Early attention to the brain, specifically in relation to orgasm rather than broader questions of sexuality and biological sex, was significantly driven by research concerning epilepsy. Yet another instance of Canguilhem’s argument that “the scientific study of pathological cases becomes an indispensable phase in the overall search for the laws of the normal state,” the experiences of individuals with epilepsy fascinated researchers who hoped to understand the biological bases of sexual functioning and remains a robust field of inquiry. Indeed, Komisaruk et al., in their recent book The Science of Orgasm claim, “Much of what is known about how the brain produces orgasms is based on studies of epileptic seizures.”
What is the connection between epilepsy and sexual functioning and how did epilepsy research come to play such a pivotal role in research on sexual functioning? Epilepsy’s role in research concerning the relationship between the brain and orgasm is a direct result of the wide berth given researchers to radically manipulate epileptics using invasive techniques. In other words, given the degree of stigmatization epileptics experienced and the infancy of ethical standards in scientific research during the early and mid-twentieth century, scientists were given tremendous freedom to conduct highly invasive experimentation on epileptics, experimentation that would have been unacceptable on subjects deemed “normal.” Scientific attention to the relationship between epilepsy and sexual functioning was piqued as a result of perceived “abnormal” sexual behavior by individuals classified as epileptic, sexual behavioral changes in epileptics following brain surgery, and the sexual effects of brain surgery performed on animals.
The relationship between epilepsy and sexual aberrations became a subject of interest in the 19th and early 20th century. A 1907 text on epilepsy, for example, claimed that “various bizarre and criminal actions, more particularly with reference to sexual perversions” were a “psychical epileptic equivalent.”
Attention to the relationship between the brain and sexual functioning was also piqued by observations of epileptics post-surgical intervention. Research on animals helped encourage attention to the effects of removing various parts of the brain. Klüver and Bucy (1939) found, in addition to a wide range of effects, that rhesus monkeys demonstrated marked hypersexuality following bilateral temporal lobectomy, suggesting the influential role of the temporal lobes in sexual function. Several studies reported individual instances of hypersexuality following lobectomy in human male subjects in the 1950s. For example, Terzian and Dalle Ore (1955) reported hypersexuality, exhibitionism, and homosexual behavior following bilateral temporal lobectomy. The association between changes in sexual behavior and lobectomy is evident in Levine and Albert’s 1951 article, “The question is frequently asked, particularly by patients’ families, if prefrontal lobotomy will result in impulsive, unpredictable sexual behavior” suggesting that this association had reached mainstream culture. This is not surprising given Freeman and Watt’s (1950) advice to wives of husbands who have undergone brain surgery and are noticeably more hypersexual:
Physical self-defense is probably the best tactic for the woman. Her husband may have regressed to the cave-man level, and she owes it to him to be responsive at the cave-woman level. It may not be agreeable at first, but she will soon find it exhilarating if unconventional.
Thus, the widespread acceptance of radical surgical intervention into epilepsy provided researchers an opportunity to observe and collect data on the role of various brain structures by noting behavioral changes in individuals after having undergone surgery.
Most published accounts of the effects of lobectomy on epileptics were limited to individual or small numbers of cases. Lobectomy, however, was not only invasive intervention widely acceptable as a treatment for epilepsy; stimulation of the brain was also a common treatment. In a 1972 article “Pleasure and Brain Activity in Man,” published in the Journal of Nervous and Mental Disease, Dr. Robert Heath provides detailed accounts of electrode and chemical stimulation of the brain in two epileptic patients. The patients were admitted to the Tulane Department of Psychiatry and Neurology, a program developed in 1950 focusing on “implanting electrodes into predetermined deep brain sites of patients with intractable behavioral and neurological illnesses.” The program, now notorious for its highly invasive procedures on patients and for its Cold War-era CIA connections, originally focused on schizophrenia but quickly began experimentation on persons with a wide range of illnesses. The implantation of electrodes in patients allowed researchers the ability to examine, not only behavioral and neurological illness, but also use these test subjects as a means to investigate the function of the brain more generally.
As the article’s title suggests, Heath’s focus in this particular report is on the relationship between pleasure and the brain, specifically where in the brain pleasure is located. Several animal studies influenced researcher’s focus on pleasure sites in the brain, including James Olds and Peter Milner’s 1954 study that found that rats would self-stimulate electrodes in the septal region of the brain upwards of 2,000 times an hour to produce a pleasurable sensation. Also, using electrodes implanted in monkeys, John Lilly found, “Given the apparatus by which he could stimulate himself once every three minutes for twenty-four hours a day, the monkey stimulated the site and had orgasms every three minutes for sixteen hours and then slept eight hours and started again the next day,” effectively “produc[ing] virtually continuous orgasms.” The influence of animal studies on Heath’s work is direct, as he states clearly that the “the design of [the self-stimulating transistorized device] was based on the technique introduced by Olds and Milner in 1954 to demonstrate the pleasure response in animals.” Old and Milner’s techniques were “incorporated and modified by the Tulane researchers in human studies, enabling them to extend their scope to man.” With Old and Milner’s technique, and subsequent developments by Olds, “the need to depend largely upon verbal reports of the subjective response was eliminated” as direct brain activity could be measured with electrodes.
In an earlier study published in 1964, Heath’s team found that, in 54 patients with a variety of mental and nervous disorders, pleasurable feelings and a degree of sexual response was consistently elicited with stimulation. The experimentation at Tulane provided a wealth of data for researchers to cull through and synthesize, generating a tremendous wave of publications covering a broad array of issues. The experimentation performed on the two patients described in the 1972 publication was separated by almost a decade and provides an in-depth analysis of two patients. The first patient, “Patient B-5” (as she is referred to throughout the article), is a woman 34 years of age with “psychomotor and grand mal epilepsy” and “borderline defective intelligence.” Over the course of 1960 and 1961, Heath’s team implanted electrodes in the deep tissues of patient B-5’s brain and administered dosages of “acetylcholine and levarterenol bitartrate through the intracerebral cannulas implanted into the septal region.” In response to the introduction of these chemicals, Heath reports “development of a sexual motive state and in most instances, within another 5 to 10 minutes, this culminated in repetitive orgasms,” confirmed by the patient as well as “her sensuous appearance and movements.” The relationship between the septal region of the brain and orgasmic sensations had already been reported by Heath’s team at Tulane, detailing a case in 1963 of a patient who repeatedly stimulated the septal region because the “feeling was ‘good’; it was as if he were building up to a sexual orgasm.”
The other patient described in the article, “Patient B-19,” is a 24-year old man with temporal lobe epilepsy and a “5-year history of overt homosexuality and a 3-year history of drug abuse” and “chronic depression, characterized by inability to experience pleasure.” In 1970, “Electrodes were stereotaxically implanted into a variety of deep sites and over the cortex of the brain.” During the first phase of research, patient B-19 “responded with pleasure only when electrical stimulation was applied [by the researcher] to the septal region, responses to stimuli to other sites being neutral or adversive.” A subsequent phase of research allowed patient B-19 to self-stimulate himself using a device with three buttons corresponding to different electrodes placed at deep sites of the brain. Each push of a button was recorded by a counter and a 1 second stimulus was delivered to the patient. As Heath explains, “The patient was permitted to wear the device for 3 hours at a time: on one occasion he stimulated his septal region 1,200 times, on another occasion 1,500 times, and on a third occasion 900 times. He protested each time the unit was taken from him, pleading to self-stimulate just a few more times.” The patient reported “feelings of sexual arousal and described a compulsion to masturbate” with self-stimulation to the septal region. In addition to generalized research into pleasure areas of the brain, “One aspect of the total treatment program for this patient was to explore the possibility of altering his sexual orientation through electrical stimulation of pleasure sites in the brain.” As Heath and his colleague Charles Moan remark in another article, “considerable interest has…fastened on the fact that a pleasurable response can be induced by direct activation of the brain and raised hopes that this might be applied to the treatment of disordered human behavior.”
Prior to the beginning of stimulation experiments, patient B-19 was shown 8-mm silent stag reels featuring heterosexual intercourse to which he reportedly responded with revulsion. After a series of stimulation experiments, both administered by the researchers and through self-stimulation described above, the patient was again shown the stag film to which “he became increasingly aroused, had an erection, and masturbated to orgasm.” Heath’s team obtained EEG readings during the film showing and the results are discussed in detail. After the film screenings:
The patient’s conversation was preoccupied with sex; a continually growing interest in women culminated in his expressed wish for heterosexual activity. A twenty-one-year-old female prostitute agreed, after being told the circumstances, to spend time with the patient in a specially prepared laboratory…EEG’s were obtained throughout his relationship with her. He reported, and she later verified in her account of the experience, that as he started to be aroused, he felt the need to confess his homosexuality and generally presented himself negatively, seemingly as a defense against progressing further. During this phase, which lasted about 20 minutes, she continually reassured him. Later, the patient began active participation and achieved successful penetration, which culminated in a highly satisfactory orgiastic response, despite the milieu and the encumbrances of the lead wires to the electrodes.
Heath and Moan report that since the studies were conducted, despite two sexual encounters with men “when he needed money,” the patient had a “close sexual relationship with a married woman for almost 10 months” and “indicates he is definitely motivated to continue” pursuing sexual relationships with women. The authors argues that “the success reported points toward future effective use of septal activation for reinforcing desired behavior and extinguishing undesired behavior.” 
Heath’s report on both patients is important to the scientific history of orgasm as he was able to obtain EEG readings during visually-induced arousal, masturbation-induced orgasm, and heterosexual intercourse. He provides extensive description and charts of the EEG readings corresponding to various levels of arousal, suggesting that the research “has helped to demarcate the pleasure areas of the human brain (the medial forebrain bundle and interpeduncular nuclei of the mesencephalon), roughly corresponding to pleasure areas of brains of animals.” Given the highly problematic acceptance of invasive brain procedures on individuals with mental and nervous disorders still prevalent at the time, research on epileptics provided scientists interested in brain correlates of sexual arousal and orgasm with a wealth of data.
Research on epilepsy, conducted by Heath and others, also pointed to corollaries between epileptic seizures and orgasm that fascinated researchers. While Heath is quick to point out differences, he does devote discussion to the “seemingly similar recordings…obtained from the septal region in association with the dysphoric, psychotic state, and the intensely pleasurable orgastic state.” Several research studies documented genital sensations, sexual arousal, and even ejaculation in individuals preceding, during, and following seizures. Kennedy (1959), Bancoud (1971), Warneke (1976), and Remillard et al. (1983) reported instances in which sexual arousal and/or orgasm or orgasm-like sensations were associated with seizure. Several studies also reported sexual automatisms during seizure that the patients subsequently did not recall, including making sexual statements, masturbation, simulated intercourse, and exhibitionism.
Research on epilepsy was also used to speculate on differences between male and female brains as well as sexual deviancy. Based on his findings and the finding of others, Remillard et al. argue, “The increased incidence of erotic ictal manifestations in women, as opposed to the more common occurrence of nonerotic ictal genital sensations in men, suggests that the neural organization of psychosexual behavior differs in human male and female brains.” Thus, research on epileptic seizures is used as an indication of sexual dimorphism of the human brain with respect to sexual arousal. Quite a few studies also examined associations between male temporal lobe epileptics and “sexual deviancy,” including transvestitism, pedophilia, homosexuality, fetishism, and sadism. Hunter et al., in their 1963 article claimed, “Since the days of Hippocrates sexual disturbances have been linked with epileptic convulsions in the relation of cause and effect.” According to Hunter et al., “The last decade has seen as upsurge of interest in [sexual perversions in epileptics], especially in relation to temporal lobe epilepsy, because of their possible relief by surgery.” This observation is borne out by numerous publications devoted to sexual perversions in epileptics in the mid-twentieth century. Threaded across these discussions is the implicit, and at times, quite explicit, suggestion that sexual perversions, particularly transvestism, are caused by damage to the brain—leading some researchers to wonder whether all cases of sexual deviancy are caused by as yet unrecognized brain damage or disease. As Hunter et al. suggest, attention to what were considered sexual abnormalities was heightened by the possibility that surgery may act as a curative. Blumer (1970), based on research conducted with 50 temporal lobe epileptics, found that a lobectomy could resolve hyposexuality (lack of libidinal and genital arousal) commonly associated with temporal lobe epilepsy, arguing that “these findings document the role of the temporal limbic structure in the regulation of sexual arousal.” As noted earlier, however, published accounts of the effects of invasive procedures were more likely to report causing sexual disturbances, rather than curing them.
 Komisaruk et al., The Science of Orgasm, 214.
 Quoted in R. Hunter et al., “Temporal Lobe Epilepsy Supervening on Longstanding Transvestism and Fetishism,” 60.
 See Heinrich Klüver and Paul C. Bucy, “Prelimary Analysis of Function of the Temporal Lobes in Monkeys.,” Archives of Neurology and Psychiatry 42.6 (Dec 1939): 979-1000. The effects Klüver and Bucy documented became known as Klüver Bucy Syndrome. Other symptoms, in addition to hypersexuality, include visual agnosia, hyperorality, hypermetamorphosis, and emotional changes.
 See Hill et al. (1957) and Terzian (1958).
 Terzian and Dalle Ore, “Sydrome of Klüver and Bucy reproduced in man by bilateral removal of temporal lobes,” 373-380.
 Julius Levine and Harold Albert, “Sexual Behavior After Lobotomy,” The Journal of Nervous and Mental Disease 113.4 (April 1951), 332. The authors, in their study, found little evidence supporting the association between hypersexuality/sexual deviancy and frontal lobotomy. Nonetheless, they seemed sympathetic to this cultural association and their language is interesting in this regard, “Any therapeutic procedure which involves a destructive attack on the higher association areas inevitably raises the problem that the ethical, more or religious behavior may be impaired; and in so far as it is generally believed that the cortex acts to modify and inhibit the more primitive urges, it may be expected that lobotomy will blunt man’s finer sensibilities.”
 Quoted in Komisaruk et al, The Science of Orgasm, 244.
 Heath, “Correlation of Brain Activity with Emotion: A Basis for Developing Treatment of Violent-Aggressive Behavior.”,” Journal of American Academy of Psychoanalysis 20 (1992): 335-346.
 For more on the program’s CIA connections, see Mohr and Gordon’s Tulane: The Emergence of a Modern University, 1945-1980. For broader discussions of connections between psychological research and the CIA, including Tulane, see Harvey M. Weinstein, Psychiatry and the CIA: Victims of Mind Control (Washington, D.C.: American Psychiatric Press, 1990); John Marks, The Search for the "Manchurian Candidate": The CIA and Mind Control (New York: Times Books, 1979); and George Andrews, mkULTRA: The CIA’s Top Secret Program in Human Experimentation and Behavior Modification.
 Lilly, The Scientist, 90.
 Mohr and Gordon, Tulane: The Emergence of a Modern University, 1945-1980, 122.
 Heath, “Pleasure and Brain Activity in Man,” The Journal of Nervous and Mental Disease 154.1 (1972), 6.
 Moan and Heath, “Septal stimulation for the initiation of heterosexual behavior in a homosexual male,” 23.
 Heath, “Electrical Self-Stimulation of the Brain in Man,” 571.
 See Heath, “Pleasure Response of Human Subjects to Direct Stimulation of the Brain: Physiologic and psychodynamic considerations,”,” in The Role of Pleasure in Behavior, Ed. Heath, New York: Harper & Row, 1964: 219-43.
 Heath, “Pleasure and Brain Activity in Man,” 12.
 Heath, “Electrical Self-Stimulation of the Brain in Man,” 573.
 Heath, “Pleasure and Brain Activity in Man,” 4.
 Ibid, 5.
 Ibid, 6.
 Moan and Heath, 23.
 Heath, “Pleasure and Brain Activity in Man,” 7.
 Ibid, 9.
 Moan and Heath, 29.
 Heath, “Pleasure and Brain Activity in Man,” 17.
 Ibid, 16.
 See Hooshmand and Brawley (1969), Freemon and Nevis (1969), and Currier et al. (1971).
 Remillard et al., “Sexual Ictal Manifestations Predominate in Women with Temporal Lobe Epilepsy: A Finding Suggesting Sexual Dimorphism in the Human Brain,” Neurology 33 (March 1983), 329.
 Hunter et al., 60.
 Hunter et alIbid., 60.
 For examples, see Blumer (1967); Davies and Morgenstern (1960); Epstein (1961); Erickson (1945); Hooshmand (1969); Hunter et al. (1963); Kolarsky et al. (1967); Mitchell et al. (1954); Taylor (1969).
 Blumer, “Hypersexual Episodes in Temporal Lobe Epilepsy,” 1105. Savard and Walker (1965) and Falconer et al. (1955) are examples of research claiming hyposexuality is resolved after lobectomy.