On January 5, 1888, second admission, in a state of violent mania. On January 4, he had become morose, irritable, whining, and sleepless; and then, after vain assaults on women, had manifested symptoms of increasing angry excitement.
On January 6, progress of the condition to severe acute delirium (great disturbance of consciousness, jactation, grinding of the teeth, grimacing, and other motor symptoms of irritation; temperature as high as 40.7° C.); impulsive masturbation. Recovery was complete by January 11, under energetic treatment with ergotin.
After his recovery the patient gives an interesting account of the cause of his illness. Always very passionate sexually; first coitus at the age of sixteen. Continence caused headache, great psychical irritability, lassitude, great loss of pleasure in work, and sleeplessness. Since he had few opportunities in the country to satisfy his desire, he had recourse to masturbation. It was necessary for him to masturbate once or twice daily. No coitus in two months. Increasing sexual excitement; could think of nothing save means for the gratification of his impulse. Masturbation was not sufficient to banish the constantly increasing torment ex abstinentia. During the last four days violent impulse to coitus; increasing sleeplessness and irritability. There was only a summary recollection of the height of the illness. Patient recovered in December. A very respectable man; he considers his inordinate desire decidedly pathological, and is anxious about his future.
Case 15. On July 11, 1884, R., aged 33, servant, was admitted suffering with paranoia persecutoria and neurasthenia sexualis. Mother was neuropathic; father died of spinal disease. From childhood he had an intense sexual desire, of which he became conscious as early as his sixth year. From this age, masturbation; from fifteenth year, faute de mieux, pederasty; occasionally, sodomitic indulgences. Later, abusus coitus in marriage cum uxore. Now and then even perverse impulse to commit cunnilingus and to administer cantharides to his wife, because her libido did not equal his own. His wife died after a short period of married life. Patient’s circumstances became straightened, and he had no means to indulge himself sexually. Then masturbation again; employment of lingua canis to induce ejaculation. At times, priapism and conditions approaching satyriasis. He was then driven to masturbate, in order not to become stuporous. Beneficial diminution of the libido nimia, with the gradually predominating sexual neurasthenia and hypochondria.
The following case, valuable for an understanding of many Messalinas, some of whom are historically celebrated, is a classical example of pure hyperæsthesia sexualis, which I take from Trelat’s “Folie lucide”:—
Case 16. Mrs. V. has suffered with a passion for men since her earliest youth. Of good family, well bred, of pleasant disposition, exceedingly modest, she was, as a little girl, a terror to her family, because she could scarcely be alone with a person of the opposite sex, no matter whether it was with child or man of any age, without exposing herself immediately and demanding satisfaction for her sexual passion, even going so far as to lay hold of him. An attempt was made to cure her by marriage. She loved her husband passionately, but even with him she could not keep from demanding coitus of every one with whom she could be alone, no matter whether it was servant, laborer, or school-boy.
Nothing could cure her of this impulse. Even when she became a grandmother, she was still a Messalina. One day she locked a twelve-year-old boy in her room and tried to seduce him. The boy defended himself and escaped. She was severely punished by his brother. All was in vain. She was put in a cloister. There she was an example of morality, and gave not the slightest cause for blame. Immediately after her return the scandal began again. The family banished her, and set aside money to support her. She earned by her own hand-work enough to buy herself lovers. Any one seeing this neatly dressed matron, of good manners and amiable disposition, would never suspect how recklessly passionate she still was at the age of sixty-five. On January 7, 1854, her family, in despair at new scandals, placed her in an asylum. She lived there until May, 1858, when she died of apoplexia cerebri, in her seventy-third year. Her conduct in the asylum was exemplary. Left to herself, and under favorable conditions, her sexual impulses manifested themselves shortly before her death. With the exception of this, during an observation of four years by physicians of the asylum, she never showed a sign of mental abnormality.
D. Paræsthesia of Sexual Feeling (Perversion of the Sexual Instinct).
In this condition there is perverse emotional coloring of the sexual ideas. Ideas physiologically and psychologically accompanied by feelings of disgust, give rise to pleasurable sexual feelings; and the abnormal association finds expression in passionate, uncontrollable emotion. The practical results are perverse acts (perversion of the sexual instinct). This is more easily the case if the pleasurable feelings, increased to passionate intensity, inhibit any opposing ideas with corresponding feelings of disgust; or the influence of such opposing concepts may be impossible on account of the absence or loss of all ideas of morality, æsthetics, and law. This loss, however, is only too frequently found where the spring of ethical ideas and feelings (a normal sexual instinct) has been poisoned from the beginning.
With opportunity for the natural satisfaction of the sexual instinct, every expression of it that does not correspond with the purpose of nature,—i.e., propagation,—must be regarded as perverse. The perverse sexual acts resulting from paræsthesia are of the greatest importance clinically, socially, and forensically; and, therefore, they must here receive careful consideration; all æsthetic and polite disgust must be overcome.