Thus it happens that it not infrequently appears combined with the other (original) sexual perversions that arise on the same basis. Not infrequently fetichism occurs in the most various forms in combination with contrary sexuality, sadism, and masochism. Indeed, certain forms of body-fetichism (hand- and foot-fetichism) probably have a more or less distinct connection with the latter two perversions (v. infra).
But if fetichism also rests upon a congenital general psychopathic disposition, yet this perversion is not, like those previously considered, essentially of an original nature; it is not congenitally perfect, as we may well assume sadism and masochism to be. While in the sexual perversions thus far described we have met only cases of a congenital nature, here we meet only acquired cases. Aside from the fact that in fetichism the causative circumstance of its acquirement is often demonstrable, here the physiological conditions are wanting, which in sadism and masochism, by means of sexual hyperæsthesia, are intensified to perversions, and justify the assumption of congenital origin. In fetichism, every case requires an event which affords the subject of perversion. As has been said, it is, of course, physiological in sexual life to be partial to one or another of woman’s peculiarities, and to be enthusiastic about it; but concentration of the entire sexual interest on such partial impressions is here the essential thing; and for this concentration there must be a particular reason in every individual affected. Therefore, we may accept Binet’s conclusion that in the life of every fetichist there may be assumed to have been some event which determined the association of lustful feeling with the single impression. This event is to be referred to the time of early youth, and, as a rule, occurs in connection with the first awakening of the vita sexualis. This first awakening is associated with some partial sexual impression (since it is always something standing in some relation to woman), and stamps it for life as the principal object of sexual interest. The circumstances under which the association arises are usually forgotten. It is only the result of the association that is retained. The general predisposition to psychopathic states and the sexual hyperæsthesia of such individuals are all that is original here.[[88]]
Like the other perversions thus far considered, erotic (pathological) fetichism may also express itself in strange, unnatural, and even criminal acts: gratification with the female person loco indebito, theft and robbery of objects of fetichism, pollution of such objects, etc. Here, too, it only depends upon the intensity of the perverse impulse and the relative power of opposing ethical motives, whether and to what extent such acts are performed. These perverse acts of fetichists, like those of other sexually perverse individuals, may either alone constitute the entire external vita sexualis, or occur together with the normal sexual act. This depends upon the condition of physical and psychical sexual power, and the degree of excitability to normal stimuli that has been retained. Where excitability is diminished, not infrequently the sight or touch of the fetich serves as a necessary preparatory act.
The great practical importance which attaches to the facts of fetichism, in accordance with what has been said, lies in two factors. First, pathological fetichism is not infrequently a cause of psychical impotence.[[89]] Since the object upon which the sexual interest of the fetichist is concentrated stands, in itself, in no immediate relation to the normal sexual act, it often happens that the fetichist diminishes his excitability to normal stimuli by his perversion, or, at least is capable of coitus only by means of concentration of his fancy upon his fetich. In this perversion, and in the difficulty of its adequate satisfaction, just as in the other perversions of the sexual instinct, lie conditions favoring psychical and physical onanism, which again reacts deleteriously on the constitution and sexual power. This is especially true in the case of youthful individuals, and particularly in the case of those who, on account of opposing ethical and æsthetic motives, shrink from the realization of their perverse desires. Secondly, fetichism is of great forensic importance. Just as sadism may extend to murder and the infliction of bodily injury, fetichism may lead to theft and even to robbery for the possession of the desired articles.
Erotic fetichism has for its object either a certain portion of the body of a person of the opposite sex, or a certain article or material of wearing-apparel of the opposite sex. (Only cases of pathological fetichism in men have thus far been observed, and therefore only portions of the female person and attire are spoken of here.) In accordance with this, fetichists fall into three groups.
(a) The Fetich is a Part of the Female Body.—Just as, in physiological fetichism, the eyes, the hand, the foot, and the hair of woman very frequently become fetiches, so, in the pathological domain, the same portions of the body become the sole objects of sexual interest. This exclusive concentration of interest on these parts, by the side of which everything else feminine fades, and all other sexual value of woman may sink to nil, so that, instead of coitus, strange manipulations of the fetich become the object of desire,—this it is that makes these cases pathological.
Case 74. (Binet, op. cit.) X., aged 34, teacher in a Gymnasium. In childhood he suffered with convulsions. At the age of ten he began to masturbate, with lustful feelings, which were connected with very strange ideas. He was particularly partial to women’s eyes; but since he wished to imagine some form of coitus, and was absolutely innocent in sexual matters, to avoid too great a separation from the eyes, he evolved the idea of making the nostrils the seat of the female sexual organs. Then his lively sexual desires were connected with this idea. He sketched drawings representing correct Greek profiles of female heads, but the nostrils were so large that immissio penis would have been possible.
One day, in an omnibus, he saw a girl in whom he thought he recognized his ideal. He followed her to her home and immediately proposed to her. Shown the door, he returned again and again, until arrested. X. never had sexual intercourse.
Hand-fetichists are very numerous. The following case is not really pathological. It is given here as a transitional case:—
Case 75. B., of neuropathic family, very sensual, mentally intact. At the sight of the hand of a beautiful young lady he is always charmed and feels sexual excitement to the extent of ejaculation. It is his delight to kiss and press such hands. As long as they are covered with gloves he feels unhappy. By pretexts he tries to get hold of such hands. He is indifferent to the foot. If the beautiful hands are ornamented with rings, his lust is increased. Only the living hand, not its image, causes him this lustful excitement. It is only when he is exhausted sexually by frequent coitus that the hand loses its sexual charm. At first the memory-picture of female hands disturbed him even while at work. (Binet, op. cit.)