of the auricle: defective lobule, abnormal development of the Darwinian tubercle, absence of the helix; irregular pigmentation of the irides, strabismus; malformations of the external genital organs: cryptorchydism, infantilism, hypo- or epispadias, pseudohemaphroditism; anomalies of the length of the limbs: oligodactylism, etc.

Together with the anatomical anomalies should be ranged the numerous tattooings with which many psychopaths are covered, and which may indicate a morbid mental state.

Tattoo-marks, so frequently observed among the insane and among criminals, are a sort of acquired sign of degeneration.1

Anomalies of sexual life.2 - We usually distinguish:

(A) Anomalies of degree: eroticism; frigidity. (B) Anomalies of nature: sexual perversion;

sexual inversion.

(A) Anomalies of degree. - Eroticism results in venereal excesses and often in indecent acts and attempts of rape.

Sexual frigidity consists in an indifference and even an aversion of the subject to sexual connection; at least to normal sexual connection, for frigidity may be associated with sexual perversion or inversion. A curious and apparently paradoxical fact is its frequency among prostitutes.

(B) Anomalies of nature. — (a) Sexual perversion consists in the abnormal character of the conditions

1 Martin. Les tatouages chez les aliénés. Thèse de Paris, 1900. 2 Krafft-Ebing. Psychopathia Sexualis.

necessary to excite sexual desire and sometimes its gratification. Its most common forms are masturbation, fetichism, exhibitionism, sadism, masochism, bestiality and necrophilia.

Masturbation is very frequent in psychopaths. Often appearing very early, it is to be regarded as a sign and not as a cause of degeneration, though in all probability it accentuates already existing defects.

Fetichism occurs almost exclusively in men; it is an anomaly in which sexual excitement and sometimes even gratification of the sexual desire, accompanied by ejaculation, are produced by the sight or contact of certain objects, or of certain parts of the female body other than the genital organs.

Fetiches may be (a) various objects: articles of clothing (gowns, petticoats, handkerchiefs), toilet articles, laces, expensive fabrics, in a word, all objects used by women; (B) parts of the body: the breasts, the hands, the feet, the hair. Several fetiches may be associated in the mind of the same patient.

Moll has justly remarked that the mere fact that an individual has a predilection for some portion of the female body does not in itself constitute fetichism. "One may like by preference a pretty mouth, light or dark hair, or large eyes, without having any genital perversion." Similarly a letter or an object belonging to a woman may produce an agreeable impression by the recollections which it gives rise to. An anomaly is present only when the presence or mental representation of such objects is in itself efficient and provokes sexual excitement without

giving rise to any recollection of any particular

woman.

Fetichism often appears at the time when normally the sexual instinct becomes manifest. The choice of the fetich depends upon the impression which is accidentally associated with the first genital excitement. While in the normal individual this accidental association leaves no trace, in the fetichist the impression and the excitation form an indissoluble combination, so that the first invariably brings about the second.

The desire to possess the fetich is sometimes so intense as to lead the patient to thefts or to various strange acts. One patient of Vallon's was arrested while cutting bits of cloth from the dresses of women who were with him at the time in a newspaper office. Most of the so-called hair despoilers are hair fetichists.

Exhibitionism has been defined elsewhere.1 It may be met with in dements and in epileptics, and often takes the form of an impulsive obsession.

Sadism consists in a sense of voluptuousness derived from suffering which the patient witnesses or inflicts upon his victim. This sense is almost always associated with a state of genital excitation. As is the case with most sexual anomalies, it is more frequent in men.

History contains terrible examples of sadism. Such is that of Marshal Gilles de Rays, who, during a period of eight years, assassinated over eight

1 See Part II, Chapter XXI.

hundred children,1 subjecting them previously to defilement and torture. The exploits of the too-wellknown Vacher are still fresh in the memories of most of us.

Sadism is exercised chiefly upon women and upon children; more rarely upon animals.

Many sadists content themselves with simulation of suffering or with fictitious humiliation inflicted upon their pseudo-victim. The sadism is then symbolic (Krafft-Ebing).

Masochism, unlike sadism, is more frequent in women. It consists in an abnormal pleasure which the subject derives from his or her own suffering or humiliation. To this category belong the individuals who request women to strike and insult them and in whom sexual excitation cannot be produced otherwise.

Bestiality consists in an impulse to copulate with animals. Like all genital impulses it often assumes the shape of an imperative idea which the subject can in some cases resist by an effort of the will or by various curious subterfuges. Magnan cites a case of a young girl who, seized with the idea of having connection with a dog, escaped the morbid impulse by turning her attention to another animal.

Necrophilia is the rarest of all forms of sexual perversion. It consists in a particular pleasure which the subject experiences from the sight or contact of a cadaver. Often, but not always, this is accompanied by an impulse to defile the corpse.

1 Quoted by Krafft-Ebing from Jacob, the historian.

(b) Sexual inversion consists in a contrast existing between the physical sex and the psychic sex: the subject presents the sexual tendencies of the opposite

sex.

Much more frequent in men than in women, sexual inversion often, but not always, leads to pederasty. Sexual inversion is always congenital. The anomaly is stamped upon the entire psychic and even physical personality of the subject.

Many of these individuals have the character and tastes of the opposite sex. The little boy plays with dolls, and finds pleasure only in the society of girls. Later on the same feminine tendencies persist, and the patient secretly abandons himself to them. We also often meet with men, apparently normal, who in their privacy dress themselves in female attire, cover themselves with laces, or passionately indulge in feminine employments, as sewing, embroidery, etc.

Physically certain anomalies are noted which resemble the normal characteristics of the feminine organism: considerable development of the breasts and hips, absence of the beard, rounded shape of the neck, etc. Occasionally we observe a more or less marked degree of pseudo-hermaphroditism. 23

The opposite anomalies are encountered in the female sexual invert: masculine features, beard, masculine voice, etc.

Some inverts may have normal sexual intercourse, but they derive no satisfaction from it, and always feel an attraction for the homologous sex; often they marry, hoping thus to cure their infirmity, but their attempt is never successful.