This corrupt woman preserved her repose of manner, her excellent appearance, and her honourable demeanour until her death. She died at the age of seventy-four years from a cerebral hæmorrhage. There was no remarkable change in the brain (Journ. de Méd. de Paris, 1889, No. 16).
With regard to the treatment of abnormal sexual hyperexcitability, the severer forms—satyriasis and nymphomania—urgently need asylum treatment. In the slighter forms favourable results will be obtained by means of psycho-therapeutics, the internal use of sedatives (such as monobromide of camphor and bromide of potassium), regulation of the diet, suitable clothing and bedding.[432]
The converse of sexual hyperæsthesia is sexual anæsthesia, or the abnormal diminution of the sexual impulse. It occurs in both sexes as a congenital condition, owing in such cases to atrophy or absence of the genital organs, after exhausting diseases, or in consequence of arrest of development of the reproductive organs from unknown causes. This latter condition is denoted by A. Eulenburg by the name of “psycho-sexual infantilism.” The same author also terms sexual anæsthesia “sexual loss of appetite.” It is commoner in women than in men. It is often merely apparent—a pseudo-anæsthesia—because the man does not understand how to awaken the still slumbering sexual perceptions (vide supra, [p. 86]). Recently Otto Adler has written a comprehensive and interesting monograph on this “Deficient Sexual Sensibility in Women” (Berlin, 1904). According to him, the statement of Guttzeit, that of ten women, four have no sensation at all “in coitu,” and submit to it without any agreeable sensation at all during the friction, and without any intimation of the intense pleasure of ejaculation—that is, that 40 % of women suffer from coldness and lack of sensibility, from “frigidity”—is indeed somewhat exaggerated in respect of the percentage; but still it is a correct expression of the fact that deficient sexual sensibility is much commoner in women than it is in men, in whom Effertz,[433] for example, estimates the frequency of frigidity at only 1 %.[434] In women various circumstances explain the frequency of deficient sexual sensibility. First of all, masturbation lowers sexual excitability in women much more than it does in man, and, above all, it blunts sensibility for normal sexual intercourse, both by means of psychical influences and by the insensibility of the external genital organs, owing to deficient stimulation of the clitoris during normal intercourse, whereas this organ is most powerfully stimulated during masturbation. Sexual frigidity also occurs in women in consequence of maladroitness and brutality of the man in coitu, giving rise rather to pain than to voluptuous sensations, and very frequently being the cause of the first onset of the so-called vaginal spasm, or “vaginismus.”[435] It is also due in some cases to impotence on the part of the man.
In an interesting and valuable work, Carl Laker, in the year 1889, described, as “A Peculiar Form of Perversion of the Sexual Impulse in the Female” (German Archives of Gynæcology, 1889, vol. xxxiv., No. 3, pp. 293 et seq.), cases of sexual frigidity in woman in coitu, which are not to be regarded as cases of “anæsthesia sexualis,” since the sexual impulse was normal—indeed, frequently was increased—and it was sexual gratification in normal intercourse which was completely wanting. In these cases gratification was obtainable only by simple or mutual onanism. There existed a normal inclination towards the other sex, associated with mental and physical health. The author assumes that, in consequence of some anatomical abnormality, stimulation of the sensory nerves by which the voluptuous sensation is perceived, especially those of the clitoris, failed to occur; but perhaps by a change of posture in coitu this stimulation can still be effected. The case previously reported by me on page 86 belongs to this category of relative or temporary sexual anæsthesia; whereas in cases of genuine absolute sexual anæsthesia the sexual impulse also is in abeyance at the outset, or disappears in consequence of excesses and in female libertines and in prostitutes.
The treatment of deficient sexual sensibility in women must, above all, take into consideration psychical influences, and depends, therefore, more on the husband or lover than it does on the physician; the conditions of intercourse must be adapted to the particular circumstances of the case (as by change of posture in coitus, preparatory tenderness, etc.). Painful sensibility in vaginismus can sometimes be cured by mechanical treatment, by the removal of painful remnants of the hymen, by the cure of small lesions, and also by extension by means of the speculum. It also appears, as is evidenced by an observation of Courty, that at the time of impregnation there occurs a stronger stimulation and voluptuous sensation in coitu in women who are at other times frigid.
Sexually frigid women of the lower classes are apt, as Effertz points out, to become prostitutes. During the practice of their profession they always keep a cool head, because they are at first and always sexually insensitive, and can devote their whole energy and regulate all their actions towards the plunder of the man. The following case reported by Effertz (op. cit., p. 51) illustrates this connexion very clearly:
“I was once consulted by a very highly placed hetaira on account of supposed articular rheumatism. When I informed her of my diagnosis of lues, she was greatly moved, and said to me that I should not therefore think the worse of her. She was better than her occupation; she had never followed it on account of evil passions; she was quite insensitive; she had done it only in order to provide for her parents freedom from care in the evening of their life, and to secure the future of her small child. She also told me on this occasion that she owed her success to her coldness, for which condition she was extremely thankful. She never gave herself for less than 1,000 marks (£50). At the same time, she made a mock of her colleagues—those stupid and wicked girls who frequently, when their heads were fired by champagne, would give themselves for nothing, and would even run after men.”
Otto Adler describes Madame de Warens, in Rousseau’s “Confessions,” as a type of such a femme de glace. Frigid women marry with comparatively greater frequency than women who are sexually very excitable, because their natural reserve endows them with greater value in the eyes of men, and also offers a certain security for their faithfulness. Such marriages are naturally in almost all cases unhappy, for the man soon grasps the true nature of the case, and since most will say with Ovid, odi concubitus qui non utrimque resolvunt, he seeks outside the house some response for his love.[436] In some cases, indeed, frigid women make a pretence of experiencing libido and the sexual orgasm, so that the man is deceived. In some cases, also, notwithstanding a manifest frigidity on the part of the wife, the marriage is none the less happy when the husband is partially or wholly impotent, and voluntarily renounces coitus. Such a case I myself recently observed.
“The case was that of a merchant, physically and bodily in excellent health, aged a little under forty years, who, since the eleventh year of his age down to the present time, has continued to masturbate (between the eleventh and eighteenth years of his life, twice daily). He has often had ejaculation without erection. When twenty years of age, he frequently attempted coitus, but could not obtain an erection. Generally speaking, he never had an erection when his attention was directed to the matter, but only without his co-operation, on other occasions than those of attempted sexual intercourse. Thus, until his engagement, in the thirtieth year of his age, he had never completed normal coitus, but had only obtained sexual gratification by means of masturbation, and therefore married with considerable hesitation, although during the eleven months of his engagement he had masturbated much less frequently. On the wedding-night, however, and later, it appeared that his wife had a natural disinclination to coitus, was extremely frigid, and only had traces of sexual sensation when, by means of onanistic stimulation on the part of her husband, her libido was slightly stimulated. Spontaneously she never felt any desire for sexual gratification, not even in consequence of masturbation. The two have lived for seven years in most happy married life, and love one another tenderly, without ever having completed coitus. This deficient sensibility in the wife, and her failure to respond, have naturally not relieved the impotence of the husband, and he gratifies himself now, as before, by solitary masturbation.”
This case proves that the capacity for love is to a certain extent independent of the strength of the libido; frigid men and women can be thoroughly “erotic”; that is to say, they can experience the need for tenderness, just as “erotomania”—that is to say, the excessive longing for love—is completely different in its nature from satyriasis and nymphomania (= excessive sexual desire).[437]