Another example of the fourth degree of sadism is the case reported by Boas (Archiv f. krimin. Anthropologie und Kriminalistik, v. 35, p. 195).

A nine-year-old girl is lured by a shoemaker into a cellar. There the patient abuses and kills the child by choking her with a pillow. The murderer thereupon thrusts a cane into the child’s vagina, which perforates the posterior vaginal wall and penetrates into the bowels.

Such extreme cases of cruelty as the last two are never found in sadistic women, at least none are on record. The woman playing the passive rôle can naturally have no use for a dead mate. She needs an active live one. Hence only the first three degrees are found in women.

Moraglia claims that some women’s features manifest cruelty during conjugation. At the beginning of the orgasm the face becomes distorted, and by showing her teeth such a woman assumes a certain ferocity of expression that is sometimes frightening.

One of the author’s patients, a woman of twenty-six years of age, mother of two children, would take on a cruel look at the height of her sexual excitement immediately before the orgasm. This frightened the husband so that he sought medical advice. She would also grasp with her teeth her consort’s lips and tongue and bite them.

Slight sadistic features are, therefore, not uncommon in women. Especially in modern times, with the increasing effemination of men and the corresponding masculination of women, the aggressive woman is not so great a rarity. The biting and scratching of the companion during sexual excitement is, therefore, not uncommon and falls yet within physiological limits. But when the individual is driven to whip, pinch and prick the body, or, particularly the genitals of her companion, in the blind impulse to satisfy sexual desire, such expression of gratification does not correspond with the natural purposes, and the acts become perverse. Such uncontrollable emotions may even lead the individual to homicidal thoughts.

Phylogenetically it is significant that sadism is found even among the lower female animals. At the time of sexual union, crabs tear off limbs from the bodies of their consorts. Spiders often bite off the heads of their mates. It is the male spider who impregnates the female at the risk of his life, and sometimes perishes in the attempt. It is the male bee that after conjugium with the queen falls dead from the fatal embrace, leaving her to fling aside his entrails and calmly pursue her course. Sadism may, hence, be considered a kind of atavism. It shows man to be, as Schopenhauer puts it, in reality a wild, cruel animal. We only see him in a tame state, which we call civilization.

In history it is known that not only the degenerated Caesars, like Nero or Tiberius, took great pleasure and delight in having youths and maidens slaughtered before their eyes, but the same is also reported of women, who did not shrink from committing sadistic acts. Valeria Messalina and Catherine de Medici found great pleasure in having the ladies of their courts whipped before their eyes. Branton relates that Catherine loved to whip with rods the prettiest ladies of her court only to satisfy her lust.

Among the cases reported in recent medical literature the case of Krafft-Ebing is remarkable.

This author saw a man with numerous scars and cuts on his arm. Every time, the man explained, he wished to approach his young wife he first had to make a cut in his arm. She would then suck the wound and during this act become violently excited sexually.

Blumroder saw a man bitten in the breast by his consort during conjugation in the great sexual excitement at the acme of libido.

One of the author’s patients, a lady of good social standing, thirty years of age, took great delight, while sitting on her consort’s lap, in biting the lobes of his ears or his arms, until he screamed with pain. He always carried marks of her teeth on his body. Post initum the face of this otherwise pretty woman became distorted. She lay for some time with open mouth, showing her teeth, and her face assuming an ironical, cruel expression.

In Moll’s case absolute frigidity is combined with sadism. The woman, twenty-six years of age, has been married for eight years and has one child. She presents signs of hysteria and neurasthenia. She never had any desire congressionis and until her marriage remained ignorant of any knowledge of sexual matters. Initus to her is not only no pleasure but on the contrary a distasteful act, and the repugnance of it has constantly increased. She can not conceive how the lumbus can have anything to do with love. She loves her husband and finds decided pleasure in kissing him. But while kissing him she experiences great lust when allowed to bite him. She would find the greatest pleasure if she could so bite him that his blood would flow. She was better satisfied, if instead of having commixtio she was bitten by her husband and allowed to bite him. When her biting caused her husband too much pain she regretted the act.

A few years ago the author treated a patient, a French lady of thirty-five years of age, who had normal genital organs and was otherwise well, except that she was laid up in a hospital in Paris for eight weeks with rheumatism. She found great delight in having her consort sugere et osculare mammas. She always requested him to continue this practice for a considerable length of time. At the height of the orgasm in complexu venereo, her face becomes distorted by ferocity, taking on a cruel look and showing her teeth. At the same time she has spasms of the muscles of the back, by which the entire body is bent backwards, the spinal column forming a convex arc at the anterior aspect, the veritable opisthotonus often seen in grand hysteria. After the paroxysm she invariably tries to choke her consort, but desists from her intent before she has done any real harm or having caused him any real pain.

Hausler reports the case of a pregnant woman who had a great desire for her husband’s blood. Several times, while he was asleep, she stabbed him and sucked his blood.

In Kiernan’s case the patient would hack herself all over her body with any instrument she could conveniently lay her hands on, not for suicidal purposes, but because she experienced a fascinating pleasure whenever she drew blood.