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The Benefits of Psychological Surgery: John Scoffern's Satire on Isaac Baker Brown

Published online by Cambridge University Press:  17 May 2012

Robert Darby
Robert Darby
Affiliation:
15 Morehead Street, Curtin, ACT 2605, Australia; e-mail: [email protected]
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Information
Medical History , Volume 51 , Issue 4 , 01 October 2007 , pp. 527 - 544
Copyright
Copyright © The Author(s) 2007. Published by Cambridge University Press

References

1 Ann Dally, Women under the knife: a history of surgery, New York, Routledge, 1991, pp. 157–9.

2 J B Fleming, ‘Clitoridectomy: the disastrous downfall of Isaac Baker Brown FRCS (1867)’, J. Obstet. Gynaecol. Br. Emp., 1960, 67: 1017–34; Andrew Scull and Diane Favreau, ‘“A chance to cut is a chance to cure”: sexual surgery for psychosis in three nineteenth century societies’, Research in Law, Deviance and Social Control, 1986, 8: 3–39; Elizabeth A Sheehan, ‘Victorian clitoridectomy: Isaac Baker Brown and his harmless operative procedure’, in Roger N Lancaster and Micaela di Leonardo (eds), The gender/sexuality reader: culture, history, political economy, London, Routledge, 1997, pp. 325–34.

3 Roy Porter and Lesley Hall, The facts of life: the creation of sexual knowledge in Britain, 1650–1950, New Haven, Yale University Press, 1995, pp. 147–8.

4 In the USA Brown's ruin was deplored as a grave setback for scientific medicine. The Medical Record attacked the anti-clitoridectomy movement in Britain as emotional and unscientific and asked, ‘What now will be the chance of recovery for the poor epileptic female with a clitoris?’, cited in Frederick Hodges, ‘A short history of the institutionalization of involuntary sexual mutilation in the United States’, in George C Denniston and Marilyn Fayre Milos (eds), Sexual mutilations: a human tragedy, New York, Plenum Press, 1997, p. 21. A number of American authorities recommended routine removal of the clitoral hood as an aid to hygiene and chastity; see Robert T Morris, ‘Is evolution trying to do away with the clitoris?’, Transactions of the American Association of Obstetricians and Gynecologists, 1892, 5: 288–302, and Belle C Eskridge, ‘Why not circumcise the girl as well as the boy?’, Tex. State J. Med., 1918, 14: 17–19. Even in recent times there are cases of girls being subjected to trimming operations in the interests of parental concepts of genital normality; for a disturbing personal account, see Patricia Robinett, The rape of innocence: one woman's story of female genital mutilation in the U.S.A., Eugene, OR, Aesculapius Press, 2006. Brown's theories had a late blooming in the determination of Dr Henry Cotton to treat mental patients by removing points of “focal sepsis”, meaning mass extraction of teeth, colons and other internal organs. See Andrew Scull, Madhouse: a tragic tale of megalomania and modern medicine, New Haven, Yale University Press, 2005.

5 Ornella Moscucci, ‘Clitoridectomy, circumcision, and the politics of sexual pleasure in mid-Victorian Britain’, in Andrew H Miller and James Eli Adams (eds), Sexualities in Victorian Britain, Bloomington, Indiana University Press, 1996, pp. 60–78; Robert Darby, A surgical temptation: the demonization of the foreskin and the rise of circumcision in Britain, University of Chicago Press, 2005, ch. 7.

6 Robert Van Howe, J Steven Svoboda and Frederick M Hodges, ‘HIV infection and circumcision: cutting through the hyperbole’, J. R. Soc. Promotion Health, 2005, 125: 259–65.

7 The Aldersgate (Street) school of medicine was established in 1825, one of several private medical schools which arose during the period when the apprenticeship model of medical education was losing favour but before the hospitals had taken on the major teaching role. The school flourished in the 1830s, posing a serious challenge to St Bartholomew's Hospital across the road, but declined in the 1840s as Barts and other London hospitals expanded their educational offerings. Among its distinguished teachers were Jones Quain, author of a standard nineteenth-century anatomy text, who left for University College in 1831, and John Snow (of cholera fame) from 1846 until the school's demise in 1849. Snow thought sufficiently highly of his appointment to describe himself as “Lecturer in forensic medicine at the Medical School, Aldersgate Street” in several papers published in the late 1840s. Information from Zachary Cope, ‘The private medical schools of London (1746–1914)’, in F N L Poynter (ed.), The evolution of medical education in Britain, London, Pitman Medical, 1966, pp. 89–109, on pp. 99–102; Peter Vinten-Johansen, et al., Cholera, chloroform and the science of medicine: a life of John Snow, New York, Oxford University Press, 2003, pp. 59, 62, 64, 100–1. A map showing the location of the Aldersgate and other medical schools was published in the Lancet, 24 Sept. 1834.

8 Frederic Boase, Modern English biography, 3 vols, London, Frank Cass, 1965, vol. 3, p. 445.

9 Lancet, 1842–43, ii: 926–7.

10 Vinten-Johansen, et al., op. cit., note 7 above, p. 100.

11 John Scoffern, ‘Case of poisoning by sulphuric acid’, Lond. Med. Gaz., 1842, 2 (NS): 352–4.

12 Diana Dixon, ‘Children's magazines and science in the nineteenth century’, Vic. Period. Rev., 2001, 34: 228–38.

13 Adrian Desmond, The politics of evolution: morphology, medicine and reform in radical London, University of Chicago Press, 1989, p. 8.

14 Ibid., p. 164.

15 Ibid., p. 13.

16 Wellesley index to Victorian periodicals, 5 vols, University of Toronto Press, 1966–1989, vol. 4, pp. 194, 206.

17 Ibid., vol. 3, pp. 386–7.

18 John Scoffern, Stray leaves of science and folk-lore, London, Tinsley Brothers, 1870. A facsimile was reprinted by Kessinger Publishing in 2006.

19 First published as Das Leben Jesu kritisch bearbeitet in 1835–6, English translation by George Eliot published in London in 1846.

20 Oxford Dictionary of National Biography, Oxford University Press, 2004, vol. 52, pp. 191–8; John Vincent (ed.), A selection from the diaries of Edward Henry Stanley, 15th Earl of Derby (1826–93), between September 1869 and March 1878, London, Royal Historical Society, 1994, Introduction, pp. 11–12; diary entry, 18 Aug. 1875, pp. 238–9.

21 Scoffern, op. cit., note 18 above, ‘The Suffolk witches’, p. 485.

22 Ibid., ‘Preadamite man’, pp. 130–1.

23 Ibid., ‘Modern mysticism and modern science’, p. 282.

24 Ibid., p. 286.

25 Ibid., ‘Popular science’, p. 1.

26 Ibid., ‘Modern mysticism and modern science’, p. 286.

27 Robert M Young, Darwin's metaphor: nature's place in Victorian culture, Cambridge University Press, 1985, p. 16.

28 Scoffern, op. cit., note 18 above, ‘Modern mysticism and modern science’, p. 279.

29 Lancet, 9 Oct. 1847, ii: 392.

30 London, published by the author. I am grateful to Hera Cook for making a photocopy of the copy held by the British Library. There is also a copy in the State Library of Victoria, possibly deposited by Baker Brown's son, who settled in the colonies.

31 ‘The system of English medical legislation explained to a Polynesian physician’, Lancet, 1830–31, ii: 665–7; Desmond, op. cit., note 13 above, p. 254.

32 Dally, op. cit., note 1 above, p. 157.

33 Scull, op. cit., note 4 above, passim.

34 Jonathan Hutchinson, ‘On circumcision as a preventive of masturbation’, Arch. Surg., 1890, 2: 267–9; Edgar Spratling, ‘Masturbation in the adult’, Med. Rec., 1895, 48: 442–3.

35 Brown, ‘Replies to the remarks of the council’, cited in ‘Clitoridectomy and medical ethics’, Med. Times Gaz., 13 April 1867, p. 391, note (a). Brown insisted that “clitoridectomy is neither more nor less than circumcision of the female; and as certainly as that no man who has been circumcised has been injured in his natural functions, so it is equally certain that no woman who has undergone the operation of excision of the clitoris has lost one particle of the natural functions of her organs”. Whatever doubts there may be about his anatomical comparisons, Brown was at least consistent: so long as a male or female remained capable of impregnating or conceiving, neither had been mutilated by either circumcision or clitoridectomy. For an extended discussion, see Darby, op. cit., note 5 above, ch. 7.

36 For recent discussions, see Christine Mason, ‘Exorcising excision: medico-legal issues arising from male and female genital surgery in Australia’, J. Law Med., 2001, 9: 58–67; Kirsten Bell, ‘Genital cutting and western discourses on sexuality’, Med. Anthropol. Q., 2005, 19: 125–48.

37 The exact passage is as follows: “And if thy right eye offend thee, pluck it out, and cast it from thee: for it is profitable for thee that one of thy members should perish, and not that thy whole body should be cast into hell. And if thy right hand offend thee, cut it off, and cast it from thee: for it is profitable for thee that one of thy members should perish, and not that thy whole body should be cast into hell” (Matthew 5: 29–30). The same sinister verses were quoted, also inaccurately, by Dr William Pratt in yet another Victorian tirade against masturbation and other sexual indulgence on the part of young men: “Flee, therefore, this youthful lust. In the name of religion, in the name of soul and body, I ask you to avoid it. … Relinquished it is to be … though the effort be as painful as the cutting off a right hand, or the plucking out a right eye. Again, the greatest teacher has spoken these stern words: ‘If thy right hand offend thee, cut it off, or if thy right eye offend thee, pluck it out; it is better to enter into life halt or maimed, than having two eyes or two hands to be cast into hell fire’”—A physician's sermon to young men, London, Baillière, Tindall, & Cox, 1872, p. 13. Ironically, the sermon in which Jesus utters these words is the one in which he declares, “Blessed are the merciful: for they shall obtain mercy.”

38 Places where both male and female circumcision were known to be practised.

39 A reference to the praise for Baker Brown's initiative in the (Anglican) Church Times, which greeted the book with glowing enthusiasm for offering “a remedy for some of the most distressing cases of illness which [the clergy] discover among their parishioners”; it reported that Mr Brown had discovered “a surgical remedy for certain forms of epilepsy” and related problems, and commented that readers would be doing a service “especially to their poorer parishioners” if they brought potential patients to the attention of medical men, “any of whom can … perform the operation with but slight assistance” (Br. med. J., 28 April 1866, i: 456). It is unlikely that the editor of the Church Times had even seen Baker Brown's book, let alone visited his surgery, and probable that he was relying solely on an advertisement put out by the publicity-conscious author.

* An act that if done by common people is called theft. Theft and kleptomania have sometimes been confounded by superficial thinkers, yet the difference between the two is obvious. Kleptomania partakes more of the nature of disease than of crime. Theft is crime pur sang. Kleptomania always affects the rich and well-to-do people (mostly ladies of refinement and education). Theft only relates to the low, the vulgar, and ill-bred. Other distinctions might be drawn, but the preceding are sufficient.

† Query,—Waltzing?—Printer's Devil.

40 Victorian medical men themselves were possessed of a mania to characterize disapproved attitudes or behaviours as organic diseases, thus bringing them within their own field of responsibility. The classic study remains Thomas Szasz, The manufacture of madness, London, Paladin, 1973, esp. ch. 12. In the USA surgeons identified “drapetomania”: the morbid tendency for slaves to try to escape, as explained by Samuel A Cartwright, ‘Report on the diseases and physical peculiarities of the Negro race’, New Orleans med. surg. J., 1851, 7: 691–715.

41 A direct reference to Baker Brown's contention that masturbation was more often the effect of a physiological or anatomical abnormality, and thus a disease susceptible to treatment by surgery, than a moral failing appropriately treated by admonition. If the “inhibitory influence” imbibed in early life did not prove sufficient to prevent “abnormal excitement” from unhinging the mind “from that steadiness which is essential to enable it to keep the passions under control of the will”, does it not follow that “cases treated by friends and spiritual advisers, as controllable at the will of the individual, may be in reality simply cases of physical illness amenable to medical and surgical treatment?”—Isaac Baker Brown, On the curability of certain forms of insanity, epilepsy, catalepsy, and hysteria in females, London, Robert Hardwicke, 1866, pp. 12–13. On this point he was aligning himself with the “hawks” in the Victorian debate on how best to treat masturbation, and following the suggestion of James Copland, who argued in his widely read medical dictionary that persons who lacked the willpower to restrain their immoral impulses were often really the victims of “physical conditions and local irritations”, meaning that vicious behaviour such as masturbation was more the result of their physical make-up than a failure of reason and volition: “the occurrence of this vice is remarkably favoured by the physical condition of the male genitals, especially as regards the neglect of circumcision. I am convinced, that the abrogation of this rite among Christians has been injurious to them, in religious, in moral, in physical, and in sanitory [sic] and constitutional points of view,—that circumcision is a most salutary rite.” In suggesting that masturbators were badly constructed rather than naughty, Copland laid out the poles of the debate about its control which continued for the next century. Was it an ethical failing, requiring counselling and stronger will? Or was it a physical problem requiring medical (perhaps surgical) intervention?—James Copland, A dictionary of practical medicine, 4 vols, London, Longmans, 1844–58, vol. 3, pp. 442, 445. For more on the hawks and doves, see Alan Hunt, ‘The great masturbation panic and the discourse of moral regulation in nineteenth and early twentieth century Britain’, J. Hist. Sex., 1998, 8: 575–615. Brown replied to the doves who urged reliance on the encouragement of self-control and attacked his surgical approach as unacceptably mutilating by accusing them of wilfully ignoring “impartial and scientific investigation” and restating his “physiological” position: “Who is there, of any experience, who has not met with a case of masturbation, in the male or female, in which no amount of moral reasoning has sufficed to put a stop to the habit? I myself have met with cases in which months and years of restraint, moral and physical, by medical and other advice—nay, with the utmost endeavours of the patients themselves, have not sufficed to overcome the habit. Are we, then, to forbid that ‘surgery shall come to the rescue, and cure what morals should have prevented,’ but, let me add, are so often impotent to stop?” (Brown, ‘Clitoridectomy’, Lancet, 3 Nov. 1866, ii: 495).

42 John Ray (1627–1705), the seventeenth-century naturalist and intelligent design exponent. The quote is probably from his book, The wisdom of God manifested in the works of the creation.

43 “A sleight of hand game or trick usually played with three inverted thimbles and a pea, the thimbles being moved about and bystanders encouraged to place bets or to guess as to which thimble the pea is under” (Shorter Oxford English dictionary, 1993).

44 Sir Charles Bell (1774–1842), author of numerous works on human anatomy and physiology. The reference here is probably to The hand: its mechanism and vital endowments as evincing design, one of the Bridgewater Treatises commissioned to illustrate “the Power, Wisdom and Goodness of God as manifested in the Creation”, published in 1833. See William H Brock, ‘The selection of the authors of the Bridgewater Treatises’, in idem, Science for all: studies in the history of Victorian science and education, Aldershot, Ashgate, 1996, pp. 162–79. According to Desmond (op. cit., note 13 above, pp. 92–3), Bell taught anatomy on Paleyite principles, as evidence of intelligent design and divine benevolence, and was so appalled by the godless Lamarckian radicals at University College that he resigned from his post there in 1830. Although he might be having a little private joke, there is nothing to indicate that Scoffern is being sarcastic here. Indeed, many Victorian intellectuals were able to accept Darwinism only because they interpreted evolution in traditional Paleyite terms as illustrating the wonders of divinely ordained adaptation; even that great rationalist W E H Lecky was confident that discoveries about the mutability of species strengthened the case for a providential Supreme Intelligence; see his History of the rise and influence of the spirit of rationalism in Europe (1865), 2 vols, London, Longmans Green, 1904, vol. 1, pp. 288–9.

45 Compare Erichsen's Surgery: “Every child who has a congenital phimosis ought to be circumcised; and even those who, without having phimosis, have an abnormally long and lax prepuce, would be improved greatly in health and morals by being subjected to the same operation. It would be well if the custom of eastern nations … were introduced amongst us.” John Erichsen, The science and art of surgery, being a treatise on surgical injuries, diseases and operations, 7th edn, 2 vols, London, Longmans Green, 1877, vol. 2, p. 931.

46 The wife of Socrates, proverbially portrayed as a shrew and scold.

47 A highly risqué remark, probably sufficiently suggestive to have got the pamphlet banned. It was not only ladies’ tongues to which the medically qualified had privileged access, and the right to view, examine and cut.

48 The Ingoldsby legends by Richard Barham (1788–1845) were published in early Victorian magazines and reissued in 1840. The stories included grotesque or comic treatments of medieval legends, and they were extremely popular, though charges of irreverence were made against them as the Victorian age became more strait-laced. Scoffern's reference suggests that ‘The Jackdaw of Rheims’ was one of the safer stories.

49 Byron was a byword for immorality and indecency; most of his poems were considered highly unsuitable for well brought up ladies.

50 Lord Dundreary was the indolent and brainless peer in Tom Taylor's comic play, Our American cousin (1858). Not to have laughed at it, along with not weeping at the fate of Desdemona in Othello, suggests a chronic lack of affect.

51 Probably meaning the innocent practice of “needlework that does not involve embroidery or ornamental work” (Shorter Oxford English dictionary, 1993), though it is interesting that the expression is also found in twentieth-century homosexual slang as a term for mutual masturbation.

52 A comic song about Mynheer Von Clam, “the richest merchant in Rotterdam”, who had failed to assist a needy relative. See http://traditionalmusic.co.uk/song-midis/Cork_Leg.htm

53 London's oldest surviving cemetery, situated in west London and coincidentally bounded on one side by Ladbroke Grove, the street in which Scoffern locates the London Surgical Home.

54 There was a Dr Kidd active at this time, and he was cited by Baker Brown as an authority for his own procedures: “as Dr Kidd has stated, in cases of epilepsy, which ‘may originate only in irritation of bad teeth acting on the brain, or worms irritating the nerves of the stomach, and so on as to other peripheral irritations; the chief skill being to find out the spot from which the irritation radiates’.” (Baker Brown, op. cit., note 41 above, p. 6.)