Psychopathia sexualis: With especial reference to contrary sexual instinct / A medico-legal study

by R. von Krafft-Ebing

Ideas of flagellation would also come to him while in a brothel, but the retention of such fancies was not essential for the performance of coitus. He considered sexual intercourse with prostitutes only a remedy against the desire for masturbation and men,—a kind of safety-valve to prevent compromising himself with some man.

The patient now wishes to marry, but fears not only that he could have no love for a decent woman, but also that he might be impotent for intercourse with one. Hence his thought and need of medical advice.

The patient is very intelligent, and is, in all respects, of masculine appearance. In dress and manner he presents nothing that would attract attention. Gait, voice, and skeleton,—the pelvis especially,—masculine in character. Genitals of normal development. The normal growth of hair for a male is abundant. The patient’s relatives and friends have not the slightest suspicion of his sexual anomalies. In his inverted sexual fancies, he has never felt himself in the rôle of a woman toward a man. For some years he has been entirely free from neurasthenic troubles.

The question as to whether he considered himself a subject of congenital inversion of sexual instinct he could not answer. It seems probable that there was a congenital weak inclination for the opposite sex, with a greater one for the same sex, which, as a result of early masturbation in consequence of the homo-sexual instinct, was still more weakened, but not reduced to nil. With the cessation of masturbation, the feeling for women became in a measure more natural, but only in a coarsely sensual way.

Since the patient explained that, for reasons of family and business, it was necessary for him to marry, it was impossible to avoid this delicate question.

Fortunately, the patient limited his inquiries to the question as to his virility as a husband; and it was necessary to reply that he was virile, and that he would probably be so in conjugal intercourse with the wife of his choice,—at least, if she were to be in mental sympathy with him; besides, that he could at all times improve his power by exercising his imagination in the right direction.

The main thing was to strengthen the sexual inclination for the opposite sex, which was defective, but not absolutely wanting. This could be done by avoiding and opposing all homo-sexual feelings and impulses, possibly with the help of the artificial inhibitory influences of hypnotic suggestion (removal of homo-sexual desires by suggestion); by the excitation and exercise of normal sexual desires and impulses; by complete abstinence from masturbation, and eradication of the remnants of the neurasthenic condition of the nervous system by means of hydrotherapy, and possibly general faradization.

I am indebted to a physician, aged thirty, for the following autobiography, which in another respect is noteworthy:—

Case 108. Mental Hermaphroditism; Abortive Contrary Sexual Instinct.—“In my ancestry I am somewhat predisposed hereditarily. My grandfather on my father’s side was a high-liver and a speculator. My father was a man of character, but for more than thirty years he has suffered with folie circulaire, without, however, being much hindered by it in business. My mother, like her father before her, suffers with stenocardiac attacks. My mother’s father and brother are said to have been sexually hyperæsthetic. My only sister, about nine years older than myself, was twice subject to attacks of eclampsia, and during puberty was religiously exalted, and probably also sexually hyperæsthetic. During many years she had to suffer with a severe hysterical neurosis, but she is now completely well.

“As an only son, and born late, I was the apple of my mother’s eye; and I have her indefatigable care to thank that I survived childhood, after having passed through all the possible diseases of children (hydrocephalus, measles, croup, small-pox, and, at thirteen, chronic intestinal catarrh that lasted a year). My mother, being herself very religious, raised me, without spoiling me, in a religious way, and implanted in me, as the guiding moral principle, an unyielding devotion to duty, which was further carried to an extreme in me by a teacher whom I still call a friend. Owing to my delicate health, my childhood, in greater part, was spent in bed; and I was thus given to quiet occupations, especially reading; and thus as a boy I came to be—if not blasé—premature at least. As early as eight or nine the parts of books that excited me most were those where injuries or operations that had to be endured by beautiful girls or ladies, were described. Thus I was thrown into great excitement by a story in which was pictured a maiden that had run a thorn into her foot, with a boy taking it out for her. Indeed, every time that I looked upon this picture, which was in nowise lascivious, I had an erection. Whenever possible, I went to see chickens killed; and if I had missed that, I looked at the spots of blood, and stroked the warm bodies of the birds, with pleasurable shudders. I would emphasize the fact that I have always been a great lover of animals, and have felt disgust and pity while killing larger animals, and even in the vivisection of frogs.