Recently, I was examining the stenographic record of a meeting held by a special commission of the German Parliament in November 1968. The legislators and psychiatric experts were discussing the efficacy of a relatively new treatment at the time for sex offenders—cyproterone acetate, an antiandrogen, widely marketed as Androcur—as they considered a law governing its uses. As I read the transcript of the discussion, Dr Ursula Laschet (then Director of the Psychoendocrinology Department of the Palatinate Psychiatric Clinic) made her appearance and was asked to talk about her department’s early experiences with the treatment.
At one point, Dr Laschet made a remark that caused me do a double-take: “Around a third of the 80 patients undergoing medication treatment came to outpatient care due to marriage difficulties—Don-Juanism.”1 Don-Juanism? Surely that was a colloquial expression at the time, I thought, although I still wasn’t entirely sure what she meant by this. Moreover, these male patients were voluntarily undergoing what was commonly referred to as “chemical castration” to deal with their “Don-Juanism.”
Then, a few pages later, Dr Werner Krause, a Professor and Researcher at the Institute for Sexual Research at the University of Hamburg, joined the conversation to make a point. He insisted it was important to distinguish those who are sexually “addicted” but do not get in trouble with the law from those whose sexual addictions lead them to commit crimes: “Don-Juanism and promiscuity are not the same thing,” he noted. “From our perspective, Don Juan was ill; Casanova was simply promiscuous.”1 There it was again, this Don-Juanism, used by a second prominent researcher and, this time, associated with addiction.
This piqued my curiosity: I was going to have to do a little digging. A quick google search of Don-Juanism in German led to results on “womanizing” and the study of Don Juan in literature and the arts. However, another definition appeared—male hypersexuality—as well as a citation in a work by the psychoanalyst Alfred Adler from 1920.
Wikipedia and chat forums not being what I would consider the most reliable sources of information, I turned to some standard historical databases. A picture began to emerge. Often talked about in the same breath with nymphomania and erotomania, Don-Juanism, or Don Juan syndrome, was indeed a recognized diagnosis that referred to forms of male hypersexuality. In history, it was most commonly known as satyriasis.
Satyriasis and other terms
Now I am guessing that specialists in the field or seasoned clinicians knew much or some of this already. But it did get me wondering. What was satyriasis and what relationship does it have to contemporary notions of sex addiction and hypersexual disorder? A closer look reveals some striking continuities with, but also some important divergences from, our more contemporary ideas on the subject.
In the early 19th century, French and English physicians seem to have led the way in the study and classification of the disorder. Like the Frenchman Duprest-Rony, they frequently linked the disorder to the vice of self-abuse and believed it could lead to impairments in both intellect and memory.2 As the physician Michael Ryan put it in 1839:
Satyriasis and nymphomania are diseases in which the sufferers evince an irresistible desire for copulation, as well as abuse of the reproductive functions. The first disease attacks the male, the second the female. M. Deslandes is of opinion, and I fully agree with him, that there is no real difference between these diseases and unbridled masturbation; and that both ought to be considered species of insanity.3
The London Medical and Physical Journal in 1833 reported on a case that clearly resonated with doctors at the time, as the case history found its way into numerous journals and books on the subject throughout the 1830s. It involved a 55-year-old man “of mild manners, of peacable character, and of great devotion”4 who fell down and struck his head on a bedpost. This led to a remarkable change in his behavior:
He is seized with a violent and continued satyriasis, and with such salacity, that he pursued beyond measure his wife, his daughters, and all those females who came in his way. This man, formerly so pious, so modest, fell into the most erotic delirium, and abandoned himself without measure to proposals and acts the most indecent. This state increased for about three months, during which time his mind and strength became weakened; when, following a violent passion, which was occasioned by the refusal of his wife lassato viro et satiate, he fell into a convulsion . . .4
Far from being a modern construct, however, the diagnosis of satyriasis dates back to ancient times. While 19th-century bourgeois physicians appear to have been most struck by the satyriac’s unbridled lustfulness, their ancient counterparts were also drawn to what they took to be the physical indicator of the disease—priapism. Soranus, students of Galen, and the Glossae Medicinales all considered these conditions related, attributing them to poor nutrition, immoderate sexual habits, and the abuse of intoxicants. According to Rufus of Ephesus (1st century CE), treatments included avoiding erotic thoughts, dreams, and conversations as well as bloodletting, a strict diet, and cold and hot baths.5
While the clinical picture of satyriasis remained fairly consistent throughout history, its purported causes changed with the times, often following the latest scientific fads. In the 1820s, for instance, proponents of phrenology localized the disorder in the brain rather than sex organs.6 During the second half of the 19th and the early 20th centuries, many considered satyriasis as well as other sexual disorders manifestations of a hereditary degeneration of the nervous system.7 This persuaded one German writer in 1921 to blame the rampant anxieties and fears accompanying the First World War for the apparent rise in the incidence of satyriasis and other sexual “perversions.”8
If satyriasis has long been a part of Western society, it must also be recognized that so, too, has been the social license given males to assertively express their sexual desires. In 1968, Werner Krause may have felt confident in his ability to differentiate between Don Juans and Casanovas, but many today appear to be far less sanguine. Given the fact that “views on the rational, emotional, and ethical boundaries of love and sex change pari passu with whatever image of man happens to be in fashion,”7 perhaps it not altogether surprising that there has been lack of a clear consensus over the proposed inclusion of “hypersexual disorder” in the DSM-5.