Читать книгу Psychopathia sexualis: With especial reference to contrary sexual instinct - R. von Krafft-Ebing - Страница 14

Only those cases can be regarded as unquestionable examples of absence of sexual instinct dependent on cerebral causes, in which, in spite of generative organs normally developed and the performance of their functions (secretion of semen, menstruation), the corresponding emotions of sexual life are absolutely wanting. These functionally sexless individuals are seldom seen, and are, indeed, always persons having degenerative defects, and in whom other functional cerebral disturbances, states of psychical degeneration, and even anatomical signs of degeneration, are observed. Legrand du Saulle describes a classical case that falls under this head (Annales médico-psychol., May, 1876).

Case 3. D., aged 33, had a mother who suffered with insanity of persecution. The mother’s father also suffered with persecutory insanity, and committed suicide. Her mother was insane, and this woman’s mother became insane in the puerperal state. Three of her mother’s children died in babyhood, and those that lived longer had an abnormal character. As early as his thirteenth year, D. was troubled with the thought of becoming insane. At fourteen he attempted suicide. Later, vagabondage, and, as a soldier, repeated insubordination and crazy pranks. His intelligence was very limited; no sign of degeneration, genitals normal. At seventeen or eighteen he had emissions of semen, had never masturbated or had sexual feeling, and never had sought intercourse with women.

Case 4. P., aged 36, common laborer, was received at my clinic in the beginning of November on account of spastic spinal paralysis. He declares he comes of a healthy family. A stutterer from his youth. Cranium microcephalic (cf. 53 cm.). Patient somewhat imbecile. He was never sociable, never had a sexual emotion. The sight of a woman never had anything enticing for him. He never had a desire to masturbate. Erections frequent, but only on waking in the morning with a full bladder, and without a trace of sexual feeling. Pollutions very infrequent,—about once a year, in sleep,—and usually while dreaming that he is concerned with a female. These dreams, however, as his dreams in general, are not markedly erotic. He says the act of pollution is not accompanied by any pleasurable sensation. Patient does not feel this absence of sexual sensations. He gives the assurance that his brother, aged 34, is in exactly the same sexual condition as himself, and he makes it seem probable that a sister, aged 21, is in a similar state. A younger brother, he says, is normal sexually. The examination of his genitals reveals nothing abnormal besides phimosis.

Hammond (“Sexual Impotence”), even with his wide experience, reports only the following three cases of anæsthesia sexualis:—

Case 5. Mr. W., aged 33; strong, healthy, with normal genitals. He had never experienced libido, and had vainly sought to awaken his defective sexual instinct by means of obscene stories and intercourse with prostitutes. On the occasion of such attempts he experienced only disgust, with even a feeling of nausea, and became nervously and mentally exhausted. Only once, when he forced the situation, did he have a transitory erection. W. had never masturbated, and had had pollutions about once every two months from his seventeenth year. Important interests demanded that he marry. He had no horror feminæ, and longed for a home and a wife, but felt that he was incapable of the sexual act. He died, unmarried, in the American civil war.

Case 6. X., aged 27; genitals normal; never felt libido. Mechanical or thermic stimuli easily induced erection, but instead of libido sexualis there was regularly a desire for alcoholic indulgence. Such excesses also induced erections, and he then sometimes masturbated. He had a disinclination for women and a loathing of coitus. If, with an erection, he made an attempt at coitus, it disappeared at once. Death in coma during an attack of cerebral hyperæmia.

Case 7. Mrs. O., normally developed, healthy, menstruated regularly; aged 35, fifteen years married. She never experienced libido, and never had any erotic excitement in sexual intercourse with her husband. She was not averse to coitus, and sometimes seemed to experience pleasure in it, but she never had a wish for repetition of cohabitation.

In connection with such pure cases of anæsthesia there should be considered other cases in which the mental side of the vita sexualis is a blank leaf in the life of the individual, but where elementary sexual sensations manifest themselves at least in masturbation (comp. the transitional Case 6). According to Magnan’s ingenious classification, which, however, is not strictly correct and somewhat too dogmatic, in such cases the sexual life is so limited as to be designated spinal. Possibly in some such cases there exists virtually a mental side of the vita sexualis, but it is very weak, and undermined by masturbation before it attains development. These represent the transitional cases from the congenital to the acquired (psychical) anæsthesia sexualis. This danger threatens many masturbators of vicious constitution. It is psychologically interesting that when the sexual element is early vitiated, then an ethical defect is manifested.

The two following cases, previously published by me in the Archiv für Psychiatrie, vii, are given here as illustrations worthy of consideration:—

Case 8. F. J., aged 19, student; mother was nervous, sister epileptic. At the age of four, acute brain affection, lasting two weeks. As a child he was not affectionate, and was cold toward his parents; as a student he was peculiar, retiring, preoccupied with self, and given to much reading. Well endowed mentally. Masturbation from fifteenth year. Eccentric after puberty, with continual alternation between religious enthusiasm and materialism,—now studying theology, now natural sciences. At the university his fellow-students took him for a fool. He read Jean Paul almost exclusively, and wasted his time. Absolute absence of sexual feeling toward the opposite sex. Once he indulged in intercourse, experienced no sexual feeling in the act, found coitus absurd, and did not repeat it. Without any emotional cause whatever, he often had a thought of suicide. He made it the subject of a philosophical dissertation, in which he contended that it was, like masturbation, a justifiable act. After repeated experiments, which he made on himself with various poisons, he attempted suicide with fifty-seven grains of opium; but he was saved, and sent to an asylum.

Patient is destitute of moral and social feelings. His writings disclose incredible frivolity and vulgarity. His knowledge is of a wide range, but his logic is peculiarly distorted. There is no trace of emotionality. He treats everything (even the sublime) with incomparable cynicism and irony. He pleads for the justification of suicide with false philosophical premises and conclusions, and, as one would speak of the most indifferent affair, he declares that he intends to accomplish it. He regrets that his penknife has been taken from him. If he had it he would open his veins as Seneca did,—in the bath. A short time before a friend had given him, instead of a poison as he supposed, a cathartic. Instead of having been a means to send him to the other world, it had sent him to the water-closet. Only the Great Operator could eradicate his foolish and fatal idea by removing his senses, etc.

The patient has a large, rhombic, distorted skull, the left half of the forehead being flatter than the right. The occiput is very straight. Ears far back, widely projecting, and the external meatus forms a narrow slit. Genitals very lax; testicles unusually soft and small.

Now and then the patient suffers with onomatomania. He is compelled to think of the most useless problems and give up to an interminable distressing and worrying thought; and is so fatigued after it that he is no longer capable of any rational thought. After some months the patient was sent home unimproved. There he spent his time in reading and frivolities, and busied himself with the thought of founding a new Christianity, because Christ had been subject to grand delusions and had deceived the world with wonders (!). After remaining at home some years the sudden occurrence of a maniacal outbreak brought him again to the asylum. He presented a mixture of primordial delirium of persecution (devil, anti-christ, persecution, poisoning, persecutory voices) and delusions of grandeur (Christ, redemption of the world), with impulsive, incoherent actions. After five months there was a remission of this intercurrent acute mental disease, and the patient returned to the level of his original intellectual peculiarity and moral defect.

Case 9. E., aged 30, journeyman-painter, was arrested while trying to cut off the scrotum of a boy he had caught in the woods. He gave as a motive for this act that he wished to cut into it in order that the world should not multiply. Often in his youth, with like purpose, he had cut into his own genitals.

It is impossible to learn anything of his ancestry. From his childhood he was mentally abnormal, violent, never lively, very irritable, irascible, selfish, and weak-minded. He hated women, loved solitude, and read much. He sometimes laughed to himself and did silly things. Of late years his hatred of women had increased, especially of those that were pregnant, they being responsible for the misery of the world. He also hated children, and cursed his father. He entertained communistic ideas, and berated the rich and the ministry, and God, who had allowed him to come into the world so poor. He declared that it would be better to castrate all children than to allow others to come into the world that could only be fated to endure poverty and misery. He had always had the intention, from his fifteenth year, to castrate himself, in order to have no part in increasing unhappiness and adding to the number of men. He hated the female sex because it was a means of procreation. Only twice in his life had he allowed women to practice manustupration on him, and, with the exception of this, he had never had anything to do with them. Occasionally he had sexual desire, but never for a natural satisfaction of it. When nature did not help him, he occasionally helped himself by means of masturbation.

He is a powerful, muscular man. The formation of the genitals presents no abnormality. On the scrotum and penis are numerous scars, which resulted from his attempts at self-emasculation, but which, he asserts, were not carried out on account of pain. Genu valgum of right limb. No evidence of onanism could be discovered. He is moody, defiant, irritable. Social feelings are absolutely foreign to him. With the exception of imperfect sleep and frequent headaches, there are no functional disturbances.

From cases of this kind, depending on cerebral causes, there must be distinguished others where the absence of function arises from an absence or malformation of the generative organs, as in certain hermaphrodites, idiots, and cretins. A case belonging here is found in Maschka’s hand-book.

Case 10. Complainant pleads for divorce on account of impotence of her husband, who has never had intercourse with her. She is thirty-one years old, and a virgin. The husband is somewhat weak mentally, physically strong; the genitals well developed. He declares that he has never had a complete erection or a flow of semen, and says that he is totally indifferent about intercourse with women.

Ultzmann’s^[38] observations show that anæsthesia sexualis is not caused by aspermia simply. He shows that even in congenital aspermia the vita sexualis and sexual power may be entirely satisfying; an additional proof that defective libido ab origine is to be sought for in cerebral conditions.

The naturæ frigidas of Zacchias are examples of a milder form of anæsthesia. They are met more frequently among women than among men. The characteristic signs of this anomaly are: slight inclination to sexual intercourse, or pronounced disinclination to coitus without sexual equivalent, and failure of corresponding psychical, pleasurable excitation during coitus, which is indulged in simply from sense of duty. I have often had occasion to hear complaints from husbands about this. In such cases the wives have always proved to be neuropathic ab origine. Some were at the same time hysterical.