Читать книгу Psychopathia sexualis: With especial reference to contrary sexual instinct - R. von Krafft-Ebing - Страница 4

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During the time of the physiological processes in the reproductive glands, desires arise in the consciousness of the individual which have for their purpose the perpetuation of the species (sexual instinct).

Sexual desire during the years of sexual maturity is a physiological law. The duration of the physiological processes in the sexual organs, as well as the strength of the sexual desire manifested, vary, both in individuals and in races. Race, climate, heredity, and social circumstances have a very decided influence upon it. The greater sensuality of southern races as compared with the sexual needs of those of the North is well known. Sexual development in the inhabitants of tropical climes takes place much earlier than in those of more northern regions. In women of northern countries ovulation, recognizable in the development of the body and the occurrence of a periodical flow of blood from the genitals (menstruation), usually begins about the thirteenth or fifteenth year; in men puberty, recognizable in the deepening of the voice, the appearance of hair on the face and the mons veneris, and the occasional occurrence of pollutions, etc., takes place about the fifteenth year. In the inhabitants of tropical countries, however, sexual development takes place several years earlier in women,—sometimes as early as the eighth year.

It is worthy of remark that girls who live in cities develop about a year earlier than girls living in the country, and that the larger the town the earlier, ceteris paribus, the development takes place.

Heredity, however, has no small influence on libido and sexual power. Thus there are families in which, with great physical strength and longevity, great libido and virility are preserved until a great age, while in other families the vita sexualis develops late and is early extinguished.

In women the time of the activity of the reproductive glands is shorter than in men, in whom the sexual function may last until a great age. Ovulation ceases about thirty years after puberty. This period of cessation of activity of the ovaries is called the change of life (climacterium). This biological phase does not represent merely a cessation of function and final atrophy of the reproductive organs, but also a transformation of the whole organism. In Middle Europe the sexual maturity of men begins about the eighteenth year, and their virility reaches its acme at forty. After that age it slowly declines.

The potentia generandi ceases usually at the age of sixty-two, but potentia cœundi may be present even in old age. The existence of the sexual instinct is continuous during the time of sexual life, but it varies in intensity. Under physiological conditions it is never intermittent (periodical), as in animals. In men it manifests an organic variation of intensity in consonance with the collection and expenditure of semen; in women the increase of sexual desire coincides with the process of ovulation, and in such a way that libido sexualis is greater after the menstrual period.

Sexual instinct—as emotion, idea, and impulse—is a function of the cerebral cortex. Thus far no definite region of the cortex has been proved to be exclusively the seat of sexual sensations and impulses.^[22]

Owing to the close relations which exist between the sexual instinct and the olfactory sense, it is to be presumed that the sexual and olfactory centres lie close together in the cerebral cortex. The development of the sexual life has its beginning in the organic sensations which arise from the developing reproductive glands. These excite the attention of the individual. Readings and the experiences of every-day life (which, unfortunately, to-day are too early and too frequently suggestive) convert these notions into clear ideas. These become accentuated by organic sensations which are pleasurable. With this accentuation of erotic ideas by lustful feelings, an impulse to induce these (sexual desire) is developed.

Thus there is established a mutual dependence between the cerebral cortex (as the place of origin of sensations and ideas) and the reproductive organs. The latter, by reason of physiological processes (hyperæmia, secretion of semen, ovulation), give rise to sexual ideas, images, and impulses.

The cerebral cortex, by means of apperceived or reproduced sensual ideas, reacts on the reproductive organs, inducing hyperæmia, secretion of semen, erection, ejaculation. This results by means of centres for vasomotor innervation and ejaculation, which are situated in the lumbar portion of the cord and lie close together. Both are reflex centres.

The erection-centre (Goltz, Eckhard) is an intermediate station placed between the brain and the genital apparatus. The nervous paths which connect it with the brain probably run through the pedunculi cerebri and the pons. This centre may be excited by central (psychical and organic) stimuli, by direct irritation of the nerve-tract in the pedunculis cerebri, pons, or cervical portion of the cord, as well as by peripheral irritation of the sensory nerves (penis, clitoris, and annexa). It is not directly subordinated to the will.

The excitation of this centre is conveyed to the corpora cavernosa by means of nerves (nervi erigentes—Eckhard) running in the first three sacral nerves.

The action of the nervi erigentes, which renders erection possible, is an inhibitory one. They inhibit the ganglionic nervous mechanism in the corpora cavernosa upon the action of which the smooth muscle-fibres of the corpora cavernosa are dependent (Kölliker and Kohlrausch). Under the influence of the action of the nervi erigentes these fibres of the corpora cavernosa become relaxed and their spaces fill with blood. Simultaneously, as a result of the dilatation of the capillary net-work of the corpora cavernosa, pressure is exerted upon the veins of the penis and the return of blood is impeded. This effect is aided by contraction of the bulbo cavernosus and ischio cavernosus muscles, which are inserted by means of an aponeurosis on the dorsal surface of the penis.

The erection-centre is under the influence of both exciting and inhibitory innervation arising in the cerebrum. Ideas and sense-perceptions of sexual content have an exciting effect. Also, according to observations made on men that have been hung, it is evident that the erection-centre may be excited by excitation of the tract in the spinal cord. Observations on the insane and those suffering with cerebral disease show that this is also possible as a result of organic irritation in the cerebral cortex (psycho-sexual centre?). Spinal diseases (tabes, especially myelitis) affecting the lumbar portion of the cord, in their earlier stages, may directly excite the erection-centre.

Reflex excitation of the centre is possible and frequent in the following ways: by irritation of the (peripheral) sensory nerves of the genitals and surrounding parts by friction; by irritation of the urethra (gonorrhœa), of the rectum (hæmorrhoids, oxyuris), of the bladder (distension with urine, especially in the morning, irritation of calculi); by distension of the vesicular seminales with semen; by hyperæmia of the genitals, occasioned by lying on the back, and thus inducing pressure of the intestines upon the blood-vessels of the pelvis.

The erection-centre may also be excited by irritation of the nervous ganglia which are so abundant in the prostatic tissue (prostatitis, 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.