Since woman has less sexual need than man, a predominating sexual desire in her arouses a suspicion of its pathological significance; and the more, when this finds expression in desire for adornment, coquetry, or male society, which, passing beyond the limits set by good breeding and manners, becomes quite noticeable.
The constitution, in both sexes, is of the greatest significance. An abnormally strong sexual instinct is frequently accompanied by a neuropathic constitution; and such individuals pass a great part of their lives heavily burdened with the weight of this constitutional anomaly of their sexual life. The power of the sexual impulse in such cases may at times rise to the importance of an organic necessity, and really endanger the freedom of the will. The want of satisfaction of this impulsive desire may, under such conditions, induce a condition allied to actual rutting, or a psychical condition, accompanied by emotions of fear, in which the individual gives up to the impulse, and responsibility becomes doubtful. If the individual does not give up to his powerful impulse, he is in danger, by reason of his enforced abstinence, of ruining his nervous system by inducing a neurasthenia, or seriously increasing such a condition if it be already present. In normally constituted individuals, too, the sexual instinct is an inconstant quantity. Aside from the temporary indifference following satisfaction, and the diminution of sexual desire in long-continued continence after a certain reactionary stage of sexual desire is overcome, the manner of life has a great influence. Those living in large cities, who are constantly reminded of sexual things and incited to sexual enjoyment, certainly have more sexual desire than those living in the country. A dissipated, luxurious, sedentary manner of life, preponderance of animal food, and the consumption of spirits, spices, etc., have a stimulating influence on the sexual life. In woman the sexual inclination is post-menstrually increased. At this time, in neuropathic women, the excitement may reach a pathological degree.
The great libido of consumptives is remarkable. Hofmann tells of a consumptive peasant who satisfied his wife sexually on the evening before his death.
The sexual acts are coitus (eventually rape) and, faute de mieux, masturbation; and, with defective moral sense, pederasty or bestiality. If sexual power is diminished or extinct, with excessive sexual desire, all manner of perversity of sexual acts becomes possible.
Excessive libido may be peripherally or centrally induced. The former manner of origin is the more infrequent. Pruritus and eczema of the genitals may cause it; and likewise certain substances, like cantharides, which powerfully stimulate sexual desire. Not infrequently, in women at the climacteric, sexual excitement occurs, occasioned by pruritus; and also in cases where there is neuropathic taint. Magnan (Annales médico-psychol., 1885, p. 157) reports the case of a lady who was afflicted mornings with attacks of frightful erethismus genitalis, and the case of a man, aged 55, who was tormented at night by unbearable priapism. In each case there was a neurosis.
The central origin of sexual excitement is of frequent occurrence[[39]] in persons having neurotic taint or hysteria, and in conditions of psychical exaltation. Here, where the cortex and the psycho-sexual centre are in a condition of hyperæsthesia (abnormal excitability of the imagination, increased ease of association), not only visual and tactile impressions, but also auditory and olfactory sensations, may be sufficient to call up lascivious concepts.
Magnan (op. cit.) reports the case of a young woman who had an increasing sexual desire from puberty, and satisfied it by masturbation. Gradually she grew to become sexually excited at the sight of any man pleasing to her; and, since she was unable to control herself, she would sometimes shut herself up in a room until the storm had passed. At last she gave herself up to men of her choice, that she might get rest from her tormenting desire; but neither coitus nor masturbation brought relief, and she went to an asylum.
The case of a mother of five children is added, who, in despair about her inordinate sexual impulse, attempted suicide, and then sought an asylum. There her condition improved, but she never trusted herself to leave it.
There are several illustrative cases in men and women in the author’s article, “On Certain Anomalies of Sexual Instinct,” Cases 6 and 7 (Archiv für Psychiatrie, vii, 2); Cases 3 and 5 are given here.
Case 11. On the afternoon of July 7, 1874, Clemens, engineer, being on his way, on business, from Trieste to Vienna, left the train at the town of Bruck, and, passing through the town to the neighboring village of St. Ruprecht, attempted a rape on an old woman, aged 70, whom he found alone in a house. He was seized by the neighbors and arrested by the local police. At his hearing he declared that he had tried to find the pound, in order to satisfy his sexual desire with a bitch. He said that he often suffered with such sexual excitement. He did not deny his act, but excused it as the result of disease. The heat, the motion of the cars, and anxiety about his family, to which he wished to go, had confused him and made him ill. Shame and remorse were not shown. His conduct was open, his mien gay; eyes red and bright, head hot, tongue coated; pulse full, soft, beating over 100; fingers somewhat tremulous. The statements of the accused were precise, but hurried; his glance uncertain, and with an unmistakable expression of lasciviousness. To the medical expert summoned to examine him, he gave the impression of one suffering with disease,—as if he were in the beginning of alcoholic insanity.