Psychopathia Sexualis: With Especial Reference to Contrary Sexual Instinct

The standard complaint against Psychopathia Sexualis is that it pathologised what it claimed to study, dressed moral condemnation in clinical language, and gave physicians a jurisdiction over sexuality that had previously belonged to priests. This is not wrong, but it is incomplete. Richard von Krafft-Ebing’s book is a considerably stranger and more contradictory document than either its critics or its defenders have tended to acknowledge, and its significance for understanding how modern sexual identity was constituted is difficult to overstate. It is, more precisely than any other single text, the machine that Foucault was describing. Reading it after Foucault is illuminating. Reading it after Boswell is vertiginous.

A freely readable edition — the Chaddock English translation of 1892, the text through which the book entered anglophone medicine and culture — is available at Project Gutenberg.

The Core Claim

Krafft-Ebing’s central proposition is that sexuality can and must be subjected to scientific description. What had previously been distributed across theology (sin), law (crime), and polite silence (unspeakability) could now be organised into a clinical taxonomy: the perversions, deviations, and inversions that constitute the book’s vast catalogue. The specific argument about “contrary sexual instinct” — the term he preferred for what would later be called homosexuality — is that it is a pathological condition rather than a moral failing, and that some of its forms are congenital rather than acquired. A person born with an inverted sexual instinct cannot be held responsible for the condition itself, even if particular acts remain subject to legal sanction.

This distinction between congenital and acquired inversion structures the book’s entire treatment of “contrary sexual instinct” and carries a practical implication Krafft-Ebing is careful to draw: that the criminal prosecution of the congenitally inverted is both medically irrational and morally unjust. Irrational, because the condition is no more voluntary than any other inherited pathology; unjust, because punishment does not alter the underlying constitution. This was, in the context of the 1880s and the ongoing enforcement of Paragraph 175 in the German Empire, a moderating position — not a liberatory one, but a moderating one.

The method is the case study. Psychopathia Sexualis grew across twelve editions published during Krafft-Ebing’s lifetime (he died in 1902) from a systematic treatise into an enormous archive — several hundred case histories, many submitted by patients and correspondents in response to earlier editions. The book solicited testimony and received it, expanded with each edition, and in doing so generated exactly the proliferating discourse about sexuality that Foucault identifies as characteristic of modern biopower.

Where the Argument Is Strongest

The clinical moderation argument, whatever its pathologising frame, had genuine historical traction. Krafft-Ebing’s testimony was used in legal proceedings across Europe on behalf of men prosecuted under sodomy laws, and his insistence that congenital inversion was a medical rather than a moral condition contributed to the slow, uneven decriminalisation debates that ran through the late nineteenth and early twentieth centuries. The book’s influence on Magnus Hirschfeld and the early homophile movement was direct; Hirschfeld’s own research programme was, in some respects, an attempt to prove the congenital thesis on firmer empirical grounds than Krafft-Ebing had managed.

The preservation of first-person testimony is the book’s least acknowledged contribution. The case histories — many of them extended autobiographies submitted by the subjects themselves — record the subjective experience of sexual non-conformity in the late nineteenth century with a specificity that survives the clinical frame in which they were embedded. Patients describing their childhoods, their sense of difference, their relationships, and their encounters with the law are not simply data points in Krafft-Ebing’s taxonomy; they are documents of lives that would otherwise leave almost no trace. The archive value of the case studies is independent of the theoretical claims built on top of them.

Krafft-Ebing also deserves credit for epistemological honesty that his more confident successors lacked. He acknowledged repeatedly that the taxonomy was incomplete, that categories bled into one another, that the boundary between congenital and acquired inversion was difficult to establish in individual cases. The uncertainty is built into the text rather than concealed by it.

Where It Strains

The etiological claims are the book’s most conspicuous vulnerability, and they collapse entirely under scrutiny. Krafft-Ebing worked within the framework of degeneracy theory — the pseudo-Darwinian idea, prevalent in late Victorian medicine, that pathological conditions accumulated across generations through hereditary transmission and environmental stress. The neurological substrate he proposes for “contrary sexual instinct” is pure speculation dressed in clinical confidence, and the degeneracy framework that anchors it has no defensible empirical basis. This matters not only as a historical embarrassment but because it is the supposed scientific foundation on which the entire nosological structure rests.

The case study method is more deeply problematic than it first appears. Krafft-Ebing’s taxonomy shaped the testimony he received. Correspondents who had read earlier editions wrote in to describe experiences that matched — and were partially constructed by — the categories already in print. The clinician and the archive were in continuous productive dialogue, each edition generating new cases that confirmed and elaborated the existing taxonomy, the taxonomy generating new categories that organised subsequent self-reports. This is circularity, not science, and it is circularity that Krafft-Ebing’s own insistence on empirical method could not see.

The Latin passages reveal another dimension of the book’s contradictions. The most clinically graphic case material — the descriptions Krafft-Ebing judged too explicit for general readership — was rendered in Latin, restricting access to those with a classical education. This is not a neutral editorial decision. It reproduces, within the text itself, a class-stratified distribution of sexual knowledge: physicians and jurists could read everything; laypeople could read the framing but not the detail. The claim to be advancing scientific knowledge through disclosure coexists with a carefully managed restriction of that disclosure. Foucault would have found the passage entirely legible.

The coining of sadism and masochism — terms derived from de Sade and Sacher-Masoch respectively — illustrates the book’s most consequential move and its most consequential problem simultaneously. Naming creates categories; categories attract recognition; recognition generates population. Once masochist exists as a clinical type, people can identify themselves as one, be identified by others as one, and be governed as one. The productive force of naming — which Foucault theorises as the central mechanism of the scientia sexualis — is visible in real time across the twelve editions.

Verdict

Psychopathia Sexualis is essential reading for exactly the reason that makes it uncomfortable: it is not a description of sexual pathology but a demonstration of how sexual identity categories are produced through the machinery of clinical description, case compilation, and taxonomic naming. Foucault theorises this mechanism; Krafft-Ebing enacts it. Boswell shows, in the medieval sources, what sexual life looked like before such machinery existed — before the sodomite had become a species, before the act had generated a type, before the confession had been redirected from the priest’s booth to the clinician’s casebook. Read in sequence, the three books compose an argument none of them individually makes: that the categories through which modern sexuality is understood were historically produced, that the production required specific institutional machinery, and that the machinery is still running.

The Chaddock translation, available freely at Project Gutenberg, preserves the clinical register and period idiom of the text. Later translations modernise the language in ways that smooth over productive strangeness. For historical purposes, the 1892 Chaddock is the right text.