Scientia Sexualis and the Patient Case History

Flore, Jacinthe

doi:10.1007/978-3-030-39423-3_2

Scientia Sexualis and the Patient Case History

Jacinthe Flore²

Chapter
First Online: 12 March 2020

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Abstract

Sexual appetite assumed a significant role in the pathologisation of perversions in the nineteenth century. Ideas of balance, frequency and amount functioned to govern sexual normality. Who is “normal” was as much a question of appetite as it was of object choice. This chapter examines how the medicalisation of sexual appetite in nineteenth-century sexology emerged through the technique of the patient case history. It considers two aspects of this technique: first, how the case history presented sexual appetite as a structuring device in the expansion of taxonomies of sexual perversions, and second, how this was accomplished by inextricably tying the imagination and narrative to the notion of sexual excess. The imagination formed the bedrock of sexuality itself and was treated as both essential and suspicious. The patient case history was a discursive device linking pathology, excess and the imagination. It constituted a technique for the ordering of knowledge on sexual appetite and its dissemination.

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Notes

1.
Richard von Krafft-Ebing, Psychopathia Sexualis: A Medico-Forensic Study, trans. Harry E Wedeck (New York: G. P. Putnam’s Sons, 1965 [1886]), 29. “Alienist” is a nineteenth-century term for psychiatrist.
2.
Jennifer Germon, Gender: A Genealogy of an Idea (New York: Palgrave, 2009), 131.
3.
Jonathan Ned Katz, The Invention of Heterosexuality (New York: Dutton, 1995), 52.
4.
In addition to “sexual inversion”, homosexuality was also known as “contrary sexual instinct” and “anthipathic sexual instinct.”
5.
Albert Moll, Les perversions de l’instinct génital: Étude sur l’inversion sexuelle, trans. Dr Pactet (Paris: Georges Carré, 1893), 234–235.
6.
Iwan Bloch, The Sexual Life of Our Time in its Relations to Modern Civilization, trans. M. Eden Paul (London: Rebman Limited, 1909 [1906]), 4.
7.
Michel Foucault, The Will to Knowledge: The History of Sexuality, Volume 1, trans. Robert Hurley (London: Penguin Books, 1978), 42–43 (emphasis original).
8.
For studies on the development of the patient case history in medicine and the history of sexuality, see Carol Berkenkotter, Patient Tales: Case Histories and the Uses of Narrative in Psychiatry (Columbia, SC: University of South Carolina Press, 2008), Ivan Crozier, “Pillow Talk: Credibility, Trust and the Sexological Case History,” History of Science 46, no. 154 (2008): 375–404, Jonathan Gillis, “The History of the Patient History Since 1850,” Bulletin of the History of Medicine 80, no. 3 (2006): 490–512, Kathryn Montgomery Hunter, Doctor’s Stories: The Narrative Structure of Medical Knowledge (Princeton: Princeton University Press, 1991), Thomas Laqueur, “Bodies, Details and the Humanitarian Narrative,” in The New Cultural History, ed. Lynn Hunt (Berkeley: University of California Press, 1989), 176–204, Harriet Nowell-Smith, “Nineteenth-Century Narrative Case Histories: An Inquiry into the Stylistics and History,” Canadian Bulletin of Medical History 12 (1995): 47–67, Matt Reed, “La manie d’écrire: Psychology, Auto-Observation and Case History,” Journal of the History of Behavioral Sciences 40, no. 3 (2004): 265–284, Anne Sealey, “The Strange Case of the Freudian Case History: The Role of Long Case Histories in the Development of Psychoanalysis,” History of Human Sciences 24, no. 1 (2011): 36–50, and John Harley Warner, “The Uses of Patient Records by Historians: Patterns, Possibilities and Perplexities,” Health and History 1, no. 2–3 (1999): 101–111.
9.
Michel Foucault, Discipline and Punish: The Birth of the Priso n, trans. Alan Sheridan (London: Penguin, 1991 [1977]), 191.
10.
Crozier, “Pillow Talk,” 378.
11.
Nowell-Smith, “Nineteenth-Century Narrative Case Histories,” 50.
12.
Gert Hekma, “‘A Female Soul in a Male Body’: Sexual Inversion as Gender Inversion in Nineteenth-Century Sexology” in Third Sex, Third Gender: Beyond Sexual Dimorphism in Culture and History, ed. Gilbert Herdt (New York: Zone Books, 1993), 217.
13.
Crozier, “Pillow Talk,” 376.
14.
Laqueur, “Bodies, Details, and the Humanitarian Narrative,” 181–182.
15.
Foucault, Discipline and Punish, 191.
16.
Ibid.
17.
Harry Oosterhuis, Stepchildren of Nature: Krafft-Ebing, Psychiatry and the Making of Sexual Identity (Chicago: University of Chicago Press, 2000), 10. It is worth noting that Karl Heinrich Ulrichs (1825–1895) and Karl-Maria Benkert (1824–1882), who both contributed to nineteenth-century writings on homosexuality and made efforts at classification while campaigning for reform, were not trained in medicine. Ulrichs introduced uranism (homosexuality) in 1864, while the writer Karl-Maria Benkert coined “homosexuality” in 1869; both labels “were actually of a nonmedical proto-emancipatory origin.” Oosterhuis, Stepchildren of Nature, 44. A key political issue in late-nineteenth-century Germany was the reform of Paragraph 175, a provision of the criminal code which criminalised what it referred to as “unnatural vice,” that is, sex between men and bestiality. See further, Harry Oosterhuis, “Albert Moll’s Ambivalence about Homosexuality and His Marginalization as a Sexual Pioneer,” Journal of the History of Sexuality 28, no. 1 (2019): 1–43, Tracie Matysik, “In the Name of the Law: The ‘Female Homosexual’ and the Criminal Code in Fin de Siecle Germany.” Journal of the History of Sexuality 13, no. 1 (2004): 26–48, Karl Heinrich Ulrichs, Riddle of Man-Manly Love: The Pioneering Work on Male Homosexuality, trans. Michael A. Lombardi-Nash (Buffalo: Prometheus Books, 1994), Hubert Kennedy, Ulrichs: The Life and Works of Karl Heinrich Ulrichs, Pioneer of the Modern Gay Movement (Boston: Alyson Publications, 1988), Manfred Herzer, “Kertbeny and the Nameless Love,” Journal of Homosexuality 12, no. 1 (1986): 1–26, and Judit Takács, “The Double Life of Kertbeny,” in Past and Present of Radical Sexuality Politics, ed. Gert Hekma (Mosse Foundation: Amsterdam, 2004), 26–40.
18.
Foucault, The Will to Knowledge, 67.
19.
Berkenkotter, Patient Tales, 2.
20.
Albert von Schrenck-Notzing, Therapeutic Suggestions in Psychopathia Sexualis with Especial Reference to Contrary Sexual Instinct, trans. Charles Gilbert Chaddock (Philadelphia: The F. A. Davis Company, 1895), viii. See further Heather Wolffram, The Stepchildren of Science: Psychical Research and Parapsychology in Germany, c. 1870–1939 (Amsterdam: Rodopi B.V., 2009).
21.
Schrenck-Notzing, Therapeutic Suggestions, viii.
22.
Hunter, Doctor’s Stories, 51.
23.
Ibid., 131.
24.
The publication and analysis of case histories were often challenged by sexologists, who would then publish revised interpretations. This practice made the sexual sciences (and its taxonomies) a uniquely dynamic domain of study in the late-nineteenth century. See further Heike Bauer, English Literary Sexology: Translations of Inversion 1860–1930 (Basingstoke: Palgrave Macmillan, 2009) and Sexology and Translation: Cultural and Scientific Encounters Across the Modern World (Philadelphia: Temple University Press, 2015), Crozier, “Pillow Talk” and Oosterhuis, Stepchildren of Nature.
25.
Bénédict Augustin Morel, Traité des dégénérescences physiques, intellectuelles et morales de l’espèce humaine et des causes qui produisent ces variétés maladives (Paris: J. B. Baillière, 1857).
26.
Nordau formulated interesting ideas on the imagination and the stimulation of the mind in the chapter on mysticism, which he called the “cardinal mark of degeneration.” Max Simon Nordau, Degeneration (New York: D Appleton & Company, 1895 [1892]), 22. See also 60–66.
27.
Daniel Pick, Faces of Degeneration: A European Disorder, c.1848–1918 (Cambridge: Cambridge University Press, 1989), 8. Several scholars have noted that harnessing degeneration offered considerable advantages to psychiatrists. Ian R. Dowbiggin observes that degeneration solved several professional difficulties and served to expand the terrain of psychiatric practice. It enabled the field to gain scientific legitimacy since conclusive somatic proof of mental insanity was still unsubstantiated. As Oosterhuis further writes, “It is difficult to escape the impression that psychiatrists consciously or unconsciously capitalized on the imprecision of degeneration theory in order to divert attention away from the lack of empirical evidence of the somatic basis of mental illness.” Oosterhuis, Stepchildren of Nature, 106–107. See also Jan Goldstein, Console and Classify: The French Psychiatric Profession in the Nineteenth Century (Cambridge: Cambridge University Press, 1981) and Ian R. Dowbiggin, Inheriting Madness: Professionalization and Psychiatric Knowledge in Nineteenth-century France (Berkeley: University of California Press, 1991).
28.
George L. Mosse, “Nationalism and Sexuality in Nineteenth-Century Europe,” Culture & Society 20 (1983): 78.
29.
Jeffrey Weeks, Sex, Politics and Society: The Regulations of Sexuality Since 1800 (London: Routledge, 2012 [1981]), 4. See also Jörg Hutter, “The Social Constructions of Homosexuals in the Nineteenth Century: The Shift from the Sin to the Influence of Medicine in Criminalizing Sodomy in Germany,” Journal of Homosexuality 24, no. 3–4 (1993): 73–93.
30.
Katz, The Invention of Heterosexuality, 28.
31.
Ibid., 24
32.
Krafft-Ebing, Psychopathia Sexualis, 377–378.
33.
Ibid., 313 and 320.
34.
Gert Hekma, “A History of Sexology: Social and Historical Aspects of Sexuality,” in From Sappho to de Sade: Moments in the History of Sexuality, ed. Jan Bremmer (New York: Routledge, 1991), 180.
35.
Ladelle McWhorter, Bodies and Pleasures: Foucault and the Politics of Normalization (Bloomington: Indiana University Press, 1999), 32.
36.
Peter Cryle and Elizabeth Stephens, Normality: A Critical Genealogy (Chicago: University of Chicago Press, 2017), 270.
37.
Ibid., 274.
38.
Frank J. Sulloway, Freud, Biologist of the Mind: Beyond the Psychoanalytic Legend (New York: Basic Books, 1979), 294.
39.
Ibid., 287.
40.
Alison Moore, “The Invention of Sadism? The Limits of Neologisms in the History of Sexuality,” Sexualities 12, no. 4 (2009): 487.
41.
Krafft-Ebing, Psychopathia Sexualis, 116.
42.
Julia Epstein, “Historiography, Diagnosis, and Poetics,” Literature and Medicine 11, no. 1 (1992): 38.
43.
Schrenck-Notzing, Therapeutic Suggestions, 2.
44.
Ibid., v.
45.
Ibid., 207.
46.
Ibid., 215.
47.
Ibid.
48.
Anna Katharina Schaffner, Modernism and Perversion: Sexual Deviance in Sexology and Literature, 1850–1930 (Basingstoke: Palgrave Macmillan, 2012), 65.
49.
Alfred Binet, Le fétichisme dans l’amour (Paris: Octave DOIN, 1888), 272.
50.
Robert A. Nye, “The History of Sexuality in Context: National Sexological Traditions,” Science in Context 4, no. 2 (1991): 399. See also Robert A. Nye, “The Medical Origins of Fetishism” in Fetishism as Cultural Discourse, eds. Emily Apter and William Pietz (Ithaca and London: Cornell University Press, 1993), 13–30.
51.
Nye, “The Medical Origins of Fetishism,” 16.
52.
See Cryle and Stephens, Normality.
53.
Nye, “The History of Sexuality in Context.”
54.
Schaffner, Modernism and Perversion, 80–81.
55.
Binet, Le fétichisme dans l’amour, 270.
56.
See Georges Didi-Huberman, Invention of Hysteria: Charcot and the Photographic Iconography of the Salpêtrière, trans. Alisa Hartz (Cambridge, MA: MIT Press, 2003).
57.
Schaffner, Modernism and Perversion, 67.
58.
Valentin Magnan, Des anomalies, des aberrations et des perversions sexuelles (Paris: A. Delahaye & E. Lecrosnier, 1885), 27 (translation author).
59.
Valentin Magnan, Recherches sur les centres nerveux: Alcoolisme, folie des héréditaires dégénérés, paralysie générale, médecine légale (Paris: G. Masson, 1893), v (translation author).
60.
Ibid., 166.
61.
Ibid., 167.
62.
Havelock Ellis, Studies in the Psychology of Sex, Volume 1 (London: William Heinemann Medical Books, 1942 [1905]), 85.
63.
Ibid., 219.
64.
See, for example, Joseph Bristow, “Symonds’s History, Ellis’s Heredity: Sexual Inversion,” in Sexology in Culture: Labelling Bodies and Desires, eds. Lucy Bland and Laura Doan (Cambridge: Polity Press, 1998), 79–99, Chris Waters, “Havelock Ellis, Sigmund Freud and the State: Discourses of Homosexual Identity in Interwar Britain,” in Sexology in Culture: Labelling Bodies and Desires, eds. Lucy Bland and Laura Doan (Cambridge: Polity Press, 1998), 165–179, and Ivan Crozier, ed., Havelock Ellis and John Addington Symonds, Sexual Inversion: A Critical Edition (Basingstoke: Palgrave Macmillan, 2008). In Frigidity, Cryle and Moore analyse Ellis’s ideas on frigidity; however, they do not take up sexual periodicity and rhythms. See Peter Cryle and Alison Moore, Frigidity: An Intellectual History (London: Palgrave Macmillan, 2011), 212–215.
65.
Ellis, Studies in the Psychology of Sex, Volume 1, 85.
66.
Ibid., 112.
67.
Ibid., 119.
68.
Ivan Crozier, “Havelock Ellis, Eonism and the Patient’s Discourse; or, Writing a Book about Sex,” History of Psychiatry 11, no. 42 (2000): 147.
69.
Ellis, Studies in the Psychology of Sex, Volume 1, 25.
70.
Ibid.
71.
Ibid., 27.
72.
Ibid., 2. Ellis also wrote that the “chief stimuli which influence tumescence and thus direct sexual choice come chiefly—indeed, exclusively—through the four senses.” Ibid., 1.
73.
Sigmund Freud, The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume VII, trans. James Strachey (London: Vintage Books, 2001 [1905]), 148. See also 136–148.
74.
Moll , for example, refers to the autobiography of Felix Platter, a sixteenth-century Swiss physician. Albert Moll, The Sexual Life of the Child, trans. Eden Paul (New York: The Macmillan Company, 1912 [1909]), 10–11. See 136–141 for more examples of autobiographies.
75.
Hunter, Doctor’s Stories, 45.
76.
Moll, Sexual Life of the Child, 22–23.
77.
Arnold I. Davidson, The Emergence of Sexuality: Historical Epistemology and the Formation of Concepts (Cambridge, MA: Harvard University Press, 2001), 76.
78.
Moll, Les perversions de l’instinct génital, 295 (translation author).
79.
Ibid.
80.
Thomas Laqueur, Solitary Sex: A Cultural History of Masturbation (New York: Zone Books, 2003), 306.
81.
Michel Foucault, Abnormal: Lectures at the Collège de France, 1974–1975, trans. Graham Burchell (New York: Picador, 2003), 278.
82.
Benjamin Kahan, ed., Heinrich Kaan’s “Psychopathia Sexualis” (1844): A Classic Text in the History of Sexuality, trans. Melissa Haynes (Ithaca: Cornell University Press, 2016), 78.
83.
Ibid.
84.
Foucault, Abnormal, 278.
85.
Kahan, Heinrich Kaan’s “Psychopathia Sexualis,” 1–2.
86.
Ibid., 2.
87.
Ibid., 31–32.
88.
Ibid., 156.
89.
Ibid., 158.
90.
Ibid.
91.
Foucault, Abnormal, 280.
92.
Kahan, Heinrich Kaan’s “Psychopathia Sexualis,” 82.
93.
Niklaus Largier, In Praise of the Whip: A Cultural History of Arousal (New York: Zone Books, 2007), 446.
94.
Krafft-Ebing, Psychopathia Sexualis, 90–91.
95.
Ibid., 93.
96.
Krafft-Ebing , Psychopathia Sexualis , 91. The consideration of K’s dreams foreshadows Sigmund Freud who would go on to place enormous significance on dreams and the psyche. On the influence of nineteenth-century sexologists on Freud, see Sulloway, Freud, Biologist of the Mind, 277–319.
97.
Krafft-Ebing, Psychopathia Sexualis, 29.
98.
John Forrester, “If p then what? Thinking in Cases,” History of Human Sciences 9, no. 3 (1996): 10.
99.
Largier, In Praise of the Whip, 434.
100.
Schrenck-Notzing, Therapeutic Suggestions, 69.
101.
Krafft-Ebing, Psychopathia Sexualis, 376.
102.
Schrenck-Notzing, Therapeutic Suggestions, 13. “Nates” is an archaic term for buttocks.
103.
Laqueur, Solitary Sex, 264.
104.
Davidson, The Emergence of Sexuality, 35.

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Flore, J. (2020). Scientia Sexualis and the Patient Case History. In: A Genealogy of Appetite in the Sexual Sciences. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-39423-3_2

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