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SEXUAL NEURASTHENIA (Nervous Exhaustion), New York, 1886, pp. 99-107.

[Chapter 3. The Relation of Neurasthenia to Other Diseases.]

[p. 99]

RELATION TO THE DISEASE OF THE SCYTHIANS; SEXUAL PERVERSION. - This name is given to a disease which has been known from remote times. A general description of it is given by Moreau in "Des Aberrations du Sens Genesiques," par le de Paul Moreau (de Tours), pages 95-97. He refers to a previous work on the subject by Montyet. In the Caucasus there are individuals who lose the attributes of virility before old age; their beard falls off; their genital organs atrophy; their amorous desires disappear; their voice becomes feeble; their body loses its force and energy, and at last they come to a condition where they partake of feminine costume, and assimilate to women in many of their occupations. The disease has been described both by Herodotus and Hippocrates. According to Herodotus the disease was a punishment upon the Scythians for pillaging the temple at Ascalon. Hippocrates says that these impotent Scythians were called Anandrii, and he says that the disease was excited by excessive riding on horseback. According to Allemand, the disease is caused by seminal emissions produced by horseback-riding. Moreau, just cited, refers to Esquirol, Morel, Moreau (de Tours), Luys, Azam, etc. Dr. Hammond, in a recent paper on this subject, delivered before the American Neurological Association,* states that in ...

*American Journal of Neurology and Psychiatry, August, 1882.


[p. 100] New Mexico,.among the Peublo Indians, who are the descendants of the Aztecs, there exist what are called "Mujerados," which means, literally, "womaned,". or feminine. These Mujerados have protuberant abdomens, well-developed mammary glands, rounded and soft limbs, shrunken genital organs, high, thin, cracked voices, and pubes devoid of hair. Dr. Hammond describes two cases to whom this description is applied, although one did not have any unusual development of the mammary glands. One had been a Mujerado for seven and the other for ten years; both dressed like women, and one appeared like a woman, both dressed and undressed. A Mujerado is found, he asserts, in every Pueblo tribe, and is an important person in the religious ceremonies, which are conducted very secretly in the spring. In order to make a Mujerado a very strong man is selected; masturbation is performed upon him many times a day; he has to ride almost continuously on horseback without saddle. By this process the genital organs become much excited, and seminal losses are produced; the nutrition of the organs is interfered with; they grow smaller and weaker, and, in time, desire and power cease; then follow the changes in character, the desire to dress like a woman and to engage in feminine occupations, just as with the Scythians; courage and manhood are lost; wives and children, for ...

[p. 101] those who have them, pass from their control. The Mujerado is held in honor, although men do not associate with him - only women. The only difference between these Mujerados and the Anandrii of the Scythians is, that in the case of the Scythians the condition is brought on accidentally, as a result of excessive horseback-riding, while in the case of the Indians it is brought on intentionally for religious purposes; the philosophy in both cases being the same - excessive equitation following masturbation; masturbation bringing on an unnaturally excitable condition of the parts and preparing them for involuntary emissions after excessive horsebackriding.

The general term, "sexual perversion," of which Dr. Spitzka speaks in an article on Lord Cornbury, may be used to cover a number of abnormal mental conditions connected with the genital system; but I see no need, practically, in describing any of these cases, to use any other term than this one, "sexual perversion."

Cases of sexual perversion are very much more frequent than is supposed; but they are very rarely studied by scientific men, and only in exceptional cases do they consult scientific men. This class of people do not wish to get well. They are content with their lot, like the majority of opium-caters and inebriates, and have no occasion to go to a physician ; they enjoy their ab-

[p. 102] normal life, or, if they. do not enjoy it, are at least not sufficiently annoyed by it, or are too ashamed of it to attempt any treatment. There are, as I have recently learned on inquiry, great numbers of such cases in the city of New York. To say all that might be said in regard to them would not add anything of importance, perhaps, to our scientific knowledge of the subject; a few cases will answer quite sufficiently for all the purposes of science.

I was at one time consulted by a man whose constant desire was to attain sexual gratification, not in the normal way or by masturbation, but by performing the masturbating act on some other person, and, in his case, it had become a mania practically, so that he was a great sufferer, and very earnestly sought relief. The patient had a number of symptoms of nervous trouble, of which this, on which he specially sought advice, was one. I saw the patient but once, and do not know the result of the plan of treatment proposed. In this case there was a combination of mental and physical infirmities. I am persuaded that a nervous constitution and excessive nervous susceptibility going on to debility, tend to induce the habit of "mental masturbation," as well as both natural and unnatural excess in sexual indulgence. The strong, the phlegmatic, the healthy, the well-balanced temperaments - those who live out-doors and work with the ...

[p. 103] muscle more than with the mind - are not tormented with sexual desire to the same degree or in the same way as the hysterical, the sensitive, the nervous - those who live in-doors and use mind much and muscle very little. Dr. Boteler, who has had much experience as a physician among the North American Indians, tells me that Indian boys do not masturbate, and do not, as a rule, in most of the tribes, commit excesses in sexual indulgence prior to marriage; and it is quite safe to assume, reasoning deductively and inductively from a general knowledge of the nervous, from observation among savages and semi-savages, among the negroes and among the strong, healthy farming population in all civilized countries, that those who live out-doors and have well-balanced constitutions of the old-fashioned sort are not annoyed by sexual desire when they have no opportunities for gratification, nor to the same degree as the delicate, finely-organized lads of our cities and of the higher civilization.

Of the unnatural forms of coitus, the habit of premature withdrawal undoubtedly is the worst; but even that is practised by some persons for years without any apparent injury, although in the case of the sensitive, the nervous, and the weak, injury of a demonstrable character will result, provided the habit be carried to any great extent. Injuries that come from these bad habits are of a functional rather than a structural char-

[p. 104] acter, and are relievable and recoverable, as a rule, by time and treatment; and this is one of the redeeming facts connected with these unfortunate habits.

Under this head of sexual perversion there are, however, two necessary subdivisions: First: those who are insane, who have the insane delusion - i.e., the delusion that cannot be corrected by the direct evidence of the senses, the delusion that they are women, and who correspondingly assume the manners, the dress, and the customs of women so far as they are able to do. This is simply a monomania, a positive insanity, and of a serious and usually incurable kind; and it is quite different, essentially, radically, from the following class of cases:

Secondly: those, like the Scythians and the Mujerados and the cases described by Ulrichs, whose sexual instincts are perverted, but who understand that perversion perfectly; who are not under the influence of any delusion, and who are not, in any true sense of the word, insane. This latter class - those who are not insane, but yet who have a sexual perversion as a disease, without any delusion, and without sufficient impairment of will-power to make the diagnosis of insanity possible - may be divided into two classes: first, those who inherit this tendency or who come into possession of it as soon the sexual passion appears, or before; second-

[p. 105] ly, those who acquire this condition as one of the symptoms of sexual debility. In both classes there may be very many symptoms of a nervous impairment. It is quite possible that in some of the cases where there is no delusion - where the man perfectly well knows that he is a man, not a woman, though he dresses as a woman and partakes of feminine occupations - there yet may be sufficient destruction or impairment of willpower to make the diagnosis of insanity possible, just as in some of the worst cases of inebriety or of opium-eating and the like; but in the majority of cases the impairment of will-power is not sufficient to bring these patients under the head of insanity. In this respect, as in the case of inebriety, as in the case of morphia-taking, each case must be studied by itself; and when any cases of this kind come into court, they considered by themselves.

PSYCHOLOGY OF SEXUAL PERVERSION. - When the prime conductor of an electrical machine is fully charged with positive electricity, it tends to discharge itself in proportion to the tension of the electricity; and the electricity upon it seeks for its opposite, the negative electricity, to equalize itself. A wave of the sea, thrown up by the wind, tends to fall more and more in proportion to its height, in obedience to the law of gravity; and when it falls it leaves a trough in the sea in its place. These physical facts suggest a law

[p. 106] which runs through all nature, which the inanimate as well as animate world obeys: reaction follows action, a necessary result of action; violent and excessive exercise of any function finds relief only in the opposite condition - in perversion. Dyspepsia, brought on by excess in eating, shows itself sometimes by a craving for the most loathsome and disagreeable things, as is seen in chlorosis and hysteria; exhaustion of the sexual organs, through excess or masturbation, brings on at first indifference to the opposite sex, then positive fear or dread of normal intercourse; confirmed, long-standing masturbators of either sex care little or not at all for the opposite sex; are more likely to fear than to enjoy their presence, and are especially terrified by the thought of sexual connection; similarly, excess in a normal way tends to make us hate the partners in our excess; the unhappiest marriages are those where there is the greatest indulgence; irritability, aversion, positive hatred and disgust toward the object of our former love follow protracted debauches. The subjects of these excesses go through the stages of indifference and of fear, and complete the circle; the sex is perverted; they hate the opposite sex and love their own; men become women, and women men, in their tastes, conduct, character, feelings, and behavior. Such, as appears to me, is the psychology of sexual perversion, whenever and ...

[p. 107] wherever found. When the sexual debility becomes organized in families, then children may be born with this tendency; hence the congenital cases of sexual perversion as before described. These cases of complete sexual perversion are far more common than is believed; but the half-way cases, those who are in the stages of indifference and dread of the opposite sex, are very numerous; we see them every day.