A clinical group that very nearly approaches the epileptic exhibitionists is made up of certain neurasthenic individuals, in whom, likewise, there may occur attacks (epileptoid?) of imperfect consciousness[[129]] in connection with a feeling of apprehensive oppression; and with this sexual impulses may be associated, resulting in acts of exhibition having an impulsive character.
Case 173. Dr. S., academic teacher, had aroused public indignation by being seen repeatedly running about in the Zoological Garden at Berlin, before ladies and children, with his genitals hanging out. S. admitted this, but denied all thought or consciousness of causing public offense, and excused himself by saying that his running about with exposed genitals afforded him relief from nervous excitement. Mother’s father was insane, and died by suicide; his mother was constitutionally neuropathic, a somnambulist, and had been temporarily insane. The culprit was neuropathic, had been a somnambulist, and had had continuous aversion to sexual intercourse with females. In his youth he practiced onanism. He was a neurasthenic man, shy, torpid, and easily became embarrassed and confused. He was sexually always much excited. Frequently he dreamed that he was running about with exposed genitals, or that, dressed only in a shirt, he hung from a fence with his head downward, so that the shirt fell down, exposing his erected penis. His dreams would induce pollution, and he would then have rest for a few days or an entire week.
Also, in his waking state, the impulse would often come upon him, just as in his dreams, to run about with exposed genitals. As he was about to expose himself, he would become very hot, and then he would run aimlessly about. The member would become moist with secretion, but pollution was never induced. Finally, when it had become flaccid, he would put it up, and then come to himself, glad if no one had seen him. In such conditions of excitement he seemed to be in a dream; as if intoxicated. He had never had the intention to offend women. S. was not epileptic. His declarations had the impress of truth. He had actually never followed or spoken to women while in this condition. Frivolity and coarseness were excluded. In agreement with Westphal, the author regards S. as belonging “to a class of individuals of peculiar hypochondriacal tendencies, in whom the attention is constantly directed, in an abnormal way, to certain bodily sensations and processes; who brood over these, connecting all kinds of peculiar conceptions with them, at last making use of quite as strange means to combat the bodily sensations and ideas.” At least, S.’s act was due to pathological sensation and idea, and S. was in a condition of pathological disturbance of mental action at the time of the commission of his acts. In the case of this exhibitionist, the manner of satisfaction of the sexual instinct may be considered as peculiar to the individual. (Liman, Vierteljahrsschrift für gerichtel. Med., N. F. xxxviii, Heft 2.)
Case 174. X., aged 38; married; father of one child. Always sullen and silent. Suffers frequently with headache. Very neurasthenic, though not insane. He is troubled much at night by pollutions. He has repeatedly followed shop-girls, for whom he had lain in wait, exposing and handling his genitals. In one case he even followed a girl into a shop. (Trochon, Arch. de l’anthropologie criminelle, iii, p. 256.)
In the following case the exhibition seems subsidiary to the impulsive desire to satisfy sudden, intense libido, by means of masturbation:—
Case 175. R., coachman, aged 49, Vienna; married since 1866; childless. Father neuropathic and given to sexual excesses; died of cerebral disease. He presents no degenerative signs.
At the age of twenty-nine he suffered a severe concussion by falling from a height. Up to that time the vita sexualis had been normal. Since that time, every three or four months, he has been seized with very painful sexual excitement, accompanied by an intense desire to masturbate. A feeling of weariness and discomfort, with a desire for alcoholic indulgence, precedes this. In the intervals he is sexually cold, and has but very infrequent desire for his wife, who, moreover, for five years has been sick, and incapable of cohabitation. He gives the assurance that, as a young man, he never masturbated, and that, in the intervals between his attacks, he has never thought of satisfying himself sexually in this way.
The impulse to masturbation during the attack is always excited by certain feminine charms,—short cloak, pretty foot and ankle, elegant appearance. Age makes no difference; even little girls excite him. The impulse is sudden and unconquerable. R. describes the situation and act as characteristically impulsive. He had often tried to resist it; but then he would grow hot, terribly frightened, his head would burn, and he would seem to be in a fog; but he never lost consciousness. At the same time he would have violent, darting pain in the testicles and spermatic cords. He regretted it, but had to confess that the impulse was stronger than his will. In such a situation it forced him to masturbate, no matter where he might be. After ejaculation he would become calm, and regain his self-control. He regarded it as a terrible affliction. Defense shows that R. has been punished six times for similar offenses—exhibition and masturbation in the open street.
On November 4, 1889, R., while in his worst condition, happened to be in the street as a crowd of school-girls went by. This awakened his unconquerable impulse. There was not time to run to a closet, he was so excited. There was immediate exhibition, masturbation in front of a house,—great scandal and immediate arrest. R. is not weak-minded, and has no ethical defect. He bemoans his fate, deeply regrets his act, and fears new attacks. He regards his condition as abnormal,—as a fate against which he is powerless.
He thinks himself still virile. Penis abnormally large. Cremasteric reflex present; patellar reflex increased. Weakness of the sphincter of the bladder, that has existed for some years. Various neurasthenic difficulties.