Within two months and a half this treatment led to the result that, as the patient stated, the perverse ideas occurred much less frequently and were constantly retreating to the background; indeed, according to the patient’s statement, erections occurred with the thoughts of nude women, became more frequent, and often induced him to masturbate with the thought of coitus without the occurrence of any idea of blows. Erotic dreams occurred but infrequently. These were concerned sometimes with normal coitus, sometimes with blows.
After two months and a half of the treatment I advised the patient to attempt coitus. Since then he has tried four times. I advised him to choose always a woman who pleased him, and sought to increase his sexual excitement before coitus by means of tincture of cantharides. The four attempts, the last of which took place on November 29, 1890, resulted as follows: At the first, prolonged manipulation of the penis by the woman was necessary in order to induce erection. Then immisio in vaginam and ejaculation with orgasm took place. During the whole act there occurred no thought of beating the woman or being beaten, but the woman in herself excited him sufficiently for the performance of coitus. At the second attempt the result was better and more quickly attained; manipulation ad genitalia by the woman was not long required. In the third attempt coitus was attained only after the patient had thought of beating for a long time, and had thus induced erection; but beating was not indulged in. At the fourth attempt coitus was attained without any thought of beating and without any manipulation ad genitalia.
Of course, the case described cannot yet be regarded in any way as cured. Though the patient were able to perform coitus in a normal or nearly normal way, that does not mean that he will always be able to do it in the future; moreover, the thought of beating still affords him great pleasure, even though it occurs much less frequently than formerly. Yet there is a possibility that the abnormal desire, which has been weakened, will remain weakened in the future, and perhaps disappear.This carefully observed case is, for several reasons, particularly interesting. It discloses clearly one of the hidden roots of sadism,—the impulse to complete subjugation of the woman, which here became consciously entertained. This is the more remarkable since it occurred in an individual decidedly timid, and in other respects modest and even apprehensive. The case also shows clearly that powerful libido, which even impels the individual to overcome all obstacles, may be present, while at the same time coitus is not desired, because the principal intensity of feeling is, ab origine, connected with the cruel part of
