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Introduction
Clitoridectomy: A Nineteenth Century Answer to Masturbation ~ by John Duffy

In the early 19th century perceptive physicians were becoming increasingly dubious of the traditional medical theories and began turning to clinical experience. Unfortunately, lacking an understanding of physiology and with no knowledge of bacteriology, they were frustrated in their attempts to prevent or cure disease. In desperation, physicians intensified their use of the traditional therapeutics--bleeding, blistering, vomiting, purging and sweating, heroic therapy which only served to increase public suspicion of the profession. Seeking to compensate for their inability to deal with disease, physicians increasingly began assuming the role of moral leaders. In the process they seized upon issues such as abortion and masturbation.

The prudishness of Victorians and veil of silence they cast over sexuality is well known, but what is not so well known is their preoccupation with masturbation. Little attention had been given to masturbation until late in the 18th century, and it was not until the second half of the 19th century that the subject became one of general concern. It first came to public attention through the efforts of a few moralists, but it was not until the medical profession, seeking to bolster its status in society, transformed the moral question of masturbation into a medical condition that it became a significant issue.

In the case of males, the apprehensions about masturbation were engendered by a widespread assumption that the loss of semen endangered the brain and nervous system. In America the superintendent of the Massachusetts Lunatic Asylum gave credence to this belief when in his 1848 annual report he asserted that 32 per cent of admissions were for "self-pollution", one of several euphemisms for masturbation. Reflecting in part the Victorian preoccupation with sexuality, by the late 19th century medical journals in Europe and America were attributing almost every conceivable medical condition to this "secret vice."

Since loss of semen was considered a real danger to males, then it followed that nocturnal emissions were equally hazardous. To solve both of these problems, a whole array of mechanical devices were constructed. They included such items as strait jackets, genital cages, and penis rings with sharp points on the inside. Most of these objects were devised by laymen, but the medical profession, which has generally reflected prevailing beliefs, was not to be outdone. Young men driven by guilt who sought a physician’s help, or who confessed to masturbation under close questioning by their physician, were treated with blistering agents, mild acid solutions, or leeches applied to the genitals. Bloodletting and cutting the foreskin were also used in serious cases. In at least one extreme case, at the request of a desperate patient who feared for his sanity, his physician castrated him. The physician in his report of the case declared that the patient was gaining weight, somewhat lethargic, but morally sound.

Reprehensible as was masturbation among males, it was an even graver problem among Victorian females, who were viewed as delicate, sensitive, frail, and emotional creatures. In response to an article in a local paper urging the medical regulation of prostitutes, the editor of the New Orleans Medical and Surgical Journal began by pointing out that the morality of American women was much higher than that of women in other countries. Most prostitutes in New Orleans, he observed, were foreigners. Having settled this point, he turned to "onanism" or masturbation, a practice "very injudicious to the health of both males and females." Men, he wrote, occasionally admitted to it, but the case with women was far different.

To ask for or expect information from adult females about this practice, he wrote, "is altogether useless and vain, although many of their diseases, as leucorrhoea, uterine haemorrhage, falling of the womb, cancer, functional disorders of the heart, spinal irritation, palpitation, hysteria, convulsions, haggard features, emaciation, debility, mania--many symptoms called nervous--un triste tableau, have been referred to masturbation as the cause." Even if these disorders did not originate in masturbation, he continued, "its practice would certainly aggravate them." The editorial concluded with a quote from a French physician: "In my opinion, neither the plague, nor war, nor smallpox, nor a crowd of similar evils have resulted more disastrously for humanity, then the habit of masturbation: it is the destroying element of civilized society."2

In 1866 an American medical journal discussed the work of a British physician, Dr. Isaac Brown Baker, who claimed success in treating epilepsy and other nervous disorders in female patients- by excising the clitoris. After noting that the great mass of English medical opinion was strongly opposed to Baker's ideas and had "unqualifiedly condemned" his operation, the American editor concurred with the English medical profession, declaring that to remove the clitoris "to allay sexual irritability is about as unphilosophical as to remove the analogous organ of the male." (4)

While the clitoridectomy was only rarely performed in the English-speaking nations, the subject of female masturbation continued to intrigue the public and the medical profession. As the century drew on, more articles on the subject began appearing in medical journals and the clitoridectomy was revived. In 1889, Dr. Joseph Jones, a former president of the Louisiana State Board of Health and a medical professor, stated that "hopeless insanity" was one of the many consequences of masturbation and that the child of a masturbator was liable to hereditary insanity.(8).

In 1894, Dr A.J. Bloch of New Orleans in an article entitled "Sexual Perversion in the Female" referred to female masturbation as a "moral leprosy." In one of his cases, he described how a schoolgirl of fourteen suffering from nervousness and pallor had been cured by "liberating the clitoris from its adhesions and by lecturing the patient on the dangers of masturbation.( 10).

As far as can be ascertained, Dr. Bloch was one of the last American surgeons to report taking such drastic measures. By this date medical studies were beginning to demonstrate that masturbation caused no serious functional disturbances and that the psychological problems involved arose from the social attitude towards the practice rather than the act itself. As these ideas gained medical acceptance during the next thirty years, the subject of masturbation in normal individuals gradually disappeared from medical journals.

BIOGRAPHICAL NOTE: John Duffy, Ph.D. is Clinical Professor Emeritus1 Tulane University School of Medicine and Professor Emeritus of History, University of Maryland. Dr. Duffy is a medical historian with some 9 published books and 50 articles. His newest book is The Sanitarians: A History of American Public Health. University of Illinois Press to be released in February 1990.

    1. Haller, John S. and Robin M., The Physician and Sexuality in Victorian America, Urbana, Chicago, and London, 1974, pp.195, 207-209.
    2. Editorial: Review of European Legislation for Control of Prostitution, New Orleans Med Surg J 11:700-705, 1854-1855.
    3. Castellanos, J.: Summary Prepared from French Journals, South J Med Sci 1:495-96, 1866-1867.
    4. Editorial: Clitoridectomy, South J Med Sci 1:794, 1866-1867.
    5. West, D.C,: Clitoridectomy, Brit Med J 2:585, 1866.
    6. Down J., and Langden, H.: Influence of Sewing Machine on Female Health, New Orleans Med Surg J 20:359-360, 1867-1868.
    7. Comment: New Orleans Med Surg J (new series) 9:67, 1881-1882.
    8. Jones, J.: General Medicine--Diseases of Nervous System, Trans La Med Soc 1889, pp. 170-171.
    9. Tait, L.: Masturbation, Med News 53:1-3, 1888.
    10. Block, A.J.: Sexual Perversion in Female, New Orleans Med Surg J (new series) 22:1-7, 1894-1895.
    11. Duffy, J. Masturbation and Clitoridectomy. The Journal of The American Medical Association. October 19, 1963, Vol. 186, pp. 246-248.

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