CHAPTER XXIV

It is the evident duty of the State to protect society from certain manifestations of the sexual impulse, occurring publicly in the form of “offences against morality,” and whenever these manifestations interfere with the persons and the rights of citizens. The sexual impulse has been compared with a powerful stream, which, when confined to its natural bed, is a never-ending source of blessing to the surrounding country; but which, as soon as with elemental force it overflows its banks and gives rise to widespread floods, is the cause of unspeakable misery among the entire population.[673] This comparison would be just if the facts were as stated. But, as I have already pointed out, as a whole, sexual perversions have played a far smaller part in the decadence of fallen nations than has hitherto been assumed. The biological and economical history of civilization has taught us to recognize numerous other influences, which, in such a process of national decay, play at least as great a part as sexual “degeneration,” and in many cases a much greater part than this. Frequently, indeed, sexual perversions and unnatural modes of gratification of the sexual impulse are in the first place a consequence of economic and social abnormalities, and are intimately connected with the so-called social problem. The above-named stream, to pursue the image, only trickles over its banks here and there, without giving rise to any widespread and devastating flood. And so long as these destructive tendencies are wanting, the State has no right to take measures against sexual perversions, or at most can justly do so only by dealing with their social causes. In view of the extensive diffusion of sexual anomalies among persons who in other respects are perfectly healthy, we must ask ourselves whether the importance of these anomalies, in respect of the offences against morality to which in certain circumstances they may give rise, has not been overestimated. This idea has recently been put forward by J. Salgó, in his valuable monograph, “The Forensic Importance of Sexual Perversities” (Halle, 1907). I am more especially pleased to find that this author shares the view which I have myself advocated for years, that sexual perversities in the majority of cases are not indications of “degeneration,” as has been assumed both by psychiatrists and neurologists, especially under the influence of the doctrine of Möbius, who pushed this idea much too far. Moreover, the late Jolly, in his lectures to practising physicians upon sexual aberrations, expressly maintained the justice of my view of sexual anomalies as an anthropological phenomenon. With regard to the nature of sexual perversions, psychiatric science will have greatly to modify its general views, in order to attain an objective consideration of their significance.

“Psychiatry,” says Salgó (op. cit., pp. 37, 38), “must not follow the decoy-call of the law (which has wandered into a blind alley), by endeavouring to cover with the mantle of specialist science the serious legal errors in the matter of perverse sexuality. The incontestable domain of psychiatric experience in forensic questions is already sufficiently large, and it needs no artificial extension. But it is an artificial extension to indicate as morbid all the aberrations of sexual activity, or any single one of such aberrations, in the absence of indubitable or demonstrable symptoms of physical disturbance, and in the absence of a clearly recognizable and abnormal course—simply because they contravene the existing criminal law.”

The blind alley of psychiatry is the prison and the asylum. Because psychiatry is principally concerned with those sexual perversities which have criminal or psychiatric importance, with the abnormalities and the crimes of the sexually perverse, psychiatric science failed to recognize the extraordinarily wide diffusion of sexual perversions among persons who are mentally and physically healthy. Among the healthy, homosexuality, sadism, masochism, fetichism, etc., may make their appearance in more or less severe forms; just as other “vicious habits” may occur in the healthy, just as passionate tobacco-smoking, or intoxication with any sport, may become an ineradicable habit, or at least a habit extremely difficult to eradicate. Neither jurisprudence nor psychiatry can be spared the accusation of having misled “public opinion,” this terrible monster so often hostile to civilization, in respect of sexual perversities, regarding whose nature recent scientific research, and above all, anthropological research, has diffused a light. I am acquainted with a number of persons whose bodily and mental health is excellent, persons who are, indeed, imposing in respect of their primeval German racial force, who have assured me that they suffer from the most severe sexual perversions! Recall the description given on [p. 584] of a masochistic “slave” of the most extreme type. I do not go so far as Salgó, who demands for sexual anomalies, in so far as they are not criminal, the same “right of existence” ([p. 7]) as for the normal sexual impulse; but I do assert that sexual anomalies exist in individuals who are in other respects perfectly healthy, and that they do not always injure the personal health or the bodily and moral well-being of another, as is the case with sexual perversions arising upon a morbid foundation and attaining forensic importance. Above all, I must sharply condemn the fashion of glorifying sexual perversities, which have been regarded as a peculiar privilege of the highest mental development, and as corresponding to an especial refinement of sensibility. This assertion may be refuted by reference to the fact, often mentioned before, that the most incredible and most artificial sexual malpractices occur among savage races, who in this respect could give points to our modern decadents and epicurean æsthetes. In any case, sexual perversions in themselves have neither a moral nor a forensic importance, and must be regarded as more or less biological variations of the normal impulse.

Where, on the other hand, the public or individual interest is injured by these perversions, the State has unquestionably the right of intervention and the right of prevention. In every case in which we have to do with the production of a public nuisance, with the bodily or mental injury of other human beings, with the employment of force, with the misuse of the lessened or absent responsibility of children, of unconscious persons, of those asleep, and of those mentally disordered, society must intervene in its own interest, and must take suitable measures to protect itself against such offences. Now, it is certain—and to have established this is an honour to psychiatric science—that it is precisely these latter sexual offences which in the great majority of cases are committed by diseased persons and by those who are more or less irresponsible. Therefore, we are thoroughly justified in demanding that in every such criminal case, the bodily and mental condition of the accused should be subjected to a medical examination. A typical mental disorder, such as imbecility, epilepsy, alcoholic insanity, general paralysis of the insane, paranoia, etc., will be detected without difficulty, and thereby responsibility will at once be excluded. More difficult are the transitional stages between health and disease, the so-called “borderland cases,” the cases of “psychopathically deficient responsibility” and of “disequilibrium.” In forensic medicine two ideas play a very great part in this connexion, that of “degeneration” and that of “diminished responsibility.”

Every sexually perverse person must be examined for signs of severe hereditary taint, as well as for the so-called “stigmata of degeneration.” If we can prove that in his family there have been several instances of severe mental disorder, of alcoholism, syphilis, diabetes, and other diseases leading to degeneration, the suspicion that there is a psychopathic foundation for the sexual offence is justified. But we must insist that congenital taint does not make itself felt in every case, and cannot, therefore, always be made responsible as a causal influence in the production of a sexual perversion.[674]

The so-called “stigmata of degeneration” have importance only when they are very markedly developed, and when several of them are simultaneously present. We distinguish physical and mental stigmata degenerationis. To the former belong disturbances and inhibitions of development, malformations, such as asymmetry of the skull, narrowness of the palate, hare-lip, cleft palate, anomalies of the teeth and the hair, difficulties of speech, tic convulsif, abnormal and morbid states of the genital organs and genital functions, and more especially malformations of the ear, such as Morel’s ear (the complete or partial absence of the helix or antihelix), the Darwinian pointed ear, etc.[675]

The mental degenerative phenomena comprise all that are known as “bizarre or abnormal” characters; those who possess such characters are termed “eccentrics” and “originals,” or are known as persons “psychopathically below par” (J. L. A. Koch), as “disequilibrated” (Eschle), as “superior degenerates” (Magnan). These phenomena comprise peculiar disturbances of the harmony of the spiritual life, characterized by lack of balance between emotion and intellect, as well as by an abnormal irritability and undue reaction to stimulation. We may find complete absence of ethical perception, so-called “moral insanity,” of which E. Kraepelin and his school have proved that it may arise secondarily as a sequel to certain mental disorders. Striking in these unbalanced persons is the disharmony of the entire conduct of life, the internal lack of the point d’appui, the unsteadiness, the suddenness of their actions, which often occur under the influence of coercive ideas and abnormal impulses, the abnormally early appearance and the extraordinary intensity of the sexual impulse, the tendency to cruelty (O. Rosenbach). In judging the personality of the degenerate as a whole, we must always take into account the entire course of life, to which only too often the remark of Stifter applies: “In his life we saw only beginnings without continuations, and continuations without beginnings.”

On the other hand, we must not forget that many of the bodily stigmata of degeneration occur also in healthy persons, and that the existence of such stigmata in mentally disordered persons and in criminals may also be referred to social causes, to bad conditions of life and deficient nutriment, to alcoholism, syphilis, or rickets. For this reason P. Näcke[676] rightly insists that many of the so-called stigmata of degeneration are socially produced, and will therefore disappear with the employment of a purposive social hygiene; he gives as an example the rachitic bandy legs of English factory labourers. Therefore, for the proof of degeneration, we must lay more stress upon mental stigmata, upon abnormality of the spiritual personality, abnormality of its intellectual and emotional character, and from this proceed to infer the irresistible character of a morbid impulsive manifestation.