distinguished, and proud lady.

At the age of twenty L. attempted coitus; but, “in spite of the greatest efforts,” as he believes, he was not successful. During the attempt the patient had no thought of shoes; on the contrary, he had first sought to excite himself sexually with shoes, and he asserts that too great excitement was to blame for his want of success in coitus. Up to this time, being thirty-one years old, he has attempted coitus only four or five times, and always in vain.

On one occasion the patient, already much to be pitied on account of his disease, had the misfortune to contract syphilis. In reply to the question as to what he regarded as the most lustful act, the patient said: “It is my greatest delight to lie naked on the floor and have myself trod upon by girls wearing elegant boots; but, of course, this is possible only in brothels.” Moreover, according to the patient’s statements, these sexual perversions of men are well known in many houses of prostitution,—a proof that these are not so very infrequent. The prostitutes call these men “boot-lovers.” But the patient has only very infrequently had the lustful act actually performed, notwithstanding the fact that it is most beautiful and pleasant to him. The patient has no thoughts that impel to intercourse; at least, not in the sense of immissio penis in vagina,—an act that affords him no pleasure whatever. Indeed, he has gradually developed a fear of coitus, which may be sufficiently explained by his numerous unsuccessful attempts; for the patient says himself that his inability to complete coitus embarrassed him exceedingly. The patient has never practiced real onanism. With the exception of a few occasions on which the patient satisfied his sexual desire by onanism with boots or in a similar way, he is innocent of such satisfaction; for, in the excitement with boots, there is scarcely ever anything more than erection; at most, only a slight discharge of fluid takes place slowly, which the patient takes to be semen.

Simply a shoe, worn by no one, excites him when he sees it, but not nearly as intensely as when it is worn by a woman. New shoes that have not been worn excite him much less than those that have been used; but they must be free from wear and look as new as possible. Shoes of this kind excite him the most. As has been said, ladies’ boots excite him when they are not on the feet. Under such circumstances, in fancy, L. creates a lady for them; he presses them to his lips and on his penis. He would “die with delight” if a proud, respectable lady were to tread upon him with her shoes.

Aside from the previously mentioned characteristics of the women (pride, wealth, social prominence), which, in connection with the elegance of the boots, constitute an especial stimulus, the patient is by no means indifferent to the physical charms of the female sex. He is enthusiastic about beautiful women without thinking of boots, but this love is not directed to sexual satisfaction. The bodily charms play a part even in connection with the boots; a homely old woman, even wearing the most elegant boots, cannot affect the patient. The rest of the attire and other circumstances also play an essential rôle, as is shown by the fact that elegant boots worn by proud, distinguished women especially excite the patient. A common servant-girl, in her working-dress, even in the most elegant shoes, would not excite him. Men’s shoes and boots no longer affect the patient; and he never in the slightest degree feels himself attracted to men sexually.

Yet the patient has erections very easily. When he takes a child in his lap, when he pats a dog or horse for some time, when he travels on the cars, or when he rides,—erections occur. In the latter case he thinks it is due to the shaking. He has erections every morning; and he can induce erection in a very short time by thinking of the act with boots that is so pleasing to him. Pollutions formerly occurred frequently at night—about every three or four weeks; now they are more infrequent, occurring once about every three months.

In his erotic dreams the patient is almost always sexually excited by the same thoughts that excite him in the waking state. For some time he thinks he has felt ejaculation during erection; but he draws this conclusion only from feeling a little moisture at the end of the penis. Books touching the sphere of the patient’s sexual ideas especially excite him. Thus, in reading “Venus in Furs,” by Sacher-Masoch, he is so excited “that the semen just runs away from him.” Moreover, with L., this kind of ejaculation, while reading, is a decided satisfaction of his sexual desire. My question, whether blows received from a woman’s hand would also excite him, the patient thinks he would have to answer in the affirmative. The patient has never made any such trial, but playful taps had, at any rate, always been very pleasing to him.

It would afford the patient a particularly intense pleasure if he were to be kicked by a woman, even without shoes, and with bare feet. He does not think that the blows, as such, would cause the excitement, but rather the thought of being maltreated by a woman; and this might follow scolding as well as actual blows. Besides, blows and cross words had an exciting effect only when they came from a proud and distinguished lady. In general it is the feeling of humiliation and slavish subjection that gives the patient lustful pleasure. “Were a lady,” the patient tells me, “to command me to wait on her, even with distant coldness, I should, nevertheless, feel sensual pleasure.”

To the question, whether with boots the feeling of humiliation came over him, the patient answers: “I think that this general passion for self-humiliation has been concentrated especially on ladies’ boots; for it is symbolic of one’s being ‘unworthy to loosen the latchet of another’s shoe’; and, besides, a subject kneels.”

Women’s stockings also have an exciting effect on the patient, but only to a slight extent, and perhaps only through awakening an idea of boots. The patient’s passion for ladies’ boots had constantly increased, but of late years he thought he had noticed a diminution of it. He seldom visits public women, and is also more capable of self-restraint. Yet this passion still rules him absolutely, and every other pleasure is spoiled by it. A pretty female boot could attract his glance from the most beautiful landscape. At the present time he often goes about at night in the corridors of hotels, seeking elegant ladies’ shoes, which he kisses and presses against his face and neck, but principally against his penis.

The patient, who is very well-to-do, a short time ago went voluntarily to Italy, only with the thought of becoming the servant of a rich and distinguished lady unacquainted with him; but the plan failed. The patient, who came only for consultation, has not yet been treated medically.

The foregoing history reaches almost to the present time, and in the interval he has made me communications by letter concerning his condition. It does not require an extensive commentary. It seems to me to be one of the best cases to illustrate the relationship between shoe-fetichism and masochism, as set forth by von Krafft-Ebing. The principal charm for the patient, as he, without leading questions, always emphasizes, is his subjection to a woman, who, in pride and position, must be as far above him as possible.

Such cases, 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 humiliation, have become the objects of especial sexual interest, are numerous. 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. The latter are the numerous cases of shoe-fetichism. These very 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 larvated masochism (the motive remaining unconscious) in which the female foot or shoe, as the masochist’s fetich, has acquired an independent significance.

Next come two cases in which the female shoe possesses a subordinate interest, but in which unmistakable masochistic desires play an important part (comp. Case 44):—

Case 61. Mr. X. aged 25, parents healthy, never sick before, places the following autobiography at my disposal: “I began to practice 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 spontaneously.

“Puberty began at the age of thirteen; with the occurrence of ejaculation lustful pleasure increased, and I 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 odor of the leather with avidity. In order to smell leather during the act of onanism, I bought a pair of leathern cuffs, which I smelled while I masturbated. My enthusiasm for ladies’ leathern shoes remains the same to-day; only, since my seventeenth year, it has been coupled with the wish to become a servant, to blacken shoes for 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-store 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 through 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 my former onanism. I learn easily, have a good memory, and have never had headache in my life. This much concerning myself.

“A few words about my brother: I am thoroughly convinced that he is also a shoe-fetichist. Of the many facts that demonstrate this to me, it is only necessary to mention that it is a great pleasure for him to have a certain 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-store, and regards the shoes on exhibition, is a “foot-lover” or not. This anomaly is uncommonly 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. 62. Reported by Mantegazza in his “Anthropological 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, induced erection and even ejaculation. Sight alone was sufficient for him in the case of elegant shoes,—i.e., shoes of black leather, buttoning up the side, and having very high heels. His sexual desire was powerfully excited by touching, kissing, or drawing on such shoes. His enjoyment was increased by driving nails through the soles so that their points would penetrate his feet while walking. This caused him terrible pain, but he had real lustful feeling at the same time. His greatest enjoyment was to kneel down before the elegantly-clad feet of ladies and have them step on him. If the wearer were an ugly woman, the shoes would not affect him, and his fancy would cool. If the patient had shoes alone at his disposal, his fancy would create a beautiful woman wearing them, and ejaculation would result. His nightly dreams were of the shoes of beautiful women. He considered the exposure of ladies’ shoes in show-windows 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 element is also plain enough, as is also the sadistic (comp. “Torture of Animals,” under “Sadism”):—

Case 63. A young, powerful man, aged 26. Nothing in the opposite sex excites his sensual feeling except elegant shoes on the feet of a handsome woman, especially when they are made of black leather and have high heels. The shoes without the wearer are sufficient. It gives him the greatest pleasure to see, touch, and kiss them. The feminine foot, when bare or covered with a stocking, has no effect on him. Since childhood he has had a weakness for ladies’ fine shoes.

X. is potent; during the sexual act the female must be elegantly dressed and, above all, have on pretty shoes. At the height of sensual excitement cruel thoughts about the shoes arise. He is forced to think with delight of the death-agonies of the animal from which the leather was taken. Sometimes he is 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 calls this “sacrificing to the feet of Venus.” At other times he has the woman walk on him with her shoes on, the harder the better.

Until the last 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, Archiv di Psichiatria, ix, fascic. iii.)

The following case reminds one of the third of this series, on account of the interest in the nails of the shoes (as capable of inflicting pain); and of the fourth, on account of the slight accompanying sadistic element:—

Case 64. X., aged 34, married; of neuropathic parentage; suffered severely from convulsions as a child; remarkably precocious, but one-sided in development (could read at age of three); nervous from childhood. At the age of seven he manifested an inclination to handle 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. Frequently 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 pavements, which, like the sight of the nail-marks in ladies’ shoes, or the sight of shoes in the windows of the shoe-shops, always gave him a feeling of lustful pleasure. He married, and during the first months of his married life was free from these desires.

Gradually he became hysteropathic and neurasthenic. At this stage he began to have hysterical attacks when the shoemaker spoke to him of nails in ladies’ shoes or of driving nails in the same. The reaction was still greater if he chanced to see a pretty lady with shoes well beset with nails. In order to induce ejaculation it was only necessary for him to cut soles out of pasteboard and beset them with nails; or he would buy ladies’ shoes, have them beset with nails in the store, and at home scrape them on the ground, and finally touch the end of his penis with them. Moreover, lustful shoe-visions occurred spontaneously, in which he satisfied himself by masturbation.

X. is otherwise intelligent, skillful in his calling, but powerless in combating his perverse inclinations. He presents phimosis; penis short, expanded at the root, and incapable of complete erection. One day the patient allowed himself to masturbate when excited by the sight of ladies’ shoes beset with nails in the window of a shoe-shop, and thus became a criminal. (Blanche, Archiv. de Neurologie, 1882, Nr. 22.)

Reference may be made here to a case of contrary sexuality, to be described later, in which the principal sexual interest was in the boots of male servants. The desire was to be trod upon by them.

Case 65. (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 of patent leather, under the condition that she would put them on immediately. After this took place, she had to go about in the street, walking in manure and mud as much as possible, in order to soil the shoes. After this, X. would lead the person to an hotel, and, almost before they had reached a room, he would cast himself on her feet, feeling an extraordinary pleasure in applying his lips to them. When he had cleansed the shoes in this manner, he paid her and went his way.

From these cases it may be plainly seen that the shoe is the fetich of the masochist, and apparently because of the relation of the dressed female foot to the idea of being trod upon and other acts of humiliation. When, therefore, in 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 that are otherwise wholly inexplicable are thus sufficiently explained. Here one has to do with larvated masochism; and this may always be assumed as the unconscious motive, when, as occurs not exceptionally, the origin of the fetichism, from an association of ideas on the occasion of some particular event, can be proved, as in Cases 87 and 88.

Such cases of desire for ladies’ shoes, without conscious motive and without demonstrable origin, are really innumerable. Three cases are here given as examples:—

Case 66. Minister, aged 50. From time to time he goes to houses of prostitution and asks to rent a room. He enters it with a girl. Then he lustfully regards her shoes, takes one off and kisses and bites it. Finally, he puts it ad genitalia and ejaculat semen semineque ejaculato axillas pectusque terit; then he comes out of his sensual ecstasy. He begs the woman to allow him to keep the shoe for a few days, and always, at the appointed time, returns it with thanks (Cantarano, La Psichiatria, v, p. 205).

Case 67. Student, Z., aged 23; comes of a tainted family. Sister was insane; brother suffered with hysteria virilis. The patient, peculiar from childhood, has frequent attacks of hypochondriacal depression, tædium vitæ, and feels that he is persecuted. In a consultation on account of mental trouble, I find him a very perverse, hereditarily predisposed man, with neurasthenic and hypochondriacal symptoms. A suspicion of masturbation is confirmed. Patient makes interesting disclosures concerning his vita sexualis. At the age of ten he was powerfully attracted by the foot of one of his comrades. At twelve he became an enthusiast for ladies’ feet. It gave him a delightful sensation to revel in the sight of them. At fourteen he began to masturbate, thinking, at the same time, of the beautiful foot of a lady. From this time on he was taken with the feet of his three-year-old sister. The feet of other females that attracted him induced sexual excitement. Only women’s feet—no other part of them—interested him. The thought of sexual intercourse with women excited his disgust. He had never attempted coitus. After his twelfth year he had no interest in the feet of male individuals. The style of covering of the female foot is indifferent to him; it is only necessary that the person seem to be sympathetic. The thought of enjoying the feet of prostitutes was disgusting to him. For years he had been in love with his sister’s feet. If he could but obtain her shoes, the sight of them 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 genitals) the simple sight of the foot had induced ejaculation. From his relatives it is ascertained that the patient has a silly admiration for the feet of his sister; so that she avoids him and seeks to hide her feet from him. The patient looks upon his perverse sexual impulse as pathological, and is painfully affected by the fact that his vile fancy has 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 imagination. 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 sleepless night. He often wondered that he could still love his sister. Although it seemed right to him that she should conceal her feet from him, yet he was often irritated because the concealment caused him to have pollutions. The patient gives assurances of being moral in other respects, which are confirmed by his relatives.

Case 68. S., New York, is accused of being a street-thief. Numerous cases of insanity in his ancestry; father, brother, and sister mentally abnormal. At seven years, violent cerebral concussion twice. At thirteen, struck with 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, those belonging to one member—and hide them in some out-of-the-way corner. Taken to task, he would lie, or declare that he had no memory 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 the shoe from the foot of one of the servants, and on another he stole his sister’s shoe from her sleeping-apartment. 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 afterward he tore the shoe from a girl’s foot in the open street, fled to his place of work, and there was arrested as a street-thief. He declared that he did not know much of his act; that it had come upon him like a stroke of lightning, at the sight of a 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 slept. His moral character and habits of life were blameless. He was an intelligent workman; but irregularity of employment, that soon followed, made him confused and incapable of work. Pardoned. (Nichols, Am. Journal of Insanity, 1859; Beck, “Med. Jurisprudence,” vol. i, p. 732, 1860.)

Dr. Pascal (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—Larvated Masochism.—There are numerous established cases in which perverted men are thrown into sexual excitement by the secretions, or even the excretions, of women, and try to see and touch them. Probably in these cases there is almost always an unconscious masochistic impulse,—pleasure in the most extreme humiliation of self, and desire to experience it.

This connection is made perfectly clear by the confessions of those affected with this repugnant perversion. Case 88 of the sixth edition—that of an individual affected with contrary sexuality, which is later described—is here instructive. The subject of this case not only revels in the thought of being the slave of the beloved man, and refers on this point to Sacher-Masoch’s “Venus in Furs,” sed etiam sibi fingit amatum poscere ut crepidas sudore diffluentes olfaciat ejusque stercore vescatur. Deinde narrat, quia non habeat, quæ confingat et exoptet, eorum loco suas crepidas sudore infectas olfacere suoque stercore vesci, inter quæ facta pene errecto se voluptate perturbari semenque ejaculari.

The masochistic significance of a disgusting act in the following case, communicated by a professional friend, is clear:—

Case 69. H. v. G., landed proprietor; major; died in his sixtieth year; came of a family in which irresponsibility, tendency to run in debt, and defect of morals are hereditary. In his youth he was given to most reckless dissipation (he was known as the leader of “naked balls”). He was always of a cynical and brutal nature, though punctilious and exact in his military service, which, on account of a disreputable affair that was not made known, he had to leave, and he lived in private life seventeen years. Untrammeled by the necessity to earn his living, he led everywhere the life of a man-of-the-town, and was everywhere avoided on account of his lascivious nature. His ostracism by the best society, which, in spite of his independence, he noticed, caused him to prefer the ordinary society of fakirs, artisans, and loafers. It cannot be ascertained that he had sexual intercourse with men, but it is certain that in his later years he arranged symposiums with mixed company and was known as a roué. In the last few years of his life he was accustomed to hang about new buildings in the evening, and of the women working there he would ask the dirtiest to accompany him. It is certain that he had the woman undress, and then he would suck her toes, his libido being excited and satisfied by the act.

Cantarano also reports a case in La Psichiatria, v year, p. 207, in which, preceding the act, apparently from a similar cause, there was biting and sucking of a woman’s toes in as filthy a state as possible.

Several cases have come to my knowledge in which, with other masochistic acts (maltreatment, humiliation), such disgusting desires were entertained; and the confessions of the individuals left no doubt of their significance.

Such cases prepare the way to an understanding of others which are absolutely incomprehensible without the connection with the masochistic desire for humiliation. It is probable, however, that this impulse, in its actual significance, remains unknown to the perverted individual, and only the desire for disgusting things rises into consciousness,—again larvated masochism.

Other cases of Cantarano’s (loc. cit.) belong here: mictio even defæcatio puellæ ad linguam viri ante actum; consumption of confects smelling like fæces, in order to become potent; and also the following case, likewise communicated to me by a physician:—

Case 70. A Russian prince, who was very decrepit, was accustomed 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 eat marchpane exclusively. Ut libidinosus fiat et ejaculare possit excrementa feminæ ore excipit. A Brazilian physician tells me of several cases of defæcatio feminæ in os viri that have come to his knowledge. Such cases occur everywhere, and are not at all infrequent. All kinds of secretions—saliva, nasal mucus, and even aural cerumen—are used in this way and swallowed with pleasure; and oscula ad nates and even ad anum are indulged in. Dr. Moll (op. cit., p. 135) reports the same thing of a man affected with contrary sexuality. The perverse desire to practice cunnilingus, which is very wide-spread, probably frequently has its root in masochistic impulses.

Palanda (Archivio di Psichiatria. x, fascicolo 3, 4) relates the following case:—

Case 71. W., aged 45, predisposed, was given to masturbation at the age of eight. A decimo sexto anno libidines suas bibendo recentem feminarum urinam satiavit. Tanta erat voluptas urinam bibentis ut nec aliquid olfaceret nec saperet, hæc faciens. After drinking he always experienced disgust and ill-feeling, and made firm resolutions to do it no more in the future. Once he had the same pleasure in drinking the urine of a nine-year-old boy, with whom he once practiced fellatio. The patient suffers with epileptic insanity.

The cases described in this group form the complete counterpart to group “d” of the sadists.

Still other older cases belong here, which Tardieu (“Étude médico-légale sur les attentats aux mœurs,” p. 206) observed in senile individuals. He describes as “Renifleurs” persons “qui in secretos locos nimirum theatrorum pasticos convenientes quo complures feminæ ad micturiendum festinant, per nares urinali odore excitati, illico se invicem polluunt.” The “Stercoraires” that Taxil (“La prostitution contemporaine”) mentions are, in relation to this subject, unique.

Finally, space is here given to the following case, reported to me by a physician:—

Case 72. A notary, known from his youth to those about him as peculiar and misanthropic. During his school-days he was given to masturbation. According to his own story, he excited his sexual desire by spreading out on the cover of his bed pieces of toilet-paper that he had used, induced erection by regarding and smelling them, and then practiced masturbation. After his death, by the side of his bed, there was found a large basket of such papers, with the dates marked on them. Here there were probably fancies of the nature of the above-mentioned acts.

(d) Masochism in Women.—In woman voluntary subjection to the opposite sex is a physiological phenomenon. Owing to her passive rôle in procreation and long-existent social conditions, ideas of subjection are, in woman, normally connected with the idea of sexual relations. So to speak, they form the harmonics which determine the tone-quality of feminine feeling.

Any one conversant with the history of civilization knows in what a state of absolute subjection woman was always kept until a relatively high degree of civilization was reached; and an attentive observer of life may still easily recognize how the custom of unnumbered generations, in connection with the passive rôle 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 behavior, though loudly reprehended, is often accepted with secret satisfaction. Under the veneer of polite society the instinct of feminine servitude is everywhere discernible.

Thus it is easy to regard masochism in general as a pathological growth of specific feminine mental elements,—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. 145). It may, however, be held to be established that, in woman, an inclination 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 use blows to display his power (as the love-serving knights did with the ladies of the Middle Ages), but prefers to demonstrate his real advantages. The barbarian has his wife plow for him, and the civilized lover speculates about her dowry; she willingly endures both.

Cases of pathological increase of this instinct of subjection, in the sense of feminine masochism, are probably frequent enough, but custom represses their manifestation. Many young women like nothing better than to kneel before their husbands or lovers. Among all Slavs of the lower classes it is said that the wives feel hurt if they are not beaten by their husbands. A Hungarian officer informs me that peasant women of the Somogy’er Comitates 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. Subjective and objective restraints—modesty and custom—naturally constitute, in women, insurmountable obstacles to the expression of perverse sexual instinct. Thus it happens that, up to the present time, but one case of masochism in a woman has been scientifically established; and this is accompanied by circumstances that obscure it.

Case 73. Miss v. X., Russian, aged 35; of greatly predisposed family. For some years she has been in the initial stage of paranoia persecutoria. This sprang from cerebro-spinal neurasthenia, the origin of which is found to be sexual hyper-excitation. Since her twenty-fourth year she has been given to masturbation. As a result of disappointment in an engagement and intense sexual excitement, she began to practice 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 reveled in the idea, and never attempted any actual realization of my fancies. These 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. Since my tenth year I have never had any more such fancies.”

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 that is conceived in imagination as whipping her, is explained by the circumstance that the masochistic desire was here present in the mind of a child before the psychical vita sexualis had developed and the instinct for the male had been awakened. Contrary sexual instinct is here expressly excluded.

An Attempt to Explain Masochism.

The facts of masochism are certainly among the most interesting in the domain of psychopathology. An attempt to explain them must first seek to distinguish in them the essential from the unessential. The distinguishing characteristic in masochism is certainly the unlimited subjection to the will of a person of the opposite sex (in sadism, on the contrary, the unlimited mastery of this person), with the awakening and accompaniment of lustful sexual feelings to the degree of orgasm. From all that has preceded it is clear that the particular manner in which this relation of subjection or domination is expressed (v. supra), whether in simply 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 undoubtedly frequent; and it is this that most frequently comes under observation and almost exclusively makes up the series of observed cases. The reason for this has been previously stated (p. 139).

Two sources of masochism can be distinguished in the sphere of normal phenomena. The first is, that in the state of lustful excitement every impression made by the person giving rise to the sexual stimulus, independently of the nature of its action, is pleasing to the individual excited.

It is entirely physiological that playful taps and light blows should be taken for caresses,

“Like the lover’s pinch which hurts and is desired.”

From here the step is not long to a state where the wish to experience a very intense impression at the hands of the consort leads to a desire for blows, etc., in cases of pathological intensification of lust; for pain is always a ready means for producing an intense bodily impression. Just as in sadism the sexual emotion leads to a state of exaltation in which the excessive motor excitement implicates neighboring nervous tracts; so in masochism an ecstatic state arises, in which the rising flood of a single emotion ravenously devours and covers with lust every impression coming from the beloved person.

The second and, indeed, the most important source of masochism is to be sought in a wide-spread phenomenon, which, though it is extraordinary and abnormal, by no means lies within the domain of sexual perversion.

I here refer to the very prevalent fact that in innumerable instances, which occur in all varieties, one individual becomes dependent on another of the opposite sex, in a very extraordinary and remarkable manner,—even to the loss of all independent will; a dependence which forces the party in subjection to acts and suffering which greatly prejudice personal interest, and often enough to offense against both morality and law.

This dependence, however, differs from the manifestations 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 equilibrium. The difference is one of intensity, not of quality, as in masochistic manifestations.

This dependence of one person upon another of the opposite sex, that is abnormal but not perverse,—a phenomena possessing great interest when regarded from a forensic stand-point,—I designate “sexual bondage;” for the relations and circumstances attending it have in all respects the character of bondage. The will of the ruling individual dominates that of the person in subjection, just as a master’s does his bondsman’s.

This “sexual bondage,” as has been said, is certainly an abnormal phenomenon. It begins with the first deviation 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 satisfied, amiable, and inclined to sexual intercourse, are here the motives of the individual in subjection. An extraordinary degree of love—which, particularly in woman, does not always indicate an unusual degree of sensuality—and a weak character are the simple elements of this extraordinary process.

The motive of the dominant individual is egoism, which finds unlimited room for action.

The manifestations of sexual bondage are various in form, and the cases are very numerous. At every step in life we find men that have fallen into sexual bondage. Among married men, hen-pecked husbands belong to this category, particularly elderly men who marry young wives and try to overcome the disparity of years and physical defects by unconditional submission to the wife’s every whim; and unmarried men of ripe maturity, who seek to better their last chance of love by unlimited sacrifice, are also to be enumerated here. Here belong, also, men of any age, who, seized by hot passion for a woman, meet coldness and calculation, and have to capitulate on hard conditions; men of loving natures who allow themselves to be persuaded to marriage by notorious prostitutes; men who, to run after adventuresses, leave everything and jeopardise their future; husbands and fathers who leave wife and child, to lay the income of a family at the feet of a harlot.

But, numerous as the examples of masculine “bondage” 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 often her first thought, but always, at least, takes the second place. But, what is still more important, the man ruled by this impulse easily satisfies it in embraces for which he finds unlimited opportunities. A 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 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 illusions of a maiden; the seducer, and the man who compromises 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 difficulties of her position.

The subject of “sexual bondage” must here receive brief consideration; for in it may be clearly seen 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 subjection of the individual affected with the abnormality to a person of the opposite sex, and of domination of the former by the latter. The two phenomena, however, must be strictly differentiated; they are not different in degree, but in quality.

Sexual bondage is not a perversion and not pathological; 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 opposed to self-interest, and often to custom and law. The motive, in obedience to which the subordinated individual acts and endures tyranny, is the normal instinct toward woman (or man); the satisfaction of which is the price of bondage. The acts of the person in subjection, by means of which the bondage is expressed, are performed at the command of the ruling individual, to satisfy selfishness, etc. For the subordinated individual they have no independent purpose; they are only the means to an end,—to obtain or retain possession of the 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 of 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 themselves. 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 tyrannized over is long closely associated with the lustful thought of the beloved person, the lustful emotion is finally connected with the tyranny itself, and the transformation to perversion is completed. This is the manner in which masochism may be acquired by cultivation.

Thus a mild degree of masochism may arise from “bondage,”—become acquired; but genuine, complete, deep-rooted masochism, with its feverish longing for subjection from the time of earliest youth, is congenital.

The explanation of the origin of the infrequent perversion of fully developed masochism is most probably to be found in the assumption that it arises from the very frequent abnormality of “sexual bondage”; in that now and then this abnormality is hereditarily transferred to a psychopathic individual in such a way that it becomes transformed into a perversion. It has been previously shown how a slight displacement of the psychical element under consideration may effect this transition.

This transformation of the abnormality into the perversion, through hereditary transference, would take place very easily where the psychopathic constitution of the descendant presented the other factor of masochism,—i.e., what has been previously called its main root,—the tendency of sexually hyperæsthetic natures to assimilate all impressions coming from the beloved person with the sexual impression.

From these two elements,—from “sexual bondage” on the one hand, and from the above-mentioned 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 on the basis of psychopathic predisposition; in that its sexual hyperæsthesia intensifies first all the physiological accessories of the vita sexualis and, finally, only its abnormal accompaniments, to the pathological degree of perversion.

At any rate, masochism, as a congenital sexual perversion, constitutes a functional sign of degeneration in (almost exclusively) hereditary taint; and this clinical deduction is confirmed in my cases of masochism and sadism. It is easy to demonstrate that the peculiar, psychically-anomalous direction of the vita sexualis which masochism represents, 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 suppose. 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 cases, from Case 53, 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 rôle, as in Case 44 and Case 50. Case 51 is particularly instructive in relation to this; for in this instance there can be no thought of a sexually-stimulating effect of punishment received in youth. Moreover, 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 in purely psychical elements, on confronting it with sadism (v. infra), is convincingly demonstrated. That passive flagellation occurs so frequently in masochism is explained simply by the fact that it is the most extreme means of expressing the relation of subjection.

I repeat that the decisive points, in the differentiation of simple passive flagellation from flagellation dependent upon masochistic desire, are that, in the former, the act is a means to make 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, in such acts (and in flagellation in masochists, having like significance) we must seek to ascertain in what relation 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 that which causes physical pain is here simply perceived as physical pleasure; but 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), with the preoccupation of consciousness with lustful emotion, the idea of maltreatment remains merely a symbol, without its quality of pain.

To a certain extent there is over-compensation of physical pain in psychical pleasure; and only the excess remains in consciousness as psychical lust. This also undergoes an increase; since, either through reflex spinal influence or through a peculiar coloring in the sensorium of sensory impressions, a kind of hallucination of bodily pleasure takes place, with a vague localization of the objectively projected sensation.

In the self-torture of religious enthusiasts (fakirs, howling dervishes, religious flagellants) there is an analogous state, only with a difference in the quality of pleasurable feeling. Here the conception of martyrdom is also apperceived without its pain; for consciousness is filled with the pleasurably colored idea of serving God, atoning for sins, deserving heaven, etc., through martyrdom.

Masochism and Sadism.

The perfect counterpart of masochism is sadism. While in the former there is a desire to suffer and be subjected to violence, in the latter the wish is to inflict pain and use violence.

The parallelism is perfect. All the acts and situations used by the sadist in the active rôle become the object of the desire of the masochist in the passive rôle. In both perversions these acts advance from purely symbolic acts to severe maltreatment. Even murder, in which sadism reaches its acme, finds, as is shown by Case 54,—of course, only in fancy,—its passive counterpart. Under favoring conditions, both perversions may occur with a normal vita sexualis; in both, the acts in which they express themselves are preparatory for coitus or substitutes for it.

But the analogy does not exist simply in external manifestation; it also extends to the subjective character of both perversions. Both are to be regarded as original psychopathies in mentally abnormal individuals, who, in particular, are affected with psychical hyperæsthesia sexualis, 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. For masochism, as shown above, these elements lie in the fact (1) that in the state of sexual emotion every impression produced by the consort, independently of the manner of its production, is, per se, attended with lustful pleasure, which, where there is hyperæsthesia sexualis, may go so far as to over-compensate all painful sensation; and in the fact (2) that “sexual bondage,” dependent on mental factors that are in themselves not perverse, may, under pathological conditions, become a perverse, pleasurable desire for subjection to the opposite sex, which—even if it be quite unnecessary to assume its inheritance from the female side—represents a pathological degeneration of the character belonging to woman,—of the instinct of subordination, physiological in woman.

In harmony with this, there are, likewise, two constituent 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 extent, as an accompanying psychical excitation, an impulse may arise to influence the object of desire in every possible way and with the greatest possible intensity, which, in individuals sexually hyperæsthetic, may become an impulse to inflict pain; and the fact (2) that, under pathological conditions, the man’s active rôle of winning woman may become an unlimited desire for subjugation.

Thus masochism and sadism represent perfect counterparts. It is also in harmony with this that the individuals affected with these perversions regard the opposite perversion in the other sex as their ideal, as shown by Case 44 and Case 50, 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 associations of related ideas, as Binet, in 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 related 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 elements and phenomena of masochism and sadism, and as a résumé 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, because 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.

The cases in which sadism and masochism occur simultaneously in one individual are interesting, but they present some difficulties of explanation. Cases 49, 50, 58, etc., are of this kind, and also particularly Case 30. From the latter it is evident that it is especially the idea of subjection that, both actively and passively, forms the nucleus of the perverse desires. Traces of the same thing are also to be observed, with more or less clearness, in many other cases. At any rate, one of the two perversions is always markedly predominant.

Owing to this marked predominance of one perversion, and the later appearance of the other, in such cases it may well be assumed that the predominating perversion is original, and that the other has been acquired in the course of time. The ideas of subjection and maltreatment, colored with lustful pleasure, either in an active or passive sense, have become deeply impressed in such an individual.

Occasionally the imagination is tempted to try the same ideas in an inverted rôle. There may even be realization of this inversion. Such attempts in imagination and in acts, however, are usually soon abandoned as inadequate for the original inclination.

Masochism and sadism also occur in combination with contrary sexual instinct, and, too, in association with all forms and degrees of this perversion. The individual of contrary sexuality may be a sadist as well as masochist (comp. Cases 48 and 49 and numerous cases in the following series of cases of contrary sexual instinct).

Wherever a sexual perversion has developed on the basis of a neuropathic individuality, sexual hyperæsthesia, 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 appearance at any point in the domain of sexual aberration.

3. The Association of Lust with the Idea of Certain Portions of the Female Person, or with Certain Articles of Female Attire—Fetichism.—In the considerations concerning the psychology of the normal sexual life in the introduction to this work (vide p. 17), 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. Indeed, the especial power of attraction possessed by certain forms and peculiarities for many men—in fact, the majority—may be regarded as the real principle of individualization in love.

This preference for certain particular physical characteristics 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 l’amour,” Revue philosophique, 1887) and Lombroso (Introduction to the Italian edition of the second edition of this work), I have called “fetichism”; because this enthusiasm for certain portions of the body (or even articles of attire) and the worship of them, in obedience to sexual impulses, frequently call to mind the reverence for relics, holy objects, etc., in religious cults. This physiological fetichism has already been described in detail on page 17 et seq.

By the side of this physiological fetichism, however, there is, in the psycho-sexual sphere, an undoubted pathological, erotic fetichism, of which there is already a numerous series of cases presenting phenomena having great clinical and psychiatric interest, and, under certain circumstances, forensic importance. This pathological fetichism does not confine itself to certain parts of the body alone, but it is even extended to inanimate objects, which, however, are almost always articles of female wearing-apparel, and thus stand in close relation with the female person.

This pathological fetichism is connected, through gradual transitions, with physiological fetichism; so that (at least in body-fetichism) it is almost impossible to sharply define the beginning of the perversion. Moreover, the whole field of body-fetichism does not really extend beyond the limits of things which normally stimulate the sexual instinct. Here the abnormality consists only in the fact that the whole sexual interest is concentrated on the impression made by a part of the person of the opposite sex, so that all other impressions fade and become more or less indifferent. Therefore, the body-fetichist is not to be regarded 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 distinguishing 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 it is 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 subjective 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 certain portion of the body that has no direct relation to sex (as have the mammæ and external genitals)—a peculiarity to be emphasized—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 manipulation 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 also possible or not.

Fetichism of inanimate objects or articles of dress, however, in all cases, may well be regarded as a pathological phenomenon; since its objects fall without the circle of normal sexual stimuli. But even here, in the phenomena, there is a certain outward correspondence with processes of the normal psychical vita sexualis; the inner connection and meaning of pathological fetichism, however, are entirely different. In the ecstatic love of a man mentally normal, a handkerchief or shoe, a glove or letter, the flower “she gave,” or a lock of hair, etc., may become the object of worship, but only because they represent a mnemonic symbol of the beloved person—absent or dead—whose whole personality is reproduced by them. The pathological fetichist has no such relations. The fetich constitutes the entire content of his idea. When he is possessed by it, sexual excitement occurs, and the fetich makes itself felt.

According to all observations thus far made, pathological fetichism seems to arise only on the basis of a psychopathic constitution that is for the most part hereditary, or on the basis of existent mental disease.

Thus it happens that it not infrequently appears combined with the other (original) sexual perversions that arise on the same basis. Not infrequently fetichism occurs in the most various forms in combination with contrary sexuality, sadism, and masochism. Indeed, certain forms of body-fetichism (hand- and foot-fetichism) probably have a more or less distinct connection with the latter two perversions (v. 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 nature; it is not congenitally perfect, as we may well assume sadism and masochism to be. While in the sexual perversions thus far described we have met only cases of a congenital nature, here we meet only acquired cases. Aside from the fact that in fetichism the causative circumstance of its acquirement is often demonstrable, here the physiological conditions are wanting, which in sadism and masochism, by means of sexual hyperæsthesia, are intensified to perversions, and justify the assumption of congenital origin. In fetichism, every case requires an event which affords the subject of perversion. As has been said, it is, of course, physiological in sexual life to be partial to one or another of woman’s peculiarities, and to be enthusiastic about it; but concentration of the entire sexual interest on such partial impressions is here the essential thing; and for this concentration there must be a particular reason in every individual affected. Therefore, 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 is to be referred to the time of early youth, and, as a rule, occurs in connection with the first awakening of the vita sexualis. This first awakening is associated with some partial sexual impression (since it is always something standing in some relation to woman), and stamps it for life as the principal object of sexual interest. The circumstances under which the association arises are usually forgotten. It is only the result of the association that is retained. The general predisposition to psychopathic states and the sexual hyperæsthesia of such individuals are all that is original here.

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 indebito, theft and robbery of objects of fetichism, pollution of such objects, etc. Here, too, it only depends upon the intensity of the perverse impulse and the relative power of opposing ethical motives, whether and to what extent such acts are performed. These perverse acts of fetichists, like those of other sexually perverse individuals, may either alone constitute the entire external vita sexualis, or occur together 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 preparatory act.