The fourth degree shows the most abnormal enormities of cruelty, such as emboweling the victim or the ablation of its genitals, evisceration, dismembering the victim, sucking its blood or devouring its flesh.

Cases of Platonic sadism are very frequently met with in all classes of society. But since the patients do nobody any harm, such cases never come to the notice of the judge or even of the physician, and are hence never recorded. They are discovered in the course of the anamnesis, at the examination for some other anomaly.

One of the author’s patients who was suffering from psychic impotence, a talented painter, in his leisure hours, while sitting in the beer-garden or while conversing with his friends, used to draw on pieces of paper horrible scenes of war and murder, of wounds and blood. When asked about this peculiarity, he confessed that in his imagination he spanks, whips and lashes women until they bleed.

Sadistic acts of the second degree sometimes come to the notice of the physician, when he is called upon to treat the wounds inflicted by the patients.

The author was once called upon by a young bride to be treated for a wound in her left breast which was inflicted through the bite of her husband in the bridal bed, at the acme of his orgasm. It took several weeks to cure this love-bite.

All such acts of the two first degrees still stand on the border-line of the normal and pathological. The acts of the last two degrees are, as a rule, only found in psychopathic degenerates. The best example of sadistic acts of the third degree is found in a recent celebrated murder case in New York city.

The patient has been twice tried for murder and has been sent to an asylum for the criminal insane. Playing the rôle of a theatrical agent, the patient used to lure young girls to his apartment by advertisement and then gratify his abnormal desires by subjecting the innocent girls to flagellation. He would sometimes have eight to ten girls in the dining-room of his boarding house and would beat one with a whip. The landlady saw poor young girls all welts and bruises from these cruel whippings. On one occasion, she found a girl of fifteen years of age in his room, whose clothing was torn and arms cut from the maltreatment. The wealthy degenerate then paid these girls hush-money to keep quiet. All these facts are in the records of the Supreme court where a habeas corpus order was argued.

An example of the fourth degree of sadism is the celebrated case of Nathan Schwartz.

On July 6, 1912, the patient, a former prize-fighter, twenty-three years of age, accidentally meets with a girl, only twelve years of age, but unusually well developed. He accosts the child and lures her to his father’s flat. There he chokes her to insensibility, undresses her, except to her union suit, and carries her to the roof of the house and hence down to the bathroom of a vacant flat. There he makes twenty jabs in her back with a knife, slashes her throat and forearms and stabs her in the heart. The union suit had forty-one rents, all made by his knife. He then puts her into a soap box where she was found by the police. Twelve days later the patient committed suicide, while the police was still looking for him.

This case may throw some light upon the brutality of the prize-fight. The study of the psychology of the votaries of this brutal sport may lead to some important discoveries. Some sadistic trait may be discovered in every one of these fighters, showing that it was not their profession that made them brutal, but that on account of an innate cruelty, they chose the cruel profession.