SEXUAL ANOMALIES IN THE INSANE AND IN PSYCHOPATHS
When one is familiar with the population of a lunatic asylum, one is struck by a singular phenomenon, from the sexual point of view. A great number of insane women give evidence of intense sexual desire. This desire is manifested in some by incessant masturbation; in others by obscene conversation; in many others, by imaginary love, sometimes sensual, sometimes platonic; often by direct provocation to coitus addressed to the medical officers; but especially by perpetual scenes of jealousy, and often by reciprocal suspicions regarding their sexual life. In fact, a lunatic asylum reveals to us, in the form of repulsive caricatures, all gradations and variations of a more or less degenerate feminine sexual life, coquetry, wearing all kinds of ornaments, jealous anger, erotic excitement, etc.
The sexual excitation of the insane often makes them soil themselves with urine and excrements, and heap insults on persons whom their diseased imagination suspects of sexual assaults or immodest acts toward themselves or others. They have a tendency to believe themselves betrothed or married to kings, emperors, Jesus Christ or God. Pregnancy and childbirth play a large part in their delirium. Some patients imagine themselves pregnant and pretend that they were fecundated secretly. Afterwards they believe that some one has taken away their child while they were asleep.
One of my former patients once accused me of going to her bed at night and fecundating her every week. She also accused me of having hidden the hundreds of children which I was supposed to have procreated with her, and martyred them. Owing to these hallucinations she heard their cries day and night.
Another patient, affected with curable acute mania, was so erotic during her attacks that she made advances toward all the doctors who visited her. Her mind was full of such erotic images that after her cure she was frightened of being pregnant, although she had passed the whole of her time of detention under supervision by female attendants. Women who in their normal state are most modest or sexually cold may be most erotic when they become insane, and may even behave as prostitutes. This is especially observed in periodic hypomania. It is a well-known fact in the female divisions of lunatic asylums, that the doctors are always surrounded by erotic patients, who catch hold of their clothes and pinch them, and try and embrace or scratch them according as they are amorous or jealous, so that they often have trouble in escaping from these signs of violent love or furious jealousy.
On the other hand, in the male divisions of asylums, one is astonished at the indifference and profound sexual apathy of nearly all insane men. Some practice masturbation and others attempt pederasty, but all with a philosophical calmness due to their dementia. Young women may even go among them without any fear of assaults or indecent language. It is only a few of the most violent who are exceptions to this rule.
A young lady doctor, assistant medical officer to the asylum at Zurich, made her visits alone among all the males, even the most violent, without any inconvenience; while, in the female divisions, she was approached by the erotic patients as much as were the male assistants. I mention this fact because some people wrongly imagine that the sexual excitation of insane women is due to the visits of male doctors. These facts are very striking and furnish perhaps the best proof that the feminine sexual appetite is especially situated in the higher brain, while the masculine appetite is situated more in the lower cerebral centers, as we have shown above. Mental alienation is due to irritations of the higher brain, and this explains why in women it lets loose such violent sexual passions and images, and why there is so little of this in men.
The sexual pathological symptoms of the insane are as follows:
(1). Erotomania (satyriasis and nymphomania), or abnormal exaltation of the sexual appetite. This is especially seen in acute mania, in the early stages of general paralysis and senile dementia, also temporarily or permanently in other psychoses. It is manifested by sexual excesses, obscene language or excessive masturbation. All these symptoms disappear after the attack of insanity.
(2). Sexual anæsthesia or hypoæsthesia or even impotence may occur in the later stages of general paralysis and senile dementia. At the commencement of general paralysis there is often violent sexual desire combined with more or less complete impotence. The same thing occurs, as we shall see, in alcoholism.