Some nations are accustomed to practise upon their female children a kind of circumcision, which consists in cutting off several parts of the vulva. This custom is very ancient, and exists particularly in Egypt, Ethiopia, around the Persian Gulf, and in several parts of central Africa. What portions of the vulva are cut off? Many authors think that these are the nympbæ, clitoris, and even the hymen. In fact, Niebuhr has given a colored plate of the sexual organs of an Egyptian girl, eighteen years old, drawn by the painter Baurenfiend, the original of which is in the library at Gottingen, in which the parts just named seem to have been extirpated. Sonnini, who has examined two young Egyptian girls, one of whom had been circumcised for two years, while the operation was performed on the other in his presence, states, contrary to Niebuhr’s opinion, that this operation has reference to the interior of the vulva, and is confined to the excision of a thick, flabby, and fleshy excrescence, covered with skin, which in several African races rises above the commissure of the external labia; the length of this was only six lines, in the two girls observed by him, but it may be four inches long, at the age of twenty-five years. As the opinion of Niebuhr agrees with that of all authors who have lived in these countries, the facts observed by Sonnini are exceptions, rather than the rule. Hence, it appears, that in many nations it is the custom to remove from the females a considerable portion of the erectile tissue, which is found around their sexual organs.
What is the origin of this singular custom? Is it to remove in infancy, from the vulva of the girls, certain prominences which, at a later period, might prove inconvenient? Has this custom been established with a view to cleanliness? May it not be, to take away the power of self-abuse? Whatever may be the reason of its existence, its effect is to deaden the venereal sense, by removing a portion of the surfaces in which it is situated. This seems positively established, by the testimony of Niebuhr, and many others.
If this be so, may not the removal of the internal labia and of the preputial portion of the clitoris—especially if these parts are large—be attempted, in order to avoid a more extreme thing, which we shall mention directly. Might not this removal blunt, if it did not deaden, the propensity to solitary enjoyments, and render the other remedies employed more efficient? Although we have but little confidence in this operation, yet, when we consider that a superficial cauterization of the nymphæ and clitoris has cured nymphomania, as will be stated hereafter, we can conceive that the excision of the internal labia may in some ca«es present a chance of success. Farther: this operation is not very painful—is easily performed—and cannot, even under the least favorable circumstances, be attended with any inconvenience, except that of being useless. It certainly would not be practised generally if it caused severe pains, or was followed by bad consequences. In Africa, it is performed by the females of Said, who use a razor. And it should be remembered, too, that it is not children who submit to this operation; but girls eight or ten years old, as may be seen in the travels of Niebuhr and Sonnini.
The exquisite sensibility of the clitoris, and the size it commonly presents in lascivious females—that which it acquires in those who masturbate, or who are affected with nymphomania—have led to the opinion, that voluptuous desires are situated exclusively in this organ, and that its removal will extinguish them. Levret was, we believe, the first who conceived the idea of curing nymphomania by this operation. Dubois performed it on a young girl, who was so addicted to onanism, that she was almost in the last stages of marasmus. Aware of the danger of her situation, and yet too weak, or too much under the control of voluptuousness, she could not resist. In vain were her hands and limbs tied: she rubbed herself against the bed, and thus procured excessive discharges. Her parents applied to Dubois, who proposed amputation of the clitoris. This was assented to. The organ was removed by one stroke of the knife: the hemorrhage was arrested by the actual cautery, and the girl recovered her health and strength. Richerand, who has reported this case, considers the operation performed on this young girl as the most efficient remedy in such a case. If the idea of cauterizing the vessels is disagreeable to the patients, the vessels of the clitoris might be tied, as are those of the penis after amputation. (Nosog. Chirurg., second edition, 1808; vol. iv., p. 326.)
The following, which is similar to the preceding, but more remarkable in some respects, was published in the Journal of Surgery, by Graefe:—
“The subject of this case was born in 1807, and grew very well, till the age of fourteen months, when she became ill: for eight days, she was affected alternately with constipation, diarrhœa, and vomiting. She remained sick till she was two years old, and did not walk till she was four. She, however, never learned to talk, and exhibited symptoms of idiocy. This idiocy resisted the most varied treatment, progressively increased, and the patient was finally reduced to a state below the brute. She swallowed her feces, and passed hour after hour in a corner, her tongue lolling from her mouth.
“The most experienced physicians considered her case as hopeless. A physician at Berlin undertook to cure her. She was now fourteen years old. He remarked first in her a strong inclination to onanism: she indulged in this practice night and day. In this, there was a curative indication, which the physician embraced immediately. It seemed evident to him that masturbation prevented the development of the intellectual faculties. Hence, she was prevented from sitting down; and the head was cauterized, to obtain revulsion by the pain. The wound from this operation did not suppurate till after six weeks. Cold effusions were applied to the wound, and a solution of antimony was injected into it. These remedies were followed by a slight degree of amendment. Douches and emetics were then used, but in vain. Finally, when the patient was fifteen years old, her physician resolved to extirpate the clitoris. The operation was performed June 20, 1822, by Professor Graefe, of Berlin. The wound soon cicatrized; and the good effects of the process exceeded all expectations. The disposition to onanism was removed; the mind became expanded; and the education of the patient commenced. In three years, she could talk, read, write, and even play a few tunes on the piano—to be sure, rather imperfectly; but still she might be regarded as being in the way of recovering from her long and cruel disease.”
The details of this case are not sufficient to establish whether idiocy was the cause or effect of onanism. We may conclude, however, from the result, that it was at least in great part the consequence of this habit. It, however, was necessary to put a stop to the onanism before the idiocy disappeared. Farther, this case shows the extent of the restorative power of nature, when it is no longer impeded by masturbation. It also shows, by the good effects arising from removing the clitoris, that it would be wrong to think, as several authors, and particularly Voisin, have asserted, that nymphomania always depended on an affection of the cerebellum. Powerful and the most energetic revulsives had been applied to this latter organ, but unsuccessfully. It was not the first time the remedies had been used. Villeneuve long since recommended the application of caustics to the legs, and of cups around the genital organs, with extensive scarifications, to appease venereal desires.
The two following facts were communicated by Biett. The first is that of a lady, thirty-five years old, who became affected with nymphomania, after long absence from her husband. After many unsuccessful efforts to cure this disease, extirpation of the clitoris was decided upon. The operation was not easy, and there was considerable hemorrhage, requiring the application of ligatures. In a few weeks, the patient recovered.
The success of this operation induced Biett to advise a similar one in the following case:—