time he had seen such a thing and he experienced erection and much 

pleasure at the sight. This was repeated the next time the cousin's nose 

bled and also whenever he witnessed any injuries or wounds, especially 

when occurring in males. A few years later he began to find pleasure in 

pinching and otherwise inflicting slight suffering. This sadism was not, 

however, further developed, although a tendency to inversion 

persisted.[103] 

Somewhat similar may have been the origin of the attraction of 

blood in a case which has been reported to me of a youth of 17, 

the youngest of a large family who are all very strong and 

entirely normal. He is himself, however, delicate, overgrown, 

with a narrow chest, a small head, and babyish features, while 

mentally he is backward, with very defective memory and scant 

powers of assimilation. He is intensely nervous, peevish, and 

subject to fits of childish rage. He takes violent fancies to 

persons of his own sex. But he appears to have only one way of 

obtaining sexual excitement and gratification. It is his custom 

to get into a hot bath and there to produce erection and 

emission, not by masturbation, but by thinking of flowing blood. 

He does not associate himself with the causation of this 

imaginary flow of blood; he is merely the passive but pleased 

spectator. He is aware of his peculiarity and endeavors to shake 

it off, but his efforts to obtain normal pleasure by thinking of 

a girl are vain. 

I may here narrate a case which has been communicated to me of 

algolagnia in a woman, combined with sexual hyperesthesia. 

R.D., aged 25, married, and of good social position; she is a 

small and dark woman, restless and alert in manner. She has one 

child. 

She has practised masturbation from an early age--ever since she 

can remember--by the method of external friction and pressure. 

From the age of 17 she was able (and is still) to produce the 

orgasm almost without effort, by calling up the image of any man 

who had struck her fancy. She has often done so while seated 

talking to such a man, even when he is almost a stranger; in 

doing it, she says, a tightening of the muscles of the thighs and 

the slightest movement are sufficient. Ugly men (if not 

deformed), as well as men with the reputation of being _roues_, 

greatly excite her sexually, more especially if of good social 

position, though this is not essential. 

At the age of 18 she became hysterical, probably, she herself 

believes, in consequence of a great increase at that time of 

indulgence in masturbation. The doctors, apparently suspecting 

her habits, urged her parents to get her married early. She 

married, at the age of 20, a man about twice her own age. 

As a child (and in a less degree still) she was very fond of 

watching dog-fights. This spectacle produced strong sexual 

feelings and usually orgasm, especially if much blood was shed 

during the fight. Clean cuts and wounds greatly attract her, 

whether on herself or a man. She has frequently slightly cut or 

scratched herself "to see the blood," and likes to suck the 

wound, thinking the taste "delicious." This produces strong 

sexual feelings and often orgasm, especially if at the time she 

thinks of some attractive man and imagines that she is sucking 

his blood. The sight of injury to a woman only very slightly 

affects her, and that, she thinks, only because of an involuntary 

association of ideas. Nor has the sight of suffering in illness 

any exciting effects, only that which is due to violence, and 

when there is a visible cause for the suffering, such as cuts and 

wounds. (Bruises, from the absence of blood, have only a slight 

effect.) The excitement is intensified if she imagines that she 

has herself inflicted the injury. She likes to imagine that the