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toms to the female reproductive system . The unwillingness of most
physicians at the time to consider subtle, psychotherapeutic tech–
niques in handling patients such as "X" and
"Y"
was an expression of
an age of rigid medical materialism in which nonorganic therapies
were viewed as unscientific . And the increase in the amount of
gynecological surgery during the final third of the nineteenth cen–
tury was intimately connected to the contemporary emphasis on
localizable pathologies and to the dramatic development of Listerian
antisepsis in the late 1860s, which vastly reduced the number of fatal
postoperative infections. Masson's cases evince medical ignorance,
misjudgment , and even malpractice, but there is precious little
evidence of a concerted sexual conspiracy .
Perhaps the most serious of Masson's accusations concerns the
idea that the case histories in this collection represent the main–
stream oflate 19th-century medicine . Masson characterizes the abu–
sive treatment of women and children as "the essence of nineteenth–
century psychiatric beliefs ." And on the important question of
female castration, he contrives to leave the impression that the ex–
ploits of Drs . Hegar and Zambaco were accepted and even practiced
by the entire profession . "Few of these articles called forth any dis–
sent from the medical profession," he writes. "I would have included
more such dissent in this anthology had I been able to find it ."
Now, at best , these statements are highly disingenuous .
It
is
true that during the 1870s and 1880s there occurred a great increase
in the amount of pelvic surgery in cases involving no overt
pathology . In particular, the unilateral and bilateral ovariotomy - or
Battey's operation , as it was called in this country - had its out–
spoken advocates on both sides of the Atlantic . But, as even a cur–
sory review of the sources will reveal, medical professionals in the
nineteenth century in fact adopted a very wide range of positions on
the question of amputative gynecological surgery. In the medical
journals, gynecological textbooks, and public press of the day , many
doctors openly counselled against these mutilating measures . Jean–
Martin Charcot, arguably the best known neuropathologist of his
age, repeatedly polemicized against the barbaric "de-sexing" of
female patients . A majority of physicians took a moderate stance on
the issue and were willing to consider such radical procedures only
in cases of the most severe and prolonged mental and physical suffer–
ing on the part of the individual. One of the writers in Masson's own
collection, Dr. Paul Flechsig, states that he has chosen to publish an
article on castration "because many psychiatrists reject the gyne-
