Satyriasis and Nymphomania.
States of mental excitement, in which an abnormal intense sexual impulse is prominent, are called satyriasis (in males) and nymphomania (in women), or uteromania.
Moreau considers these cases peculiar to themselves, but he is certainly in error. The sexual complexus of symptoms is always but the partial manifestation of a general psychosis (mania, hallucinatory insanity?).
The essential element of the state of sexual excitement is a condition of psychical hyperæsthesia with involvement of the sexual sphere. The imagination calls up only sexual images, which may lead to hallucinations, illusions, and true hallucinatory delirium.
The most indifferent ideas excite sensual association, and the lustful coloring of the ideas and apperceptions is very much intensified.
The abnormal state of consciousness implicates the whole course of feeling and desire, and is accompanied by general physical excitement like that that accompanies coitus (v. “Physiology”). Often the genitals are in a constant state of turgor (priapism in males).
The man affected with this sexual passion seeks to satisfy his desire at any price, and, therefore, becomes very dangerous to women. Faute de mieux, he practices onanism or sodomy. The nymphomaniacal woman seeks men by exhibition, or to attract them by her sensual conduct; at the sight of men she is intensely excited sexually, and satisfies herself by masturbation, or by pelvic movements of coitus.
Satyriasis is infrequent. Nymphomania is more frequently observed, and not seldom in the climacteric. It may occur in senility. Abstinence,[[124]] with constant excitation of the sexual sphere as a result of psychical or peripheral irritation (pruritus pudendi, oxyuris, etc.), may cause these conditions, but probably only in those predisposed.
The assertion that it may also result from poisoning by cantharides seems to depend upon confounding it with priapism. The primary lustful feeling that accompanies priapism due to cantharides soon becomes painful. Satyriasis and nymphomania are acute abnormal psycho-sexual states.
There are also cases that, not without reason, might be called chronic satyriasis or nymphomania. To these belong the men who, for the most part as a result of abusus veneris, or more particularly of masturbation, suffer with neurasthenia sexualis, and at the same time have intense libido sexualis. The imagination, as in acute cases, is in a state of excitement, and the mind full of obscene images; so that the most elevated ideas are besmirched with the most cynical images and thoughts.
The thought and desire of such men are solely directed to the sexual sphere; and since their flesh is weak, led on by their fancy, they come to indulge in the grossest perversions of the sexual act.
Analogous cases in women may be called chronic nymphomania. They naturally lead to prostitution. Legrand du Saulle (“La folie,” p. 510) reports interesting cases which apparently are pure.
Melancholia.—The thoughts and feelings of melancholiacs are not favorable for the excitation of sexual desires. At the same time, these patients sometimes masturbate. In my experience such cases have always been hereditarily predisposed and previously given to onanism. The act did not seem to be so much due to a lustful desire as to be induced by habit, ennui, anxiety, and the impulse to change temporarily the painful mental condition.
Hysteria.—In this neurosis the sexual life is very frequently abnormal; indeed, always in predisposed individuals. All the possible anomalies of the sexual function may occur here, with sudden changes and peculiar activity; and, on an hereditary degenerate basis and in moral imbecility, they may appear in the most perverse forms. The abnormal change and inversion of the sexual feeling are never without effect upon the patient’s disposition.
The following case, reported by Giraud, is one of this nature worthy of repetition:—
Case 164. Marian L., of Bordeaux. At night, while the household was asleep under the influence of narcotics she had administered, she had given the children of the house to her lover for sexual enjoyment, and had looked on at the immoral acts. It was found that L. was hysterical (hemianæsthesia and convulsive attacks), but before her illness she had been a moral, trustworthy person. Since her illness she had become a shameless prostitute, and lost all moral sense.
In the hysterical the sexual sphere is often abnormally excited. This excitement may be intermittent (menstrual?). Shameless prostitution, even in married women, may result. In a milder form the sexual impulse expresses itself in onanism, going about in a room naked, smearing the person with urine and other things, or wearing male attire, etc.
Schüle (Klin. Psychiatrie, 1886, p. 237) finds very frequently an abnormally intense sexual impulse “which disposes girls, and even women living in happy marriage, to become Messalinas.”
The author cited knows cases in which, on the wedding-journey, attempts at flight with men, who had been accidentally met, were made; and respected wives who entered into liaisons, and sacrificed everything to their insatiable impulse.
In hysterical insanity the abnormally intense sexual impulse may express itself in delusions of jealousy, unfounded accusations against men for immoral acts,[[125]] hallucinations of coitus,[[126]] etc.
Occasionally frigidity may occur, with absence of lustful feeling,—due, for the most part, to genital anæsthesia.
Paranoia.—Abnormal manifestations in the sexual sphere, in the various forms of paranoia, are not infrequent. Many of these cases are developed on sexual abuse (masturbatic paranoia) or sexual excitement; and, according to experience, in individuals psychically degenerate, with other functional signs of degeneracy, the sexual sphere is, for the most part, deeply implicated.
In paranoia religiosa and erotica the abnormally intense and, under certain circumstances, perverse sexual instinct is most clearly manifested. In the first variety, however, the condition of sexual excitation is expressed not so much in a direct method of satisfaction of the sexual desires as (there are exceptions) in platonic love,—in enthusiastic admiration of a person of the opposite sex who is pleasing æsthetically. Under certain circumstances, the enthusiasm is for a fanciful person, a portrait, or a statue.
A love for the opposite sex that is weak and purely mental, too, often has its basis in weakness of the genitals due to long-continued masturbation; and, under the guise of virtuous admiration of a beloved person, great lasciviousness and sexual perversion are often concealed. Episodically, especially in women, violent sexual excitement may occur as a nymphomania.
For the most part, paranoia religiosa rests upon sexuality which manifests itself in a sexual impulse that is abnormally early and intense. The libido finds satisfaction in masturbation or religious enthusiasm, the object of which may be a certain minister, saint, etc.
The psycho-pathological relations between the sexual and religious domains have been described in detail on p. 8 et seq.
Apart from masturbation, sexual crimes are relatively frequent in religious paranoia.
Marc’s work (p. 160) contains a remarkable example of religious insanity.
Giraud (Annal. méd. psychol.) has reported a case of rape of a little girl by a religious paranoiac, aged 43, who was temporarily erotic. Here, also, belongs a case of incest (Liman, Vierteljahrsschr. f. ger. Med.).
Case 165. M. impregnated his daughter. His wife, mother of eighteen children, and herself pregnant by her husband, lodged the complaint. M. had had religious paranoia for two years. “It was revealed to me that I should beget the Eternal Son with my daughter. Then a man of flesh and blood would arise by my faith, who would be eighteen hundred years old. He would be a bridge between the Old and New Testaments.” This command, which he deemed divine, was the cause of his insane act.
Sexual acts that have a pathological motive sometimes occur in persecutory paranoia.
Case 166. A married woman of thirty had, by means of money and sweetmeats, enticed a boy of five, who played near her, handled his genitals, and then attempted coitus. She was a teacher, who had been betrayed and then cast off. Previously moral, for some time she had given herself to prostitution. The explanation of her immoral change was given, when it was found that she had various delusions of persecution, and thought she was under the secret influence of her seducer, who impelled her to sexual acts. She also believed that the boy had been put in her way by her seducer. Coarse sensuality as a motive for her crime came less into consideration, as it would have been easy for her to satisfy sexual desire in a natural way. (Küssner, Berl. klin. Wochenschrift.)
Cullerre (“Perversions sexuelles chez les persécutés,” in Annal. médico-psychol., March, 1886) has reported similar cases,—the case of a patient who, suffering with paranoia sexualis persecutoria, tried to violate his sister, giving as a reason that the impulse was given him by Bonapartists.
In another case a captain, suffering with delusions of persecution by electro-magnetism, was driven to pederasty,—a thing he abhorred. In a similar case the persecutor impelled to onanism and pederasty.