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From the liner notes

From the writer of Caliber 9 and The Italian Connection comes Madness starring Joe Dallesandro, a story about how a violent criminal, Joe Brezzi, breaks out of prison and, having stolen a car and killed two people in the process, makes his way to a remote country cottage. Hidden beneath its flooring is the substantial proceedsfrom a robbery which Joe took part in several years previously, but before he can retrieve the loot a vehicle pulls up outside. Womanizer Sergio has traveled up to his weekend retreatto do some hunting, joining him are his trusting wife Liliana and her flirty sister Paola who has also come along for a break from city life. The escaped convict flees the cottage and quietly observes the sexual tension between Sergio and Paolo, which Liliana is completely oblivious to. Joe bides his time and waits until the next morning when Sergio leaves to go hunting and Liliana takes the car to get some supplies from town. With only Paola in the cottage, he makes his move.