3. I sought, by means of hypnosis—which was hard to induce—and

suggestion, to fortify the patient in this as far as possible. All attempts at coitus were forbidden in order to save the patient from a discouraging result. Within two months and a half this treatment led to the result that, as the patient stated, the perverse ideas occurred much less frequently and were constantly retreating to the background; indeed, according to the patient’s statement, erections occurred with the thoughts of nude women, became more frequent, and often induced him to masturbate with the thought of coitus without the occurrence of any idea of blows. Erotic dreams occurred but infrequently. These were concerned sometimes with normal coitus, sometimes with blows. After two months and a half of the treatment I advised the patient to attempt coitus. Since then he has tried four times. I advised him to choose always a woman who pleased him, and sought to increase his sexual excitement before coitus by means of tincture of cantharides. The four attempts, the last of which took place on November 29, 1890, resulted as follows: At the first, prolonged manipulation of the penis by the woman was necessary in order to induce erection. Then immisio in vaginam and ejaculation with orgasm took place. During the whole act there occurred no thought of beating the woman or being beaten, but the woman in herself excited him sufficiently for the performance of coitus. At the second attempt the result was better and more quickly attained; manipulation ad genitalia by the woman was not long required. In the third attempt coitus was attained only after the patient had thought of beating for a long time, and had thus induced erection; but beating was not indulged in. At the fourth attempt coitus was attained without any thought of beating and without any manipulation ad genitalia. Of course, the case described cannot yet be regarded in any way as cured. Though the patient were able to perform coitus in a normal or nearly normal way, that does not mean that he will always be able to do it in the future; moreover, the thought of beating still affords him great pleasure, even though it occurs much less frequently than formerly. Yet there is a possibility that the abnormal desire, which has been weakened, will remain weakened in the future, and perhaps disappear. This carefully observed case is, for several reasons, particularly interesting. It discloses clearly one of the hidden roots of sadism,—the impulse to complete subjugation of the woman, which here became consciously entertained. This is the more remarkable since it occurred in an individual decidedly timid, and in other respects modest and even apprehensive. The case also shows clearly that powerful libido, which even impels the individual to overcome all obstacles, may be present, while at the same time coitus is not desired, because the principal intensity of feeling is, _ab origine_, connected with the cruel part of the sadistic (lustful and cruel) circle of ideas. This case also contains weak elements of masochism (_v. infra_). Cases are by no means infrequent in which men with perverse inclinations induce prostitutes, by paying them high prices, to allow themselves to be whipped and even wounded by them. Works on prostitution contain reports of them (_vide_ Coffignon, “La Corruption à Paris,” etc.). (d) _Defilement of Women._—The perverse sadistic impulse, to injure women and put contempt and humiliation upon them, is also expressed in the desire to defile them with disgusting or, at least, foul things. The following case, published by Arndt (_Vierteljahrsschr. f. ger. Medicin_, N. F. xvii, H. 1), belongs here:— Case 31. A., medical student at Greifswald, accusatus quod iterum iterumque puellis honestis parentibus natis in publico genitalia sua e bracis dependentia plane nudata quæ antia summo amiculo (overcoat) tecta erant, ostenderat. Nonnunquam puellas fugientes secutus easque ad se attractas urina oblivit. Hæc luce clara facta sunt; nunquam aliquid hæc faciens locutus est. A. is twenty-three years old, powerfully built, neat in dress, and decent in manners. Indication of cranium progeneum; chronic pneumonia of the apex of the right lung; emphysema. Pulse, 60; in excitement, not more than 70 to 80. Genitals normal. Complaints of occasional disturbances of digestion and hardness of the abdomen, vertigo; excessive excitement of the sexual desires, which early led to onanism. The sexual desire has never been directed toward a natural method of satisfaction. Complaints of occasional attacks of depression, or thoughts of deprecation of self, and of perverse impulses, for which he could find no motive; such as laughing at serious things, throwing his money in the water, and running about in the pouring rain. The father of the culprit is of a nervous temperament; his mother is subject to nervous headache. A brother suffered with epileptic convulsions. From his youth the culprit presented a nervous temperament, was inclined to convulsions and attacks of syncope, and when he was severely scolded would fall into a state of momentary stiffness. In 1869 he studied medicine in Berlin. In 1870 he went to the war as a hospital-assistant. His letters at this time betray a peculiar torpidity and weakness. On his return home, in 1871, his emotional irritability was noticed by those about him. Thereafter frequent complaints of bodily ailments; unpleasantness resulting from a love affair. In November, 1871, he pursued his studies diligently in Greifswald. He was considered very gentlemanly. In confinement he is quiet, calm, and sometimes self-absorbed. His acts he attributes to painful sexual excitement, which of late had become excessive. He declared that he had been fully conscious of his perverse acts, and had afterward been ashamed of them. He had not experienced actual sexual satisfaction in their commission. He obtained no correct insight into his position. He considered himself a kind of martyr,—fallen a victim to an evil power. Presumption of irresponsibility, as a result of absence of free will. The impulse to defile occurs also, paradoxically, in the aged, when there is a re-appearance of sexual instinct, which, under such circumstances, is so often expressed in perverse acts. Thus Tarnowsky reports (p. 76) the following case:— Case 32. I knew such a patient, who had a woman dressed in a _décolleté_ ball-dress lie down on a low sofa in a brightly lighted room. Ipse apud januam alius cubiculi obscurati constitit adspiciendo aliquantulum feminam, excitatus in eam insiluit excrementa in sinus ejus deposuit. Hæc faciens ejaculationem quandam se sentire confessus est. An officer of Vienna informs me that men, by means of large sums of money, induce prostitutes to suffer ut illi viri in ora earum spuerent et fæces et urinas in ora explerent.[56] The following case by Dr. Pascal (“Igiene dell’amore”) seems also to belong here:— Case 33. A man had an inamorata. His relation with her was that he had her allow him to blacken her hands with coal or soot, and then she had to sit before a mirror in such a way that he could see her hands in it. While conversing with her, which was often for a long time, he looked constantly at her mirrored hands, and finally, after a time, he would take his leave, fully satisfied. The following case, communicated by a physician, may be of interest in relation to this subject:— An officer was known in a brothel in K. only by the name of “Oil.” “Oil” induced erection and ejaculation only by having puell. publ. nudam step into a tub filled with oil, while he rubbed the oil all over her body. These acts lead to the presumption that certain cases of injury of females (_e.g._, sprinkling with sulphuric acid, ink, etc.) depend upon a perverse sexual impulse; at least, here it is a kind of injury, and those injured are always females, and the perpetrators males. At least in the future, in crimes of this kind, pains should be taken to examine the vita sexualis of the culprits. The case of Bachmann, given below, throws a clear light on the sexual nature of such crimes; for, in this case, the sexual motive in the deed is proven. (e) _Other Attacks on Females_—_Symbolic Sadism._—The foregoing groups do not exhaust the forms in which the sadistic impulse toward women is expressed. If the impulse is not overmastering, or there is yet sufficient moral resistance, it may happen that the perverse inclination is satisfied by an act that is apparently quite senseless and silly, but which has a symbolic meaning for the perpetrator. This seems to be the meaning of the two following cases:— Case 34. (Dr. Pascal, “Igiene dell’amore.”) A man was accustomed to go, on a certain day once a month, to an inamorata and cut her “bang.” This gave him the greatest pleasure. He made no other demands on the girl. Case 35. A man in Vienna regularly visits several prostitutes only to lather their faces and then to remove the lather with a razor, as if he were shaving them. He never hurts the girls, but becomes sexually excited and ejaculates during the procedure. The significance of the following cases, in which a sadistic comedy is played, is clearer:— Case 36. A man always announces to a puella publica his intended visits. She must stand at the window, awaiting him, with her face done up, and, on his entrance into the room, complain of severe toothache. He is sorry for her, asks particularly about the pain, takes the cloth off and puts it on again; but he never has coitus, and finds his satisfaction simply in this act.[57] The following case, which, unfortunately, was not carefully examined scientifically, is peculiar to itself:— In an examination before a criminal court in Vienna, the following facts were brought to light: Count N., accompanied by a young girl, appeared in the public garden of an hotel, and, by his actions there, gave public offense. He demanded of his companion that she kneel down before him and implore him with folded hands. Then she was compelled to lick his boots. Finally, he demanded of her, publicly, “an unheard-of thing” (osculum ad nates, or the like), and only desisted after she had sworn to do it at home. In this case, the most remarkable thing was the desire of the perverse individual to humiliate the woman before witnesses (comp. the fancies of sadists, Case 29); further, that the desire to humiliate the woman came entirely into the foreground, and acts of a purely symbolic nature were undertaken. Of course, with these, in this imperfectly-observed case, acts of cruelty were probable. (f) _Sadism with Other Objects_—_Whipping of Boys._—Besides the sadistic acts with females described, others occur with other living, sensitive objects,—children and animals. There may be a full consciousness that the impulse is really directed toward women, and that only _faute de mieux_ the next attainable objects (pupils) are abused. But the condition of the perpetrator may be such that the impulse to cruel acts enters consciousness accompanied only by lustful excitement, while its real object (which alone can explain the lustful coloring of such acts) remains in the dark. The first alternative suffices as an explanation of the cases which Dr. Albert describes (Friedreich’s _Blätter f. ger. Med._, p. 77, 1859),—cases in which lustful teachers whipped their pupils on the naked nates without cause. We must think of the second alternative, the sadistic impulse with unconsciousness of its object, when boys are immediately excited sexually at the sight of punishment of their companions, and are thus determined in their later vita sexualis, as in the following cases:— Case 37. K., aged 37, merchant, applied to me in the fall of 1889 for advice concerning an anomaly of his vita sexualis, which made him fear invalidism and impossibility of future happiness in marriage. Patient came of a nervous family. As a child he was delicate, weak, and nervous. Healthy except for measles; he later became strong. At the age of eight, while at school, he saw how the teacher punished the boys taking their heads between his thighs and spanking them with a ferule. This sight caused the patient lustful excitement. “Without any idea of the danger and enormity of onanism,” he satisfied himself with it, and from that time often masturbated, during which he always called up the memory-picture of a boy being punished. Thus it continued until his twentieth year. Then he learned the significance of onanism, was terribly frightened, and tried to overcome his impulse to masturbate; but he fell into the practice of psychical onanism, which he regarded as innocuous and morally defensible, and for which he made use of the memory-pictures of boys being whipped, previously mentioned. Patient now became neurasthenic, suffered with pollutions, and tried to cure himself by visiting brothels; but he could not induce erection. Then he sought to obtain normal sexual feelings by means of social intercourse with ladies; but he recognized that he was entirely insensible to the charms of the fair sex. The patient is an intelligent man, normally developed, and of æsthetic taste. There is no inclination to persons of his own sex. My advice consisted of means to combat the neurasthenia and pollutions; interdiction of psychical and manual onanism; avoidance of all sexual excitants; and, possibly, hypnotic treatment to ultimately induce a return of the vita sexualis to its normal condition. Case 38. Abortive sadism. N., student, came under observation in December, 1890. He had practiced masturbation from early youth. According to his statements, he became sexually excited when he saw his father whip the children, and, later, when he saw the teacher whip his companions. When a spectator of such scenes, he always experienced lustful feelings. He could not say exactly when this first occurred, but it may have been at about the age of six. He could not tell exactly when he began to masturbate, but he stated with certainty that his sexual instinct was first awakened by the punishment of others, and thus he unconsciously came to practice onanism. The patient remembered clearly that from the age of four to the age of eight he was frequently spanked, and that this caused him pain, never lustful pleasure. Since he did not always have opportunity to see others whipped, he began to _imagine_ how others were punished. This excited his lust, and he would then masturbate. Whenever he could, he managed to see others punished at school. Now and then he also felt desire to whip others. At the age of twelve he induced a comrade to allow him to whip him. He found great sexual pleasure in it. When, however, his companion beat him in return, he experienced nothing but pain. The impulse to beat others was never very strong. The patient experienced more satisfaction in filling his imagination with scenes of whipping. He never indulged in any other sadistic acts, and never had any desire to see blood, etc. Until his fifteenth year his sexual indulgence consisted of onanism, indulged in after such fancies. After that (dancing lessons, association with girls), the early fancies disappeared almost entirely, and were accompanied by but weak lustful feelings; so that the patient gave them up entirely. In their place came thoughts of coitus in a natural way, without anything sadistic. The patient indulged in coitus for the first time “on account of his health.” He then tried to abstain from onanism, but was not successful, though he often indulged in coitus, and with more pleasure than he had in onanism. He wished to be freed from onanism as something vicious. He had coitus once a month, but masturbated once or twice every night. He was normal sexually, with the exception of the onanism. There was no neurasthenia; genitals normal. Case 39. P., aged 15, of high social position, came of an hysterical mother, whose brother and father died in an asylum. Two children of the family died, in early childhood, of convulsions. The patient is talented, virtuous, and quiet; but at times he is very disobedient, stubborn, and passionate. He has epilepsy, and practices onanism. One day it was learned that P., with money, induced a comrade of fourteen, B., to allow himself to be pinched on the arm, back, and thigh. When B. cried, P. became excited and struck at B. with his right hand, while with his left he made manipulations in the left pocket of his trousers. P. confessed that to maltreat his friend, of whom he was very fond, gave him peculiar delight; and that ejaculation while hurting his friend gave him much more pleasure than when he masturbated alone, (_v._ Gyurkovechky, “Pathol. und Therapie der männl. Impotenz.,” p. 80, 1889.) That in all these cases of sadistic abuse of boys there can be no thought of a combination of sadism and contrary sexual instinct, as often occurs (_v. infra_) in individuals of contrary sexuality, is shown—aside from the absence of all positive signs of it—by a study of the next group, where, in association with the object of injury,—animals,—the instinct for women is seen to appear repeatedly. (g) _Sadistic Acts with Animals._—In numerous cases, sadistically perverse men that are afraid of criminal acts with human beings, or that care only for the sight of the suffering of a sensitive being, make use of the sight of dying animals, or torture animals, to stimulate or excite their lust. The case of a man in Vienna, which is reported by Hofmann in his “Text-Book of Legal Medicine,” is noteworthy in relation to this. According to the evidence of several prostitutes, before the sexual act he was accustomed to excite himself by torturing chickens and pigeons and other birds, and, therefore, was called “Hendlmann” (chicken). For the elucidation of such cases the observation of Lombroso is of value, according to whom two men had ejaculation when they killed chickens or pigeons, or wrung their necks. The same author, in his “Uomo delinquente,” p. 201, speaks of a poet of some reputation, who became powerfully excited sexually whenever he saw calves slaughtered, and also at the sight of bloody flesh. According to Mantegazza (_op. cit._, p. 114), among degenerate Chinamen, a horrible sport consists of committing sodomy with geese, and cutting their necks off _tempoire ejaculationis_! Mantegazza (“Fisiologia del piacere,” 5th ed., pp. 394, 395) mentions the case of a man who once saw chickens killed, and from that time had a desire to wallow in their warm, steaming entrails, because he experienced a feeling of lust while doing it. Thus, in these and similar cases, the vita sexualis is so constituted _ab origine_ that the sight of blood, death, etc., excites lustful feeling. It is so in the following case:— Case 40. C. L., aged 42, engineer, married, father of two children; from a neuropathic family; father irascible, a drinker; mother hysterical, subject to eclamptic attacks. The patient remembers that in childhood he took particular pleasure in witnessing the slaughtering of domestic animals, especially swine. He thus experienced lustful pleasure and ejaculation. Later he visited slaughter-houses, in order to delight in the sight of flowing blood and the death throes of the animals. When he could find opportunity, he killed the animals himself, which always afforded him a vicarious feeling of sexual pleasure. At the time of full maturity he first attained to a knowledge of his abnormality. The patient was not exactly opposed in inclination to women, but close contact with them seemed to him repugnant. On the advice of a physician, at twenty-five he married a woman who pleased him, in the hope of freeing himself of his abnormal condition. Although he was very partial to his wife, it was only seldom, and after great trouble and exertion of his imagination, that he could perform coitus with her; nevertheless, he begat two children. In 1866 he was in the war in Bohemia. His letters written at that time to his wife, were composed in an exalted, enthusiastic tone. He was killed in the battle of Königgrätz. If, in this case, the capability of normal coitus was much impaired by the predominance of perverse ideas, in the next it seems to have been entirely repressed:— Case 41. (Dr. Pascal, “Igiene dell’ amore.”) A gentleman visited prostitutes, had them purchase a living fowl or rabbit, and required them to torture the animal. He had in mind the head and tearing out the eyes and entrails. If he found a girl who would consent, and go about it right cruelly, he was delighted, and paid her and went his way without asking anything more or touching her. The last two sections show that the suffering of any living being may become a source of perverse sexual enjoyment to sadistically constituted persons, and that there may be sadism with almost any [living] object. However, it would be erroneous and an exaggeration to try to explain by sadistic perversion all the remarkable and surprising acts of cruelty that occur; and, in the innumerable cruelties, as they here and there occur in history or in certain psychological manifestations among the people at the present time, it would be erroneous to assume sadism as a motive. Cruelty arises from various sources, and is natural to primitive man. Compassion, in contrast with it, is a secondary manifestation, and acquired late. The instinct to fight and destroy, so important an endowment in prehistoric conditions, is long afterward operative; and, in the ideas engendered by civilization, like that of “the criminal,” it finds new objects, even though its original object—“the enemy”—still exists. That not simply the death, but also torture, of the conquered is demanded, is in part explained by the sense of power, which satisfies itself in this way; and in part by the insatiableness of the impulse of vengeance. Thus all cruelty and all historical enormities may be explained without recourse to sadism (which may often have been in operation, but which cannot be assumed, since it is relatively an infrequent perversion). At the same time, there is still another powerful psychical element to take into consideration, which explains the attraction that is still exerted by executions, etc.; and that is, the pleasure there is in intense and unusual impressions and rare sights, in contrast with which, in coarse and blunted beings, pity is silent. But undoubtedly there are individuals for whom, in spite of, or even by reason of, their lively compassion, all that is connected with death and suffering has a mysterious attraction; who, with inward opposition, and yet following a dark impulse, occupy themselves with such things, or at least with pictures and notices of them. Still, this is not sadism, as long as no sexual element enters into consciousness; and yet it is possible that, in unconscious life, slender threads connect such manifestations with the hidden depths of sadism. (h) _Sadism in Woman._—That sadism—a perversion, as we have seen, frequent in men—is much less frequent in women, is easily explained. In the first place, sadism, in which the need of subjugation of the opposite sex forms a constituent element, in accordance with its nature, represents a pathological intensification of the masculine sexual character; in the second place, the obstacles which oppose the expression of this monstrous impulse are, of course, much greater for a woman than for a man. Yet sadism occurs in women; and it can only be explained by the primary constituent element,—the general hyper-excitation of the motor sphere. Only two cases have thus far been scientifically studied. Case 42. A married man presented himself with numerous scars of cuts on his arms. He told their origin as follows: When he wished to approach his wife, who was young and somewhat “nervous,” he first had to make a cut in his arm. Then she would suck the wound, and during the act become violently excited sexually. This case recalls the wide-spread legend of the vampires, the origin of which may perhaps be referred to such sadistic facts.[58] In a second case of feminine sadism, for which I am indebted to Dr. Moll, of Berlin, by the side of the perverse impulse, as so frequently occurs, there is anæsthesia for the normal activities of the sexual life; and here there are also traces of masochism (_v. infra_). Case 43. Mrs. H., of H., aged 26, comes of a nervous family, in which nervous or mental diseases are said not to have occurred; but the patient herself presents signs of hysteria and neurasthenia. Although eight years married, and the mother of a child, Mrs. H. never had desire to perform coitus. Very strictly educated as a young girl, until her marriage she remained almost innocent of any knowledge of sexual matters. She has menstruated regularly since her fifteenth year. There does not seem to be any essential abnormality of the genitals. To the patient coitus is not only not a pleasure, but even an unpleasant act; and repugnance to it has constantly increased. The patient cannot understand how any one can call such an act the greatest delight of love, which, to her, is something far higher and unconnected with such a sensual impulse. At the same time, it should be mentioned that the patient really loves her husband. In kissing him, too, she experiences a decided pleasure, which she cannot exactly describe. But she cannot conceive how the genitals can have anything to do with love. In other respects Mrs. H. is a decidedly intelligent woman, of feminine character. Si oscula dat conjugi, magnum voluptatem percipit in mordendo eum. Gratissimum ei esset conjugem mordere eo modo ut sanguis fluat. Contenta esset, si loco coitus morderetur a conjuge ipsæque eum mordere liceret. Tamen eam pœniteret, si morsu magnum dolorem faceret. (Dr. Moll.) In other cases of sadism which history and literature afford, we are compelled to think of a reversal of the feminine sexual character,—a partial viraginity,—in order to explain the sadistic acts. In history there are examples of famous women who, to some extent, had sadistic instincts. These Messalinas are particularly characterized by their thirst for power, lust, and cruelty. Among them are Valeria Messalina herself, and Catherine de Medici, the instigator of the Massacre of St. Bartholomew, whose greatest pleasure was found in having the ladies of her court whipped before her eyes, etc. The gifted Henry von Kleist, who was undoubtedly mentally abnormal, gives a masterly portrayal of complete feminine sadism in his “Penthesilea.” In scene xxii, Kleist describes his heroine with Achilles, whom she had been pursuing in the fire of love, betrayed into her hands, as, overcome with lustful, murderous fury, she tears him in pieces and sets her dogs on him: “She strikes, tearing the armor from his body; they set their teeth in his white breast,—she and her dogs, the rivals, Oxus and Sphynx,—they on the right side, she on the left; and as I approached blood dripped from her hands and mouth.” And later, when Penthesilea becomes satiated: “Did I kiss him to death? No. Did I not kiss him? Torn in pieces? Then it was a mistake; kissing rhymes with biting, and one who loves with the whole heart might easily mistake the one for the other.”[59]