introduction of catheter, etc.).

The experiment of Goltz, according to whom, when (in dogs) the lumbar portion of the cord is severed, erection is more easily induced, shows that the erection-centre is also subject to inhibitory influences from the brain. In men the fact that the will and emotions (fear of unsuccessful coitus, surprise inter actum sexualem, etc.) may inhibit the occurrence of erection, and cause it, when present, to disappear, also indicates this. The duration of erection is dependent upon the duration of its exciting causes (sensory stimuli), the absence of inhibitory influences, the nervous energy of the centre, and the early or late occurrence of ejaculation (_v. infra_). The central and highest portion of the sexual mechanism is the cerebral cortex. It is justifiable to presume that there is a definite region of the cortex (cerebral centre) which gives rise to sexual feelings, ideas, and impulses, and is the place of origin of the psycho-somatic processes which we designate as sexual life, sexual instinct, and sexual desire. This centre is excitable to both central and peripheral stimuli. Central stimuli, in the form of organic excitation, may be due to diseases of the cerebral cortex. Physiologically they consist of psychical stimuli (memory and sensory perceptions). Under physiological conditions these stimuli are essentially visual perceptions and memory-pictures (_i.e._, lascivious stories) and also tactile impressions (touch, pressure of the hand, kiss, etc.). Within physiological limits auditory and olfactory perceptions certainly play but a very subordinate _rôle_. Under pathological conditions (_v. infra_) the latter have a very decided influence in inducing sexual excitement. Among animals the influence of olfactory perceptions on the sexual sense is unmistakable. Althaus (“Beiträge zur Physiol. und Pathol. des Olfactorius.” _Archiv für Psych._, xii, H 1) declares that the sense of smell is important with reference to the reproduction of the species. He shows that animals of opposite sexes are drawn to each other by means of olfactory perceptions, and that almost all animals, at the time of rutting, emit a very strong odor from their genitals. An experiment by Schiff is confirmatory of this. He extirpated the olfactory nerves in puppies, and found that, as the animals grew, the male was unable to distinguish the female. On the other hand, an experiment by Mantegazza (“Hygiene of Love”), who removed the eyes of rabbits and found that the defect constituted no obstacle to procreation, shows how important in animals the olfactory sense is for the vita sexualis. It is also remarkable that many animals (musk-ox, civet-cat, beaver) possess glands on their sexual organs, which secrete materials having a very strong odor. Althaus also shows that in man there are certain relations existing between the olfactory and sexual senses. He mentions Cloquet (“Osphrésiologie,” Paris, 1826), who calls attention to the sensual pleasure excited by the odors of flowers, and tells how Richelieu lived in an atmosphere loaded with the heaviest perfumes, in order to excite his sexual functions. Zippe (_Wien. Med. Wochenschrift_, 1879, Nr. 24), in connection with a case of kleptomania in an onanist, likewise establishes such relations, and cites Hildebrand as authority, who in his popular physiology says: “It cannot be doubted that the olfactory sense stands in remote connection with the sexual apparatus. Odors of flowers often occasion pleasurable sensual feelings, and when one remembers the passage in the ‘Song of Solomon,’ ‘And my hands dropped with myrrh and my fingers with sweet-smelling myrrh upon the handles of the lock,’ one finds that it did not escape Solomon’s observation. In the Orient the pleasant perfumes are esteemed for their relation to the sexual organs, and the women’s apartments of the Sultan are filled with the perfumes of flowers.” Most, professor in Rostock (comp. Zippe), relates: “I learned from a sensual young peasant that he had excited many a chaste girl sexually, and easily gained his end, by carrying his handkerchief in his axilla for a time, while dancing, and then wiping his partner’s perspiring face with it.” The case of Henry III shows that contact with a person’s perspiration may be the exciting cause of passionate love. At the betrothal feast of the King of Navarre and Margaret of Valois, he accidentally dried his face with a garment of Maria of Cleves, which was moist with her perspiration. Although she was the bride of the Prince of Condé, Henry conceived immediately such a passionate love for her that he could not resist it, and made her, as history shows, very unhappy. An analogous instance is related of Henry IV, whose passion for the beautiful Gabriel is said to have originated at the instant when, at a ball, he wiped his brow with her handkerchief. Professor Jäger, the “discoverer of the soul,” refers to the same thing in his well-known book (2d ed., 1880, chap. xv, p. 173); for he regards the sweat as important in the production of sexual effects and as being especially seductive. One learns from reading the work of Ploss (“Das Weib”) that attempts to attract a person of the opposite sex by means of the perspiration may be discerned in many forms in popular psychology. In reference to this, a custom which holds among the natives of the Philippine Islands when they become engaged, as reported by Jäger, is remarkable. When it becomes necessary for the engaged pair to separate, they exchange articles of wearing-apparel, by means of which each becomes assured of faithfulness. These objects are carefully preserved, covered with kisses, and smelled. The love of certain libertines and sensual women for perfumes[23] indicates a relation between the olfactory and sexual senses. A case mentioned by Heschl (_Wiener Zeitschrift f. pract. Heilkunde_, March 22, 1861) is remarkable, where the absence of both olfactory lobes was accompanied by imperfectly developed genitals. It was the case of a man aged 45, in all respects well developed, with the exception of the testicles, which were not larger than beans and contained no seminal canals, and the larynx, which seemed to be of feminine dimensions. Every trace of olfactory nerves was wanting, and the trigona olfactoria and the furrow on the under surface of the anterior lobes were absent. The perforations of the ethmoid plate were sparingly present, and occupied by nerveless processes of the dura instead of by nerves. In the mucous membrane of the nose there was also an absence of nerves. Finally, the clearly-defined relation of the olfactory and sexual senses in mental diseases is worthy of notice, in that in the psychoses of both sexes dependent on masturbation, as well as in insanity due to disease of the sexual organs of the female, or during the climacteric[24], olfactory hallucinations are especially frequent, while in cases where a sexual cause is wanting they are very infrequent. I am inclined to doubt[25] that olfactory impressions in man, under normal conditions, as in animals, play an important _rôle_ in the excitation of the sexual centre. On account of the importance of this _consensus_ for the understanding of pathological cases, it is necessary here to thoroughly consider the relations existing between the olfactory and sexual senses. The sexual sphere of the cerebral cortex may be excited, in the sense of an excitation of sexual concepts and impulses, by processes in the generative organs. This is possible as a result of all conditions which also excite the erection-centre by means of centripetal influence (stimulus resulting from distension of the seminal vesicles; enlarged Graafian follicle; any sensory stimulus, however produced, about the genitals; hyperæmia and turgescence of the genitals, especially of the erectile tissue of the corpus cavernosum of the penis and clitoris, as a result of luxurious, sedentary life; plethora abdominalis, high external temperature, warm beds, clothing; taking of cantharides, pepper, and other spices). Libido sexualis may also be induced by stimulation of the gluteal region (castigation, whipping).[26] This fact is not unimportant for the understanding of certain pathological manifestations. It sometimes happens that in boys the first excitation of the sexual instinct is caused by a spanking, and they are thus incited to masturbation. This should be remembered by those who have the care of children. On account of the dangers to which this form of punishment of children gives rise, it would be better if parents, teachers, and nurses were to avoid it entirely. Passive flagellation may excite sensuality, as is shown by the sects of flagellants, so wide-spread in the thirteenth and fifteenth centuries. They were accustomed to whip themselves, partly as atonement and partly to kill the flesh (in accordance with the principle of chastity promulgated by the Church,—_i.e._, the emancipation of the soul from sensuality). These sects were at first favored by the Church; but, since sensuality was only excited the more by flagellation, and the fact became apparent in unpleasant occurrences, the Church was finally compelled to oppose it. The following facts from the lives of the two heroines of flagellation, Maria Magdalena of Pazzi and Elizabeth of Genton, clearly show the significance of flagellation as a sexual excitant. The former, a child of distinguished parents, was a Carmelite nun in Florence (about 1580), and, by her flagellations, and, still more, through the results of them, she became quite celebrated, and is mentioned in the Annals. It was her greatest delight to have the prioress bind her hands behind her and have her whipped on the naked loins in the presence of the assembled sisters. But the whippings, continued from her earliest youth, quite destroyed her nervous system, and perhaps no other heroine of flagellation had so many hallucinations (“Entzückungen”). While being whipped her thoughts were of love. The inner fire threatened to consume her, and she frequently cried, “Enough! Fan no longer the flame that consumes me. This is not the death I long for; it comes with all too much pleasure and delight.” Thus it continued. But the spirit of impurity wove the most sensual, lascivious fancies, and she was several times near losing her chastity. It was the same with Elizabeth of Genton. As a result of whipping she actually passed into a state of bacchanalian madness. As a rule, she rested when, excited by unusual flagellation, she believed herself united with her “ideal.” This condition was so exquisitely pleasant to her that she would frequently cry out, “O love, O eternal love, O love, O you creatures! cry out with me, love, love!” It is known, on the authority of Taxil (_op. cit._, p. 175), that rakes sometimes have themselves flagellated, or pricked until blood flows, just before the sexual act, in order to stimulate their diminished sexual power. These facts find an interesting confirmation in the following experiences, taken from Paullini’s “Flagellum Salutis” (1st ed., 1698; reproduction, Stuttgart, 1847):— “There are some nations, viz., the Persians and Russians, where the women regard blows as a peculiar sign of love and favor. Strangely enough, the Russian women are never more pleased and delighted than when they receive hard blows from their husbands, as John Barclay relates in a remarkable narrative. A German, named Jordan, went to Russia, and, pleased with the country, he settled there and took a Russian wife, whom he loved dearly and to whom he was always kind in everything. But she always wore an expression of dissatisfaction, and went about with sighs and downcast eyes. The husband asked the reason, for he could not understand what was wrong. ‘Aye,’ she said, ‘though you love me you do not show me any sign of it.’ He embraced her and begged to be told what he had carelessly and unconsciously done to hurt her feelings, and to be forgiven, for he would never do it again. ‘I want nothing,’ was the answer, ‘but what is customary in our country,—the whip, the real sign of love.’ Jordan observed the custom and accustomed himself to it, and then his wife began to love him dearly. Similar stories are told by Peter Petrius, of Erlesund, with the addition that the husbands, immediately after the wedding, among other indispensable household articles, provide themselves with whips.” On page 73 of this remarkable book, the author says further: “The celebrated Count of Mirindula, John Picus, relates of one of his intimate acquaintances that he was an insatiable fellow, but so lazy and incapable of love that he was practically impotent until he had been roughly handled. The more he tried to satisfy his desire, the heavier the blows he needed, and he could not attain his desire until he had been whipped until the blood came. For this purpose he had a suitable whip made, which was placed in vinegar the day before using it. He would give this to his companion and on bended knees beg her not to spare him, but to strike blows with it, the heavier the better. The good count thought this singular man found the pleasure of love in this punishment. While in other respects he was not a bad man, he understood and hated his weakness. Coelius Rhodigin relates a similar story, as does also the celebrated jurist, Andreas Tiraquell. In the time of the skillful physician, Otten Brunfelsen, there lived in Munich, then the Capital of the Bavarian Electorate, a debauchee who could never perform his [sexual] duties without a severe preparatory beating. Thomas Barthelin also knew a Venetian who had to be beaten and driven before he could have intercourse,—just as Cupid himself moved reluctantly driven by his followers with sprays of hyacinth. A few years ago there was in Lübeck a cheesemonger, living on Mill Street, who, on a complaint to the authorities of unfaithfulness, was ordered to leave the city. The prostitute with whom he had been went to the judges and begged in his behalf, telling how difficult all intercourse had become for him. He could do nothing until he had been mercilessly beaten. At first the fellow, from shame and to avoid disgrace, would not confess, but after earnest questioning he could not deny it. There is said to have been a man in the Netherlands who was similarly incapable, and could do nothing without blows. On the decree of the authorities, however, he was not only removed from his position, but also properly punished. A credible friend, a physician in an important city of the kingdom, told me, on July 14th, last year, how a woman of bad character had told a companion, who had been in the hospital a short time before, that she, with another woman of like character, had been sent to the woods by a man who followed them there, cut rods for them, and then exposed his nates, commanding them to belabor him well. This they did. It is easy to conclude what he then did with them. Not only men have been excited and inflamed to lasciviousness, but also women, that they too might experience greater intensity of pleasure. For this reason the Roman woman had herself whipped and beaten by the _lupercis_. Thus Juvenal writes:— “‘Steriles moriuntur, et illis Turgida non prodest condita psycido Lyde: Nec prodest agili palmas præbere Luperco.’” In men, as well as in women, erection and orgasm, or even ejaculation, may be induced by irritation of various other regions of the skin and mucous membrane. These “erogenous” zones in woman are, while she is a virgin, the clitoris, and, after defloration, the vagina and cervix uteri. In woman the nipple particularly seems to possess this quality. Titillatio hujus regionis plays an important part in the _ars erotica_. In his “Topographical Anatomy,” 1865, Bd. i, p. 552, Hyrtl cites Val. Hildebrandt, who observed a peculiar anomaly of the sexual instinct in a girl, which he called _suctusstupratio_. She had her mammæ sucked by her lover, and finally, by gradually drawing on her nipples, she became able to suck them herself,—an act that gave her most intense pleasure. Hyrtl also calls attention to the fact that cows sometimes suck the milk from their own udders. L. Brunn (_Zeitg. f. Literatur_, etc., d. Hamburg. Correspondent, 1889, Nr. 21), in an interesting article on “Sensuality and Love of Kin,” points out how zealously the nursing mother gives herself to nursing the babe, “for love of the weak, undeveloped, helpless being.” It is easy to assume that, by the side of the ethical motives, the fact that the sucking may be attended by feelings of physical pleasure plays a part. The remark of Brunn, which is correct in itself, but one-sided, that, according to Houzeau’s experience, among the majority of animals it is only during the time of nursing that the relations between mother and offspring are close, and thereafter indifferent, also speaks in favor of this assumption. Bastian found the same thing (blunting of the feeling for the offspring after weaning) among savages. Under pathological conditions, as is shown by Chambard, among others, in his thesis for the doctorate, other portions of the body (in hysterical persons) about the mammæ and genitals may attain the significance of “erogenous” zones. In man, physiologically, the only “erogenous” zone is the glans penis, and, perhaps, the skin of the external genitals. Under pathological conditions the anus may become an “erogenous” area. Thus anal auto-masturbation, which seems to be only too frequent, and passive pederasty would be explained. (Comp. Gamier, “Anomalies sexuelles,” Paris, p. 514; F. Moll, “Conträre Sexualempfindung,” p. 163.) The psycho-physiological process comprehended in the idea of sexual instinct is composed of (1) concepts awakened centrally or peripherally; (2) the pleasurable feelings associated with them. The longing for sexual satisfaction (libido sexualis) arises from them. This desire grows stronger constantly, in proportion as the excitation of the cerebral sphere accentuates the feeling of pleasure by appropriate concepts and activity of the imagination; and the pleasurable sensations are increased to lustful feeling by excitation of the erection centre and the consequent hyperæmia of the genitals (entrance of liquor prostaticus into the urethra, etc.). If circumstances are favorable for the performance of the sexual act satisfactorily, the constantly-increasing desire is complied with; if, however, conditions are unfavorable, inhibitory concepts occur, overcome the sexual longing, and prevent the sexual act. To civilized man cultivation of a readiness with ideas which inhibit sexual desire is necessary and distinctive. The moral freedom of the individual, and the decision whether, under certain circumstances, excess, and even crime, be committed or not, depend, on the one hand, upon the strength of the instinctive concepts and the accompanying organic sensations; on the other, upon the power of the inhibitory concepts. Constitution and, especially, organic influences have a marked effect upon the instinctive impulses; education and cultivation of self-control have a decisive influence on the opposing concepts. The exciting and inhibitory powers are variable quantities. Over-indulgence in alcohol in this respect is very fatal, since it awakens and increases libido sexualis, while at the same time it reduces moral resistance. THE ACT OF COHABITATION.[27] The essential condition for the man is sufficient erection. Anjel (_Arch. für Psych._, viii, H. 2) calls attention to the fact that in sexual excitement the erection centre is not alone influenced,—the nervous excitement is distributed to the entire vasomotor system of nerves. The proof of this is the turgescence of the organs in the sexual act, injection of the conjunctiva, prominence of the eyes, dilatation of the pupils, and cardiac palpitation (resulting from paralysis of the vasomotor nerves of the heart, which arise from the cervical sympathetic, and the consequent dilatation of the cardiac arteries, and the increased stimulation of the cardiac ganglia induced by the consequent hyperæmia of the cardiac walls). The sexual act is accompanied by a pleasurable feeling, which, in the male, is conditioned by the passage of semen through the _ductus ejaculatorii_ to the urethra, caused by sensory stimulation of the genitals. The pleasurable sensation occurs earlier in the male than in the female, grows rapidly in intensity until the moment of commencement of ejaculation, reaching its height in the instant of free emission, and disappears quickly _post ejaculationem_. In the female the pleasurable feeling occurs later and comes on more slowly, and generally outlasts the act of ejaculation. The distinctive event in coitus is ejaculation. This function is dependent on a centre (genito-spinal), which Budge has shown to be situated at the level of the fourth lumbar vertebra. It is a reflex centre. The stimulus that excites it is the ejection of sperma from the vesiculæ seminales into the pars membranacea urethræ, which follows reflexly from stimulation of the glans penis. As soon as the collection of semen, with ever-increasing pleasurable sensation, has reached a sufficient amount to be effectual as a stimulus of the ejaculation-centre, the centre acts. The reflex motor path lies in the fourth and fifth lumbar nerves. The action consists of a convulsive excitation of the bulbo-cavernosus muscle (innervated by the third and fourth sacral nerves), which forces the semen out. In the female as well, at the height of sexual and pleasurable excitement, a reflex movement occurs. It is induced by stimulation of the sensory genital nerves, and consists of a peristaltic movement in the tubes and uterus as far down as the portio vaginalis, which presses out the mucous secretions of the tubes and uterus. Inhibition of the ejaculation centre is possible as a result of cortical influence (want of desire in coitus, emotions in general; influence of the will, in a measure). Under normal conditions, with the completion of the sexual act, libido sexualis and erection disappear, and the psychical and sexual excitement gives place to a comfortable feeling of lassitude. III. GENERAL PATHOLOGY.[28] (NEUROLOGICAL AND PSYCHOLOGICAL.) Abnormality of the sexual functions proves to be especially frequent in civilized races. This fact is explained in part by the frequent abuse of the sexual organs, and in part by the circumstance that such functional anomalies are often the signs of an abnormal constitution of the central nervous system, which is, for the most part, hereditary (“functional signs of degeneration”). Since the generative organs stand in important functional connection with the entire nervous system, and especially with its psychical and somatic functions, it is easy to understand the frequency of general neuroses and psychoses arising in sexual (functional or organic) disturbances. SCHEMA OF THE SEXUAL NEUROSES. } }_a._ Anæsthesia. }1. Sensory. }_b._ Hyperæsthesia. } }_c._ Neuralgia. I. PERIPHERAL.[29] }2. Secretory. }_a._ Aspermia. } }_b._ Polyspermia. }3. Motor. }_a._ Pollutions } } (spasm). } }_b._ Spermatorrhœa } } (paralysis). II. SPINAL. }1. Affections of the erection centre. }2. Affections of the ejaculation centre. }1. Paradoxia. }2. Anæsthesia. III. CEREBRAL. }3. Hyperæsthesia. }4. Paræsthesia. II. SPINAL NEUROSES. _1. Affections of the Erection Centre._ (a) _Irritation_ (priapism) arises reflexly from peripheral sensory irritants (_e.g._, gonorrhœa); directly, from organic irritation of the nerve-tracts from the brain to the erection centre (spinal disease in the lower cervical and upper dorsal regions), or of the centre itself (certain poisons); or from psychical irritation. In the latter case satyriasis exists, _i.e._, abnormal duration of erection, with libido sexualis. In simply reflex or direct organic irritation, libido sexualis may be wanting, and the priapism be accompanied by unpleasant feelings. (b) _Paralysis_ from destruction of the centre or of the nerve-tracts (nervi erigentes), in diseases of the spinal cord (paralytic impotence). A milder form is that of lessened excitability of the centre, resulting from overstimulation (in sexual excesses, especially in onanism), or from alcoholic intoxication, abuse of bromides, etc. It may be accompanied by cerebral anæsthesia, and often with anæsthesia of the external genitals. Cerebral hyperæsthesia is here more frequent (increased libido sexualis, lust). A peculiar form of diminished excitability is shown in those cases where the centre responds only to certain stimuli. Thus there are men for whom sexual contact with their virtuous wives does not supply the necessary stimulus for the excitation of an erection, but in whom it occurs when the act is attempted with a prostitute, or in the form of some unnatural sexual act. As far as psychical stimuli are here concerned, they may be inadequate (_v. infra_, paræsthesia and perversion of sexual instinct). (c) _Inhibition._ The erection centre may become functionally incapable as a result of cerebral influence. This inhibitory influence is an emotion (disgust, fear of contagion), or an idea[30] of impotence. There are many men in the first condition who have an unconquerable loathing for their wives, or fear of infection, or are suffering with perverse sexual feelings. In the latter condition are neuropathic individuals (neurasthenics, hypochondriacs), frequently weakened sexually (masturbators), who have reason, or think they have, to mistrust their sexual power. This idea acts as an inhibitory concept, and makes the act with the person concerned of the opposite sex temporarily or absolutely impossible. (d) _Irritable weakness._ In this condition there is abnormal impressionability of the centre, but accompanied by rapid diminution of its energy. There may be functional disturbance of the centre itself, or weakness of the innervation through the nervi erigentes; or there may be weakness of the ischio-cavernosus muscle. Cases in which the erection is ineffectual, on account of abnormally early ejaculation, form a transition to the following anomalies:— _2. Affections of the Ejaculation Centre._ (a) _Abnormally easy ejaculation_ from absence of cerebral inhibition, resulting from excessive psychical excitement or irritable weakness of the centre. In this case, under certain circumstances, the simple conception of a lascivious situation is sufficient to set the centre in action (high degree of spinal neurasthenia, usually resulting from sexual abuse). A third possibility is hyperæsthesia of the urethra, by virtue of which, when the semen enters it, an immediate and excessive reflex action of the ejaculation centre is induced. In such a case, simple proximity to the female genitals may be sufficient to induce ejaculation (_ante portam_). In case of hyperæsthesia of the urethra as a cause, the ejaculation may be accompanied by painful, instead of pleasurable, sensations. Usually, in cases where there is hyperæsthesia of the urethra, there is, at the same time, irritable weakness of the centre. Both functional disturbances are important in the production of pollutio nimia and diurna. The accompanying pleasurable feeling may be pathologically absent. This occurs in defective men and women (anæsthesia, aspermia?), and, further, as a result of disease (neurasthenia, hysteria); or (in prostitutes) it follows overstimulation and the blunting thus induced. The intensity of the pleasurable feeling depends on the degree of psychical and motor excitement accompanying the sexual act. Under pathological conditions this may become so pronounced that the movements of coitus take on the character of involuntary convulsive movements, and even pass into general convulsions. (b) _Abnormally difficult ejaculation._ It is occasioned by inexcitability of the centre (absence of libido, paralysis of the centre: organic, from disease of brain or spinal cord; functional, from sexual abuses, marasmus, diabetes, morphinism), and, in this case, for the most part, in connection with anæsthesia of the genitals and paralysis of the erection centre. Or it is the result of a lesion of the reflex arc, or of peripheral anæsthesia (urethra), or of aspermia. The ejaculation occurs not at all, or tardily, in the course of the sexual act, or only afterward, in the form of a pollution. III. CEREBRAL NEUROSES.