PART VI.
PATHOLOGY OF SEXUALITY
CHAPTER XV
PARADOXIA
The pathology of love treats only of sensual love or of sensuality. The anomalies of sentimental love lie more properly within the province of the metaphysician or sociologist. Hence only the pathologic aspect of sensuality will be considered in the following part.
The analysis of sexuality has revealed the great complexity of the sexual instinct. No wonder, therefore, that the intricacies of love show many and varied anomalies. The anomalies based upon anatomical defects may easily be omitted. The number of works written on this subject is legion. They could fill whole libraries. But the psychical anomalies of love have enjoyed until very recently scanty attention at the hands of medical writers. Especially has modern gynaecology hitherto entirely neglected the psychical part of its specialty and has directed its attention only upon diseases that require surgical interference or other local manipulation.
The anomalies of the sexual impulse which will be analyzed in the following chapters are those based upon some defects in either of the three regions of the sexual sphere, the spinal cord, where the centres of erection and ejaculation are situated; the cerebellum, the seats of the impulses of voluptas and of libido and of the sensations of touch, sight, smell, and hearing, which usually provoke the impulses; and the cerebrum, with the higher sensations, as the sentiment of beauty, of affection, of admiration, of worship and of respect.
The anomalies based upon defects in these nervous centres properly belong within the province of the neurologist and alienist. Yet in a treatise on sex-attraction such anomalies should not be passed in silence. All the peculiarities of the woman’s body and mind, her nutrition and nerve activity are only a dependency of the ovary. The same may be justly said of the man. Almost all of the activities of the normal man stand in some relation to the testicular functions. The knowledge of the abnormal psychical elements of the sexual instinct is, therefore, of such importance to the general health and well-being of the public and to the whole social structure, that every physician and student of law or pedagogy ought to acquire a general knowledge of the anomalies of sexual affections. The man and woman who do not experience connubial satisfaction will often seek a substitute for their unrequited love. The whole foundation of society, the family, will begin to sag, if in our nervous age the anomalies of sexuality are prudishly overlooked and their study neglected.
The pathology of the sexual affections is, therefore, not only a proper study for every student of medicine but for every student of education, law and sociology as well. Krafft-Ebing’s general classification of the anomalies of the sexual instinct will also be followed here with more or less minor modifications. Krafft-Ebing divides the pathology of sexuality into four parts.
I. PARADOXIA.
It means sexual activity in individuals who should normally present no sexual manifestations, as the occurrence of sexual excitation before the physiological age.
II. ANAESTHESIA.
It signifies partial or total absence of sexual feeling, i. e., impotence of voluptas. It also comprises all other kinds of impotency, as impotence of libido or of copulation.
III. HYPERAESTHESIA.
It signifies the abnormal intensity of the sexual desire and impulse, 1) Mixoscopy, 2) Erotomania, 3) Satyriasis, 4) Nymphomania, 5) Masturbation, 6) Incest.
IV. PARAESTHESIA.
It covers all possible forms of perversion of sexual feeling and sexual activity. A) Heterosexuality: Inclination to persons of the opposite sex, but with perverse activity. 1) Masochism, 2) Sadism, 3) Fetichism, 4) Exhibitionism. B) Homosexuality: The sexual feeling is directed toward the same sex. a) Perversity, 1) out of lust, 2) as a profession, 3) through necessity, 4) out of fear, b) Perversion, 1) psychical hermaphrodism, 2) strict homosexuality, 3) effemination or viraginity, 4) transvestism. C) Bestiality: The sexual feelings are directed in conjugium cum animalibus.
Paradoxia.—Paradoxia signifies the sexual activity in individuals who should normally present no sexual manifestations. The occurrence of sexual excitement at an age when the individual should ordinarily be without it belongs to this part of the pathology of sexuality.
The continuance of the same degree of sexual desire in very old men or in women after the climacterium, as it existed before, is certainly unusual; yet it cannot be called pathological. The occurrence of pregnancies in wives of very old men and in women after the climacteric period proves that the ovaries continue to secrete ova even after menstruation has ceased, and that the testicles do not cease producing spermatozoa even beyond the limit of three scores and ten. Now, the sexual desire depends more upon the activity of the sexual glands than upon the physiological changes in the nervous apparatus of the generative organs in men or upon any changes in the uterus, which is only a repository for the development of the foetus. Hence the absence of erection in men or of menstruation in women does not necessarily imply absence of sexual desire.
The appearance of sexual desire in boys before puberty and in girls long before menstruation has set in is also, as yet, within the limits of the normal; it becomes pathological only when the sexual desire is manifested in infants or very small children. Complete sexual development has been witnessed in children as early as the second year. The precocity of development in the organs of generation is usually accompanied by corresponding precocity in sexual desire.
The writer saw a baby who had a sanguineous discharge from her genitals, for the first time, when she was only five days old. This discharge appeared afterwards regularly every four weeks. At the autopsy of another child one year old, one ovary was so enlarged that it awakened the writer’s curiosity. At the microscopical examination he found a ripe Graafian follicle. The writer also observed erections in a boy eight days old, immediately after the ritual circumcision. In the beginning he attributed these erections to the irritation of the wound. But the erections continued even after the wound was completely healed. The penis had the size of that of a boy four to five years of age.
But even where the development of the genital organs conforms with the age of the child, many cases are recorded of children of great precocity. At this period of early childhood there can be naturally no other sex activity except the habit of autoeroticism. The natural curiosity of children leads them to an examination and finally to a titillation of their private organs, often without the aid of any vicious instruction. When the child has thus found that a certain mode of handling these organs is attended with pleasurable sensations, he repeats the action, and the habit is established.
Hirschsprung (Berl. Klin. Wochenschr. 1866, No. 38) observed three cases of sexual activity in boys in the earliest childhood. The youngest child was only sixteen months old. Membro mentulato, the boy continued for over an hour to make rocking or wriggling movements, until it would fall back exhausted and bathed in perspiration. Deep sleep terminated the attacks which were repeated daily.
Rohleder (Die Masturbation, 3d Edit., p. 58) describes a case of a boy, fifteen months old, qui faciebat motiones voluptarias fricando virilia sua contra mammam matris. The attacks were marked by staring eyes, burning face and oppressed breathing. At the acme of the attack the child would break out in loud sobbing. The paroxysm would last about ten minutes. Thereupon the child would fall asleep.
The early aberration of the sexual instinct in childhood is more frequently met with in girls than in boys. Probably because the means for sensual gratificaton at the disposal of the infant girl are more numerous than that of the boy. The mere thigh-crossing of the infant girl will serve the purpose.
Townsend reports five cases of stuprum manu in girls under one year of age. One, an infant, eight months old, would cross her right thigh over the left, close her eyes, clench her fists, and after a minute or two there would be complete relaxation, with perspiration and redness of face. This would occur once a week or oftener.
In Lombroso’s case a girl of three years of age faciebat stuprum manu aperte et pæne jugiter until marriage, and even afterwards. She bore twelve children, neque desistebat a stupro manu even during pregnancy. Of her twelve children, five died in infancy, four were hydrocephalous, and the three surviving children were confirmed masturbators, the oldest having begun the practices at seven, the youngest at four years of age.
One of the writer’s patients, a young woman of twenty-four years of age, incipiebat masturbari, tres annos nata, ponendo pulvinum in femoribus et premendo eum quoad muliebria humescebant.
In Blackmer’s case, a girl eight years of age impudenter se stuprabat from her fourth year and, at the same time, sollicitans pueros of ten to twelve years of age ad stuprum. She planned to kill her parents that she might devote herself completely to such enjoyment.
Zambaco relates the histories of two sisters, one of whom at the age of seven feminabat cum pueris, corrumpebat sororem, quattuor annos natam, ad stuprum manu, and at the age of ten was given to the practice of cunnilingus.
In Moll’s case, a girl of seven had an impulsive inclination to her brother, three and a half years of age, cujus virilia amabat contrectare et quem inducebat ad contrectandum muliebria sua.
Jacobi (A. Am. Jour. of Obstetr. 1876, p. 597) relates the history of a case of a girl of three who, at irregular intervals, had attacks of stuprum when sitting down. She began by keeping her thighs closely joined or by crossing her legs. She then started to move and rub her limbs violently. The face became purple, and there was twitching about the eyes which looked excited, and the child perspired freely. After the attack she used to lean back exhausted, sighing and breathing hurriedly.
In another case Jacobi saw thigh friction, up and down movements, quick breathing, perspiration, in a female infant of nine months.
Magnan cites a case of a seven-year-old girl who jugiter se stuprabat with great violence. Even in the moment of being photographed, she turned up her petticoat and gave herself up to her favorite pastime.
Rachford (Archive of Pediatry, 1907) has collected 52 cases, 48 occurring in female and 4 in male children, of pseudomasturbation, as he calls it. But since the same symptoms of orgasm, as interrupted panting respiration, flushed cheeks, redness of face, staring eyes, large immobile pupils, perspiration and exhaustion are seen in the infant during its practice, as are found in the masturbating practices of older children, there is no reason to call these infantile manipulations by any other name than masturbation.
Precocity of sexual activity is usually based upon a neuropathic predisposition. Such children are, as a rule, tainted hereditarily. The following case is very instructive on account of the severity of the attacks and the attending circumstances:
Little L’s mother left her husband and went to live with a very rich man. The child is the product of this concubinage. Some time after the death of her legal husband, the mother left the father of the child, deserted the child and married another man. The foundling has been since taken care of by a children’s aid society. The foster-mother, with whom the child has been living for the last six months, brought her to the author for examination, with the following history:
Soon after Mrs. L. received the child she noticed that the same was suffering from hysterical attacks. It sometimes whined and cried for several days in succession. It was always very restless and fidgety, giving the impression as if it was suffering from chorea minor. It was frequently running to the water-closet without any apparent necessity. Mrs. L. went to the society to find out what was the matter with the child and was told there that the child has been a confirmed masturbator since she was two and a half years old. Two other families, to whom the child has been successively given for adoption, have returned her to the society on account of this perversity. She was also told that if she refused to keep the child, the society will have to send it to an insane asylum as the last resort. For this reason, Mrs. L., who in the meantime had become attached to the child, resolved to try to break up the bad habit before she adopted it. Mrs. L., who is a highly intelligent lady and seems to possess an unusual power of observation, describes the attacks as follows:
The usual mode of the child’s practice is volvulam manibus permulcere. The acme of the attack is manifested by the rigidity of the entire body, by the panting respiration, the staring eyes, the immobile pupils, redness of face, perspiration and general excitement. After a short interval of exhaustion, she gives herself again to her favorite pastime. In this way the child jugiter stuprum manu faciebat, even in the presence of others. All punishments by Mrs. L. and in the institution, where her little hands were even burned with hot iron, were of no avail. When her hands were tied so that she could not use them, fricabat muliebria sitting on a chair, by violent circular motions of her pelvis, which simply frightened her foster-mother. When lying in bed the child crosses her legs and rubs the thighs violently against each other.
When the child was asked how it happened to start the performance of such practices, it answered that it had been first taught by her unnatural mother ut tractaret matris muliebria stupri causa. Also the matron of a certain institution is said to have taken the child into a dark closet et adduxit puellam ad matronæ manustuprum. The truth of these assertions cannot be proven, but by some experimenting, undertaken with the child, it has been proven beyond the shadow of a doubt that some adult woman abusa est puella ad stuprum suum.
The examination of the five-year-old girl shows a bright, nervous child, pale, with deeply set eyes, surrounded by dark rings, and somewhat enlarged cervical and inguinal glands. The entire body is covered with blond soft hair of unusual length. The same long hair covers the somewhat enlarged labia majora, so that they make the appearance of that of a girl near puberty. They are quite separated from each other, as found in the adult. The clitoris is somewhat elongated, but the prepuce is not adherent to the glans. Otherwise the genitals do not show any marked anomaly.
Sometimes the masturbatic practices are provoked by irritation at the peripheric region. The boy who has the impulse to touch and pull everything will, if not prevented by mother or nurse, surely play with his little organ. Sometimes there is a phimosis or an inflammation of the prepuce, or an accumulation of smegma in the infant boy; in girls there may be uncleanliness in the vulva, worms, eczema or pruritus. All these anomalies cause a certain itching which incites the child to touching and rubbing these parts. These manipulations produce an agreeable tickling sensation and awaken the feeling of lust. This feeling operates in the memory and excites the child to a state of activity before sexual consciousness has had time to awaken.
The habit of masturbation is sometimes contracted in infancy, by the laxness of stupid servants or ignorant mothers. They often try to calm the infant by tickling the child’s genitals and thus awaken lustful feelings which later on drives the child to renew the manipulation without outside help. In this way masturbation is found in the best and purest homes.
Another practice resorted to by nurse-girls and mothers is to amuse the child by gently striking its buttocks, a region which is highly erogenous. Every one who has read “Les Confessions,” by Rousseau, knows how this savant, when a boy, became sexually excited when his nurse punished him by whipping him on his buttocks. Thus nurses, and even mothers, innocently induce the child to the habit of masturbation. A still greater danger lurks from vicious servants and voluptuous nurse-girls who deliberately handle the infant’s or the very young child’s lumbus libidinis causa. They touch and strike the genitals of boys as well as that of girls for their own pleasure. There are few nurse-girls, says Parke, who do not delight to initiate the boy, committed to their care, in sexual matters. He relates many histories of patients who were induced to abnormal practices by their nurses in early youth. Lawson-Tait, in warning parents against allowing children to sleep with their nurses or with servants, says that in every instance where he found a number of children affected by masturbation, the contagion could be traced to a servant. Freund relates several examples of severe youthful hysteria where the starting-point could be traced to some sexual manipulations by servants, nurse-girls and governesses.
Sexual precocity is, therefore, not seldom caused by tactile stimulation. Still in the majority of cases precocity may be easily traced to a hereditary taint.