A peasant, thirty years of age, in the best circumstances, consulted me because he wished to marry, but thought he was not equal to the duties of married life. The history showed that he had formerly mas turbated considerably, but had given up the habit ten years ago, having received a severe lecture from his confessor. This exhortation, however, mule so deep an impression, that after repeated opportunity for sexual congress be was not able to have a sufficient erection. Being pressed by his relatives to marry, he came to me for consultation; my firm assertion that the damage was not great enough to prevent marriage quieted him perceptibly. Later on he told me joyfully that he had married, that there were prospects of progeny, and that his powers were normal.
Such cases are certainly not rare: in a second case a young man who had formerly masturbated, was, by the reading of a book about self-abuse, entirely deprived of the ability to partake in the sexual excesses of his associates. It was only after earnest exhortation that lie could be per suaded to enter married life, which in the future proved to be a fertile one. In a third case a gonorrhceal affection, which had been acquired at the first cohabitation, and had soon been entirely cured, sufficed to in terfere with sufficient erections through the first months of married life. Here also, as in the preceding case, the affirmation that the patient was absolutely free from syphilis quieted him, and cohabitation was afterward regularly and successfully performed.
The examples last mentioned form a transition to that group of lighter cases of psychical impotence which may be called temporary. Here neither sexual power is diminished nor is there a want of moral courage, but unexpected obstacles during cohabitation bring about a strong psychi cal depression, and in consequence of this an excitement sufficient for a repetition of the unsuccessful embrace. These scenes occur very fre quently in the first part of married life. Owing to the conditions de scribed under female sterility, the first attempts are unsuccessful; husbands whose consciences are not quite clear are reminded of their past sins and ascribe to these their ill success. The depression of mind caused by this situation may also deter from further attempts. Even with perfectly virtuous men ill success, brought about by lack of dexterity and experience, may lead to a despondency which for a longer or shorter time renders the success of further attempts more and more improbable. With some
men a normal condition returns spontaneously; others only reach their aim through the doctor's office; in still other cases sometimes medical assistance (dilatation of the external female genitals) may assist in over coming the obstacle; but in some cases there result those conditions of the female, which have already been discussed under sterility of the latter ( vagin ism u s, etc.).
But even with some men experienced in the customary transactions of married life. there may occur a temporary psychical impotence. Excess ive mental work, sadness, trifling diseases combined with a hypochondri acal state of mind, may abolish generative power for a shorter or longer time. After a removal of the cause there may also be a return to the normal condition. Such cases are also spoken of as temporary im potence.
A certainly infrequent occurrence is the " relative psychical impo tence." By this is meant that the impotence exists only toward a cer tain female, here the wife, while cohabitation is easily performed with others. It is possible, though not very probable, that a young husband may be impotent in his relations with his wife from bashfulness or too great reverence; much more likely are the cases where mental peculiari ties, repulsive properties of character, and still more ugly bodily defects of the wife, give rise to a passive behavior of the husband. We must be very careful about the acceptance of this form of impotence. Sometimes when the wife's exterior seems to be very fine, there is still a defect which in the beginning is even kept silent by the husband. Thus I know of one husband who was shocked by an extensive disgusting hairiness of his wife at an abnormal place, and of another to whom cohabitation became repulsive by the discovery that his wife had a false set of teeth.
The occurrence of psychical impotence may be explained by what has been said about the inhibitory influence of the brain upon the sexual . activity. This influence becomes efficient the more easily when the cen tre of sexual activity itself is already in a condition of weakness or paraly sis, and when the conduction to the sexual organs has become deficient.