(3). Subjects affected with systematic delirium of persecution and grandeur (paranoia) sometimes commit atrocious sexual excesses, and often tyrannize and torment in a terrible way the women who are their victims. It is especially in the religious forms of this delirium, combined with fanatic ecstasy, that the most repulsive sexual orgies occur. I have treated a patient with paranoia who, full of pious sayings, regarded himself as a kind of prophet. He made a poor girl and her mother sleep in his room and had connection with them alternately. Finally, he mixed his semen in coffee with the girl's menstrual blood and made her drink the mixture, pretending that this was a religious ceremony intended to produce a strong race. In the end he set fire to the house of these poor women.
Subjects affected with partial paranoia often turn the heads of susceptible women by the aid of ascetic religious phraseology, to gratify afterwards their sexual passions. The worst cases are those who are able to hide from the public their delirious ideas, and pass for normal individuals, misunderstood victims, or even saints. I have examined a very orthodox clergyman, highly esteemed by his congregation on account of his ascetic and enthusiastic preaching. In his own home he illtreated his wife, half strangled her, and exacted all kinds of sexual depravity. Unfortunately, the nature of his delirium was not very evident, and he dissimulated so well that the jurists would not admit his irresponsibility, in spite of my medical certificate. His wife was obliged to run away to escape from her martyrdom. The community of property in force in this family completely ruined this unfortunate woman. The husband was not a hypocrite, but simply insane. Volumes could be written on sexual atrocities committed by such people.
I will mention briefly the systematic delirium directed toward pathological love. This is a very common symptom in insane women who combine their amorous sentiments for man with the maddest ideas and hallucinations. An insane woman suddenly discovers that the object of her love is a king or Jesus Christ, and that she is betrothed to him. In her delirium she imagines herself to be queen of the world. In her dreams and hallucinations her king or Christ is in bed with her and she imagines she has connection with him. Still under the influence of hallucinations, she believes herself pregnant and carries an imaginary child for nine months in her womb. She may even imagine that she has given birth to a child, and that the child has been taken away from her by the aid of narcotics, as we have seen above. Although there is an infinite variety in the gradations, the pathological images of the cerebral sexual sphere of insane women always revolve round this eternal theme.
These pathological irradiations of the sexual sphere are associated voluntarily with jealous obsessions and ideas of persecution, which make the subjects furious, and which are confirmed by their paræsthesias and hallucinations. Illusions of memory play a great part in these cases, for the subjects have often never felt what they complain of, and it is then a question of veritable hallucinational memory. We may here observe by the way that, even among healthy people, the sexual passions, like the others, always tend to falsify memory, making things appear in the exclusive sense of the affective state. Once fixed in the memory, such conceptions, the false tendency of which was originally based on passion, gradually assume the subjective character of certainty. Cool-headed people, or those whose affective state directs them to contrary conceptions, then see in such individuals a deliberate intention to misrepresent the facts. This is the reason why people so often hurl mutual insults at each others heads, calling each other liars and calumniators, owing to the affective illusion of memory.
(4). One of the worst of the sexual anomalies in the insane is pathological jealousy, especially in men. Their wives then become martyrs, especially in cases of alcoholism and paranoia. It is not uncommon for assassination to put an end to their torments. Among insane women, jealousy is certainly not less, but they have less legal power and less muscular strength. The most violent jealousy is found in alcoholics.
Jealous delirium renders the subject furious; a word, a look, or some trivial circumstance are enough for him to prove the infidelity of his wife. The latter has to avoid the slightest thing which might arouse jealousy, but all in vain; reserve and even prudery are regarded by the jealous husband as hypocrisy. The unfortunate man watches his wife, night and day, like a watchdog: he threatens and insults her with no reason, and calumniates her in all ways, even in the presence of a third party. He even lays elaborate traps for her. Cases of this kind are legion.
(5). It is necessary to say that the sexual paræsthesias, of which we have spoken, sadism, masochism, fetichism, inversion, etc., often occur in the insane.
(6). The most atrocious sexual crimes are very often the work of idiots or imbeciles, but especially moral idiots, i.e., persons whose idiocy is limited to the moral sense, who are also called simply amoral. This is due to hereditary taint, an innate absence of all sentiments of sympathy, pity and duty. Rape, violation of children, sexual assassination, etc., are usually due to the concomitant action of moral idiocy and violent or perverted sexual passions.
(7). Hypochondria also causes singular results in the sexual sphere. We have already dealt with the masturbation of certain hypochondriacs, which is often wholly or partly imaginary. Others believe they have committed terrible sexual excesses, when nothing of the kind has occurred. I have seen a hypochondriac married and strongly built, who believed his health was ruined because he cohabited with his wife once every two or three months. Other hypochondriacs become impotent simply because they think they are. Others again imagine they are affected with venereal disease, which they have never contracted.
(8). Hysterical men and women have a very peculiar sexuality. Hysteria depends on auto-suggestion or on an exalted and morbid dissociability of psychic activity. A single idea is sufficient in a hysterical subject, to produce the realization of what it represents. The passionate imagination may lead to opinions and actions which are absolutely contradictory. Love and hatred often alternate by transformation. According to the influences to which she is exposed, the same hysterical woman may become a good or evil genius.