Only when the cerebral cortex, as the place of origin of sensations and perceptions, fails to perform its functions in the manner just described, or when the anatomico-physiological processes in the genital organs which normally act as peripheral stimuli fail to occur, or when there is a failure in the conducting tracts, are sexual perceptions and impulses lacking. Such anomalies may be congenital. A milder form is that, likewise congenital, in which a woman has a sexually “cold nature;” in these cases the sexual impulse is not completely wanting, but it is so slight in intensity that it can be awakened only by very powerful stimuli, and in her normal state the woman so affected is quite free from any wish for sexual gratification.
Such congenital subnormal intensity or entire lack of the sexual impulse may be due to very various causes. According to von Krafft-Ebing, these causes may be organic or functional, mental or physical, and central or peripheral. The declining intensity of the sexual impulse with the advance of years, and the temporary disappearance of that impulse after the sexual act, are both physiological occurrences. Education and mode of life have a marked influence on the intensity of the vita sexualis. Strenuous mental activity, earnest study, severe physical exertion, mental depression, and sexual continence, notably diminish the excitability of the sexual impulse. At first, indeed, abstinence leads to an increase in the intensity of the impulse, but sooner or later the functional activity of the organs of generation declines, and therewith also the intensity of the sexual impulse. As peripheral causes of diminution or disappearance of the sexual impulse, von Krafft-Ebing mentions oöphorectomy, degeneration of the reproductive glands, marasmus, sexual excess, whether in the form of coitus or of masturbation, and alcoholism. In like manner is to be interpreted the disappearance of the sexual impulse in general disorders of nutrition (diabetes, morphinism, etc.).
A decline in the intensity of the sexual impulse in consequence of degeneration of the conducting tracts, is found, according to von Krafft-Ebing, in diseases of the brain and the spinal cord. Central affection of the sexual impulse may be due to organic disease of the cerebral cortex (dementia paralytica, general paralysis of the insane, in the later stages), or it may be due to functional disorder, such as hysteria, or to mental diseases (melancholia or hypochondriasis).
Finally, in some instances, the sexual impulse in women manifests itself, not in the normal manner with copulation with the male as its goal, but in a form demanding some abnormal kind of gratification (psychopathia sexualis), whether it be because sexual intercourse with the male affords the woman no enjoyment, or simply because no opportunity exists for such intercourse.
Masturbation is very frequent; the habit having been acquired from bad example by the girl during the menarche, it is sometimes continued by the wife during married life. In these cases we often find distinct changes in the genital organs, such as hypertrophy of the clitoris, enlargement and bluish discoloration of the nymphæ, retroversion of the uterus, tenderness and displacement of the ovaries, considerable vaginal discharge, and sometimes menorrhagia.
Kussmaul draws attention to the connection between masturbation and nymphomania, on the one hand, and imperfect development of the uterus and the other genital organs, on the other. Campbell records the case of a woman addicted to masturbation, who had never menstruated, and who, in addition to imperfectly developed genital organs, had a dermoid cyst of the ovary. In a young woman who indulged in masturbation, Aran found that the uterus and its annexa were imperfectly developed. Vaddington also describes a case of abnormal sexual impulse which was associated with absence of the uterus.
Troggler reports the case of a woman twenty years of age, who had been six months married to a healthy, potent man, was herself healthy and blooming, with a good family history, and had never suffered from any severe illness. At the age of thirteen she had learned to masturbate, effecting this by stimulation of the clitoris. Now she found no gratification in coitus, so that she continued to masturbate, and during coitus obtained satisfaction by manual friction of the clitoris. Examination showed that the clitoris was strikingly large, the vagina flaccid, and that there was some vaginal discharge; in other respects the genital organs were normal.
Not infrequent, it may be in those whose mental condition is in other respects fairly normal or it may be in psychopathic subjects, is the existence of contrary sexual sensation, or sexual inversion, a condition which has been described by Casper, Westphal, von Krafft-Ebing, and Moll, and has indeed been well known since the days of antiquity. In the case of a considerable number of notable women, homosexual practices have been recorded. According to the observations of Coffignon, in Paris the homosexual instinct, when occurring in other women than prostitutes, is found chiefly among the ladies of the aristocracy.
Of homosexually inclined women, some engage in the practice of tribadism, familiar to the ancient world, and recorded by Martial in a satire, in which sexual gratification is obtained by mutual friction of the genital organs, or by penetration of one woman’s clitoris into the vagina of the other; whilst some indulge in the amor lesbicus, in which gratification is obtained lambendo linguâ genitalia, a very ancient practice indeed, transported from Phœnicia to Greece (where in especial it was indulged in by the women of Lesbos), and later from Syria to Italy, where it was widely diffused among the Romans of the imperial age. Sappho, celebrated as the tenth muse, is supposed to have been addicted to the practice of Lesbian love.
All such homosexual (female) individuals are, then, endowed with the perverse instinct toward sexual connection with women instead of with men. In such cases, the genitals are usually quite normal; sometimes, however, the woman thus affected is markedly of a male type, being called by von Krafft-Ebing a gynandrist, the affection itself being termed gynandry; when the woman concerned not only possesses a homosexual impulse, but also in other respects exhibits tendencies properly characteristic of the male sex, she is called virago, and the affection is termed viraginity.