Paul Broca's clitoridectomy as a cure for "nymphomania": A pseudo-medical mutilation.

Paul Broca (1824-1880) is considered one of the founding fathers of modern neurology, mainly because of his major contribution to the anatomo-clinical method (Figure 1) (Sagan, 1979). He has also distinguished himself by his fascination with cranial measurements at the origin of modern physical anthropology and, unfortunately, racial theories based on cranial indices (facial angle and brain volume, mainly) (Gould, 1981).But what is less known is that Broca has been illustrated by particularly archaic and mutilating therapeutic practices, such as what is now considered to be female genital mutilation.

Análisis de la enfermedad dermatológica en 8 Cantigas de Santa María del Rey Alfonso X el Sabio. Parte II: mutilación genital, escrofulodermia, sarna, erisipela y los males del Rey Alfonso / Dermatologic Diseases in 8 of the Cantigas of Holy Mary of Alfonso X the Learned. Part 2: Genital Mutilation, Scrofuloderma, Scabies, Erysipelas, and the Ailments of the King

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[The effect of circumcision on the mental health of children: a review]. / Sünnetin Çocuk Ruh Sagligi Üzerine Etkisi: Gözden Geçirme Çalismasi.

Circumcision is one of the oldest and most frequently performed surgical procedures in the world. It is thought that the beginning of the male circumcision dates back to the earliest times of history. Approximately 13.3 million boys and 2 million girls undergo circumcision each year. In western societies, circumcision is usually performed in infancy while in other parts of the world, it is performed at different developmental stages. Each year in Turkey, especially during the summer months, thousands of children undergo circumcision. The motivations for circumcision include medical-therapeutic, preventive-hygienic and cultural reasons. Numerous publications have suggested that circumcision has serious traumatic effects on children's mental health. Studies conducted in Turkey draw attention to the positive meanings attributed to the circumcision in the community and emphasize that social effects limit the negative effects of circumcision. Although there are many publications in foreign literature about the mental effects of the circumcision on children's mental health, there are only a few studies in Turkey about the mental effects of the one of the most frequently performed surgical procedures in our country. The aim of this study is to review this issue. The articles related to circumcision were searched by keywords in Pubmed, Medline, EBSCHOHost, PsycINFO, Turkish Medline, Cukurova Index Database and in Google Scholar and those appropriate for this review were used by authors.

[Sexual mutilations through ages]. / Les mutilations sexuelles à travers les âges.

Among the ethnic mutilations (volunteer mutilations performed for religious, aesthetic, moral or hygienic purposes), genital mutilation (circumcision, castration, total emasculation, infibulation, excision, etc.) have always fascinated the human mind and are the subject of our historical overview.

Religious differences in female genital cutting: a case study from Burkina Faso.

The relationship between religious obligations and female genital cutting is explored using data from Burkina Faso, a religiously and ethnically diverse country where approximately three-quarters of adult women are circumcised. Data from the 2003 Burkina Faso Demographic and Health Survey are used to estimate multilevel models of religious variation in the intergenerational transmission of female genital cutting. Differences between Christians, Muslims, and adherents of traditional religions are reported, along with an assessment of the extent to which individual and community characteristics account for religious differences. Religious variation in the intergenerational transmission of female genital cutting is largely explained by specific religious beliefs and by contextual rather than individual characteristics. Although Muslim women are more likely to have their daughters circumcised, the findings suggest the importance of a collective rather than individual Muslim identity for the continuation of the practice.

Female circumcision: obstetrical and psychological sequelae continues unabated in the 21st century.

OBJECTIVES: To assess the incidence of female circumcision/female genital cutting (FGC) among pregnant women and describe the obstetrical and psychological sequelae of female circumcision. METHOD: Four thousand eight hundred pregnant women over a 4-year period were assessed for female circumcision. Odd ration (OR) and 95% confidence interval (CI) were calculated to measure association between female circumcision, maternal morbidity, and birth outcome. Variables included prolonged maternal hospitalization, low birth weight, prolonged labor, obstructed labor, cesarean section, and fetal outcome. Assessment measures to determine cognitive and emotional effects included the Mini international Neuro-psychiatric interview and Rey memory test. RESULTS: The prevalence of female circumcision was 38%; women who were circumcised were more likely have extended hospital stay. There was a positive association between such women and prolonged labor, cesarean section, post-partum hemorrhage, early neonatal death, and hepatitis C infection. Psychiatric sequelae included: 80% continued to have flashbacks to the FGC event; 58% had a psychiatric disorder (affective disorder); 38% had other anxiety disorders, and 30% had post-traumatic stress disorder. CONCLUSION: Female circumcision is associated with adverse materno-fetal outcome and psychiatric sequelae. Many will need psychiatric as well as gynecological care.

The relevance of castration and circumcision to the origins of psychoanalysis: 1. The medical context.

In this paper the author outlines and discusses the origins and the decline of castration and circumcision as a cure for the nervous and psychic disturbances in women and little girls between 1875 and 1905. The author argues that the opposition to this medical practice affected the conception of hysteria, promoting a distinction between sexuality and the genital organs, and the emergence of an enlarged notion of sexuality, during the period from Freud's medical education to the publication of the Three Essays on the Theory of Sexuality. The hypothesis is put forward that Freud came directly in contact with the genital theory of the neurosis at the time of his training on the nervous disturbances in children with the paediatrician, Adolf Baginsky, in Berlin, in March 1886. It is hypothesized that this experience provoked in Freud an abhorrence of circumcision 'as a cure or punishment for masturbation', prompting an inner confrontation which resulted in a radical reorganization of the way of thinking about sexuality. It is also suggested that this contributed to Freud developing a capacity to stay with contradictions, something which would become a central quality of the psychoanalytic attitude.

The historical response to female sexuality.

In the past, medical attitudes to female sexuality were grotesque, reflecting the anxiety and hypocrisy of the times. In the medieval world, the population feared hunger, the devil, and women, being particularly outraged and threatened by normal female sexuality. The 19th century attitude was no better as academics confirmed the lower intellectual status of women, particularly if they ventured into education. The medical contribution to this prejudice was shocking, with gynaecologists and psychiatrists leading the way designing operations for the cure of the apparently serious contemporary disorders of masturbation and nymphomania. The gynaecologist, Isaac Baker Brown (1811-1873), and the distinguished endocrinologist, Charles Brown-Séquard (1817-1894) advocated clitoridectomy to prevent the progression to masturbatory melancholia, paralysis, blindness and even death. Even after the public disgrace of Baker Brown in 1866-1867, the operation remained respectable and widely used in other parts of Europe. This medical contempt for normal female sexual development was reflected in public and literary attitudes. There is virtually no novel or opera in the last half of the 19th century where the heroine with "a past" survives to the end. The wheel has turned full circle and in the last 50 years new research into the sociology, psychology and physiology of sexuality has provided a greater understanding of decreased libido and inadequate sexual response in the form of hypoactive sexual desire disorder (HSDD). This is now regarded as a disorder worthy of treatment.

Female circumcision: history, medical and psychological complications, and initiatives to eradicate this practice.

Female circumcision - a procedure where the parts of the female genitals are removed, which is also known as female genital cutting (FGC) or female genital mutilation (FGM) - continues to be practiced in more than 28 African countries. It is estimated that 80-100 million women have been circumcised. We performed a review of the literature to examine the history of female circumcision, its medical and psychological consequences, and government and non-government educational initiatives that are currently being taken to eradicate this practice.

Rethinking the history of female circumcision and clitoridectomy: American medicine and female sexuality in the late nineteenth century.

During the late nineteenth and early twentieth centuries, there was one kind of female orgasm and it was clitoral; there was also only one kind of healthy sexual instinct for a woman and it was for penetrative sex with her husband. When a woman behaved outside of this normality-by masturbating or by not responding to her husband's affections-her sexual instinct was seen as disordered. If healthy women, then, were believed only to be sexual within the marital embrace, what better way to explain these errant behaviors than by blaming the clitoris, an organ seen as key to female sexual instinct? Doctors corrected a clitoris in an unhealthy state using one of four surgeries-removing smegma or adhesions between the clitoris and its hood, removing the hood (circumcision), or removing the clitoris (clitoridectomy)-in order to correct a woman's sexual instinct in an unhealthy state. Their approach to clitoral surgery, at least as revealed in published medical works, was a cautious one that respected the importance of clitoral stimulation for healthy sexuality while simultaneously recognizing its role as cause and symptom in cases of insanity that were tied to masturbation.

[Female genital mutilations: ethical and forensic medicine aspects]. / Le mutilazioni genitali femminili: profili etici, deontologici e medico-legali.

The female genital mutilation involves both anthropological and ethical aspects as well as legal issues: because the spreading of population from Africa and Middle East to Western countries, the problem is world wide considered by both International (e.g. WHO, UNICEF, UNFPA) and National Authorities. The Italian Parliament are now examining many proposal of law to prevent the female genital mutilations.