Clitoridectomy is one of those few acts that conference-attenders discussing human rights and the media can uniformly agree is wrong. And so it was in our discussion at the Premio Ischia last week .
Whatever arguments are produced about ends and means, misrepresented causes and unintended effects, journalism that highlights and discourages the genital mutilation of women in Africa is 'a clear good thing'.
While one of my fellow speakers was making this case, I knew somewhere in the back of my mind that The TImes had once played a part in this campaign. Perhaps I could risk boasting of our achievement or hailing the virtuous and farsighted intentions of a previous editor.
After now, however, reminding myself of what actually happened 143 years ago, it was probably as well that I kept quiet. As in so much discussion of newspaper ethics - a fashionable subject again this week - good ends and good intentions are not as closely connected as we sometimes like to think.
The story began long ago in a Saturday issue of The Times, December 15, 1866, which published a puff-piece promoting the merits of a surgeon, Mr Isaac Baker Brown, who enthusiastically claimed to cure hysteria, nymphomania, melancholia and much else besides by snipping away at what seemed to be the less necessary sexual organs of his patients.
The base for these activities was not, in fact, some savage part of the Empire between the Nile and the Euphrates but between the Grand Union Canal and the Serpentine in Notting Hill Gate, West London. The credulous reporter had not had to travel far.
Office records for that time are, sadly, poor. The offending story, headed "The London Surgical Home", is clear enough: it can still be found in the blue-bound archive copies,squashed between "The Perils of the Whale Fisheries" and a Latin poem celebrating the return to health of the Vice-Chancellor of Cambridge University. But its author, following the rules of those days, was unidentified and is still unknown.
Did the Editor, John Delane, summon his reporter and ask a few tough questions about the operation which allegedly produced the first physical cure for mental illness?
Or was he perhaps a bit squeamish when faced with the news that a woman in London, in an institution boasting the patronage of the Princess of Wales, might be separated from her clitoris with red-hot wire in an attempt to cure her of epilepsy, mania, masturbation and other diseases from which her male guardian, with 200 or 300 guineas to spend, might judge her to be suffering?
We do not know. Delane had had some medical training himself. His own wife had been sent to an asylum after only a few years of marriage because of what his biographer describes as "deplorable mental failings". Maybe he felt guilty. Maybe his mind was preoccupied with the death of his great friend, Palmerston, the Fenian Irish and the failing Reform Bill.
We do know, however, the reaction of the medical authorities of the time. The editorial writer in The Lancet of December 22, 1866 was scathing about Mr Brown and about The Times, calling, with vigorous irony, for a "grand assize of clitoridectomy" at which the lunatic asylums of Europe would be cleared by means of what Mr Baker Brown "with the pardonable pride of an inventor, calls my invention". The Lancet would have much preferred the subject never to have been mentioned. But since the press had raised the issue, respectable doctors had the duty, "howsoever repulsive", of examining it. And for three months at the beginning of 1867 that is exactly what they did.
Brown, a respected Royal College fellow whose work was supported by the Church Times and the Archbishops of York and Canterbury, did not give up without a fight. He produced letters showing that distinguished colleagues, including some of those now criticising him for quackery, self-promotion and worse, had referred patients for clitoris removal, praising him for the dexterity with which he applied his little surgical axes and wires. He called for the success of some thirty of his cases to be investigated by an independent committee. And he went back to The Times, denying its reporter's claim that mental illness was being treated by clitoridectomy and demanding a correction.
The Times appears to have stood by its story. It did not print any correction. Its only concession to Brown was to publish his correspondence with the Office of Commissioners in Lunacy, the section of the 19th-century Establishment that had most to lose from a doctor claiming to cure madness without recourse to madhouses. The one female of unsound mind who had arrived at his London Surgical Home in the past year, Brown told the secretary to the lunacy commissioners on January 10, had been properly and immediately removed to the local asylum. The Times duly carried the claim, without comment, in a short item between a Chilean diplomatic reshuffle and an obituary of the man who invented lightning conductors.
The lunacy commissioners seemed happy to accept Brown's clarification and to attack The Times both for the "gravity" of its mistake and for the difficulty faced by the doctor in procuring publicity for his denial. The British Medical Journal was more suspicious, seeing a medical promotional campaign that had gone wrong, not an error by The Times. It pointed out that the original claim to operate upon mental illness had come from an official of the Home itself and suggested acidly that Brown had felt "highly favoured that a special reporter should have been dispatched from Printing House Square to describe his situation".
On February 9 the BMJ produced the rescuing evidence that The Times did not seem to have found for itself. Brown had written a medical paper which set out a host of cases, a "quite maniacal 23-year-old Irish female", a suicidal and a string of epileptics whose condition had been cured by his operation. The BMJ accused the clitoridectomist of panicking under pressure and conveniently forgetting both his own past claims and the notes of triumph which the press had sounded on his behalf.
Meanwhile, Brown made a foolish mistake. Despite promising to give up his operation until the evidence had been judged, he was still experimenting on new arrivals at his Home. His patient was a woman whose sexual organs had allegedly been made white by masturbation; and although her clitoris was removed by special forceps this did not, it seems, prevent her from having two more fits. This operation was enough to force the resignation of one of the Home's most distinguished visiting surgeons whose support had given much lustre to the clitoridectomy cause.
In April the issue was debated at the Obstetrical Society. It was a bitter and heated occasion. On the one side were the men (all men) of the gynaecological establishment: "We being men have our patients who are women at our mercy and I think that if we should cheat or victimise them in any way we should be unworthy of the profession of which we are members," said Seymour Haden, Brown's chief critic. With the cheers and cries of "hear hear" still ringing around the room, he painted a dramatic picture of his opponent, drugging his victims with chloroform, snipping the clitoris and inviting the father or husband to pay his 100-guinea fees (tens of thousands of pounds in the money of today).
On the other side was Brown, claiming he had never demanded such huge sums, that everyone knew what he was doing, that clitoridectomy worked and that he had the support at the highest levels in church and state and from the ancient Greek, Hippocrates, the father of medicine. Despite being barracked throughout, Brown forced his opponents to concede that they had no objection to his operation, merely to the means of consent given by patients and the unseemly publicity he had received through the reporter whom he called the "bona fide attache" of The Times.
Brown lost his membership of the society by 194 votes to 38. His career in London was over. A different course was now set for an operation which we now deplore in Africans but which we Britons embraced more recently than we care to remember. Hovering in the background was The Times, which had reported, probably accurately, the self-serving puffery of Brown but which could hardly claim the virtue of exposing the surgeon mutilator. The Editor, not for the first or last time in newspaper history, had done good by accident. He seems to have chosen lofty silence as his best policy.
After his disgrace Brown left for America, where regulations were looser and royal colleges were unknown, but not before receiving gifts from admirers and grateful patients. One was a six-piece silver dessert service, each item engraved to Baker Brown FRCS "in token of his marked medical skill and singular success in the treatment of female diseases". We learn this from the Standard of April 18. The same story was repeated by the BMJ of April 27. There was no last press release from Brown in The Times.
Because of fears that African rituals were increasingly being performed in London clinics, clitoridectomy was specifically banned under English law in 1985. Many illegal operations are still thought to take place in Britain every year.
