The Psychology of Sex (Vol. 1-6). Havelock Ellis

similar to hysteria.^[263] The present writer, when in 1894 briefly discussing hysteria as an element in secondary sexual characterization, ventured to reflect the view, confirmed by his own observation, that there was a tendency to unduly minimize the sexual factor in hysteria, and further pointed out that the old error of a special connection between hysteria and the female sexual organs, probably arose from the fact that in woman the organic sexual sphere is larger than in man.^[264]

When, indeed, we analyze the foundation of the once predominant opinions of Charcot and his school regarding the sexual relationships of hysteria, it becomes clear that many fallacies and misunderstandings were involved. Briquet, Charcot's chief predecessor, acknowledged that his own view was that a sexual origin of hysteria would be "degrading to women"; that is to say, he admitted that he was influenced by a foolish and improper prejudice, for the belief that the unconscious and involuntary morbid reaction of the nervous system to any disturbance of a great primary instinct can have "quelque chose de dégradant" is itself an immoral belief; such disturbance of the nervous system might or might not be caused, but in any case the alleged "degradation" could only be the fiction of a distorted imagination. Again, confusion had been caused by the ancient error of making the physical sexual organs responsible for hysteria, first the womb, more recently the ovaries; the outcome of this belief was the extirpation of the sexual organs for the cure of hysteria. Charcot condemned absolutely all such operations as unscientific and dangerous, declaring that there is no such thing as hysteria of menstrual origin.^[265] Subsequently, Angelucci and Pierracini carried out an international inquiry into the results of the surgical treatment of hysteria, and condemned it in the most unqualified manner.^[266] It is clearly demonstrated that the physical sexual organs are not the seat of hysteria. It does not, however, follow that even physical sexual desire, when repressed, is not a cause of hysteria. The opinion that it was so formed an essential part of the early doctrine of hysteria, and was embodied in the ancient maxim: "Nubat illa et morbus effugiet." The womb, it seemed to the ancients, was crying out for satisfaction, and when that was received the disease vanished.^[267] But when it became clear that sexual desire, though ultimately founded on the sexual apparatus, is a nervous and psychic fact, to put the sexual organs out of count was not sufficient; for the sexual emotions may exist before puberty, and persist after complete removal of the sexual organs. Thus it has been the object of many writers to repel the idea that unsatisfied sexual desire can be a cause of hysteria. Briquet pointed out that hysteria is rare among nuns and frequent among prostitutes. Krafft-Ebing believed that most hysterical women are not anxious for sexual satisfaction, and declared that "hysteria caused through the non-satisfaction of the coarse sensual sexual impulse I have never seen,"^[268] while Pitres and others refer to the frequently painful nature of sexual hallucinations in the hysterical. But it soon becomes obvious that the psychic sexual sphere is not confined to the gratification of conscious physical sexual desire. It is not true that hysteria is rare among nuns, some of the most tremendous epidemics of hysteria, and the most carefully studied, having occurred in convents,^[269] while the hysterical phenomena sometimes associated with revivals are well known. The supposed prevalence among prostitutes would not be evidence against the sexual relationships of hysteria; it has, however, been denied, even by so great an authority as Parent-Duchâtelet who found it very rare, even in prostitutes in hospitals, when it was often associated with masturbation; in prostitutes, however, who returned to a respectable life, giving up their old habits, he found hysteria common and severe.^[270] The frequent absence of physical sexual feeling, again, may quite reasonably be taken as evidence of a disorder of the sexual emotions, while the undoubted fact that sexual intercourse usually has little beneficial effect on pronounced hysteria, and that sexual excitement during sleep and sexual hallucinations are often painful in the same condition, is far from showing that injury or repression of the sexual emotions had nothing to do with the production of the hysteria. It would be as reasonable to argue that the evil effect of a heavy meal on a starving man must be taken as evidence that he was not suffering from starvation. The fact, indeed, on which Gilles de la Tourette and others have remarked, that the hysterical often desire not so much sexual intercourse as simple affection, would tend to show that there is here a real analogy, and that starvation or lesion of the sexual emotions may produce, like bodily starvation, a rejection of those satisfactions which are demanded in health. Thus, even a mainly a priori examination of the matter may lead us to see that many arguments brought forward in favor of Charcot's position on this point fall to the ground when we realize that the sexual emotions may constitute a highly complex sphere, often hidden from observation, sometimes not conscious at all, and liable to many lesions besides that due to the non-satisfaction of sexual desire. At the same time we are not thus enabled to overthrow any of the positive results attained by Charcot and his school.

It may, however, be pointed out that Charcot's attitude toward hysteria was the outcome of his own temperament. He was primarily a neurologist, the bent of his genius was toward the investigation of facts that could be objectively demonstrated. His first interest in hysteria, dating from as far back as 1862, was in hystero-epileptic convulsive attacks, and to the last he remained indifferent to all facts which could not be objectively demonstrated. That was the secret of the advances he was enabled to make in neurology. For purely psychological investigation he had no liking, and probably no aptitude. Anyone who was privileged to observe his methods of work at the Salpêtrière will easily recall the great master's towering figure; the disdainful expression, sometimes, even, it seemed, a little sour; the lofty bearing which enthusiastic admirers called Napoleonic. The questions addressed to the patient were cold, distant, sometimes impatient. Charcot clearly had little faith in the value of any results so attained. One may well believe, also, that a man whose superficial personality was so haughty and awe-inspiring to strangers would, in any case, have had the greatest difficulty in penetrating the mysteries of a psychic world so obscure and elusive as that presented by the hysterical.^[271]

The way was thus opened for further investigations on the psychic side. Charcot had affirmed the power, not only of physical traumatism, but even of psychic lesions—of moral shocks—to provoke its manifestations, but his sole contribution to the psychology of this psychic malady—and this was borrowed from the Nancy school—lay in the one word "suggestibility"; the nature and mechanism of this psychic process he left wholly unexplained. This step has been taken by others, in part by Janet, who, from 1889 onward, has not only insisted that the emotions stand in the first line among the causes of hysteria, but has also pointed out some portion of the mechanism of this process; thus, he saw the significance of the fact, already recognized, that strong emotions tend to produce anæsthesia and to lead to a condition of mental disaggregation, favorable to abulia, or abolition of will-power. It remained to show in detail the mechanism by which the most potent of all the emotions effects its influence, and, by attempting to do this, the Viennese investigators, Breuer and especially Freud, have greatly aided the study of hysteria.^[272] They have not, it is important to remark, overturned the positive elements in their great forerunner's work. Freud began as a disciple of Charcot, and he himself remarks that, in his earlier investigations of hysteria, he had no thought of finding any sexual etiology for that malady; he would have regarded any such suggestion as an insult to his patient. The results reached by these workers were the outcome of long and detailed investigation. Freud has investigated many cases of hysteria in minute detail, often devoting to a single case over a hundred hours of work. The patients, unlike those on whom the results of the French school have been mainly founded, all belonged to the educated classes, and it was thus possible to carry out an elaborate psychic investigation which would