A new anatomical study shows there is more to the clitoris than anyone ever thought.

PENIS ENVY may be a thing of the past. The clitoris, it turns out, is no "little hill" as its derivation from the Greek kleitoris implies. Instead, it extends deep into the body, with a total size at least twice as large as most anatomy texts show, and tens of times larger than the average person realises, according to new studies by Helen O'Connell, a urology surgeon at the Royal Melbourne Hospital in Melbourne. The clitoris earned its Lilliputian reputation, in part, because much of its elaborate 3D structure is on the inside, hidden by fat and bone--an anatomical smoke screen that has helped fool lay people and experts alike. "There is a lot of erectile tissue down there that is not drawn in any anatomy textbooks, save perhaps a couple of really old dissections in the French and German literature." says O'Connell. "Just because you can't see the rest does not mean it is not there." Nor does it mean it is not important. O'Connell's detailed descriptions of female sexual anatomy could help prevent women who have pelvic operations from ending up with impaired sexual function. "The dissections are wonderful," says Cindy Amundsen, a gynaecologist at the University of Houston in Texas. "The erectile tissue is closer to the urethra and encompasses a far larger area of the anterior vaginal wall than most people thought". O'Connell first realised just how little was known about female sexual anatomy when she was studying for her surgical exams in the late 1980s. Even nowadays, she says, textbooks routinely recycle decades-old, inaccurate illustrations of female sex organs, or omit diagrams altogether. The written accounts can also lack a certain something. One text describes female genitalia as the same as the guys' only turned inside out; another, as the "poor homologue" of the male. And none of them--not even the anatomists' bible, Gray's Anatomy--describe in detail the nerves and blood vessels that go to the clitoris. "For a surgeon," says O'Connell, "that's unacceptable." Details, details The study of men's sexual anatomy has fared slightly better. Back in the 1970s, modern micro-dissection techniques were brought to bear on the nerves and blood vessels that supply the penis. The information gleaned helped spawn "nerve sparing" surgery that reduces the risk of impotence following operations for diseases like prostate or bladder cancer. Helped by John Hutson, an expert on paediatric genital reconstruction at the University of Melbourne, O'Connell hoped to do the same for women's sexual anatomy and surgery.

But as she started to map out the nerves, she realised it wasn't just the fine detail that was missing from the textbook picture of the clitoris. "I thought, Damn! I'm not sure the gross anatomy is correct, either," she says. Since then O'Connell and her assistant Robert Plenter have dissected the bodies of 10 adult women, relying heavily on photography to capture the 3D structure of the clitoris. She has described in detail the dorsal nerves (much bigger than in the anatomy books) that are thought to carry the sensory information on the first step of its journey to the brain, as well as the cavernosal nerves that probably control the smooth muscles of the clitoris, and the size of its blood vessels, enabling it to swell during sex. She has also concluded that the clitoris as described in most textbooks is a mere shadow of its real self. According to O'Connell's dissections, the external tip of the clitoris, or glans, connects on the inside to a pyramid-shaped mass of erectile tissue, far larger than previously described. The "body" of the clitoris, which connects to the glans, is about as big as the first joint of your thumb. It has two arms up to 9 centimetres long that flare backwards into the body, lying just a few millimetres from the ends of the muscles that run up the inside of the thigh. Also extending from the body of the clitoris, and filling the space between its arm, are two bulbs, one on each side of the vaginal cavity. The bulbs do, in fact, make an appearance in at least some textbooks, but few recognise them as part of the clitoris. Indeed, they are usually referred to as the "bulbs of the vestibule"--the vestibule being the vagina. To make their origins clearer, O'Connell wants to rename them the "bulbs of the clitoris". The penis also has bulbs of erectile tissue at its root that extend into the body cavity, but "the bulbs are more prominent in females", she says. Gray's Anatomy and other texts also claim that the clitoris, unlike the penis, is entirely separate from the urethra, the tube that connects the bladder to the outside. O'Connell disagrees. According to her dissections, the clitoris surrounds the urethra on three sides, while the fourth is embedded in the front wall of the vagina. That layout makes perfect sense if you think about what the clitoris has to do. Freud described it as a tool for arousing the rest of the female much as "pine shavings can be kindled in order to get a log of harder wood on fire". But the clitoris also helps squeeze the urethra shut during intercourse, perhaps stopping bacteria making their way up to the bladder and causing an infection. The engorged bulbs of the clitoris may also help hold the walls of the vagina rigid, aiding penetration. Understanding the clitoris's design, could also help protect women's ability to have good sex. According to O'Connell's descriptions, the cavernosal nerves travel alongside the walls of the uterus, vagina, bladder and urethra. And although practically nothing is known about how operations for, say, incontinence or bladder cancer or hysterectomies affect sexual function, the positions of the nerves suggest that it could be at risk. "Lots of operations involve dissections around the urethra. That could affect patients' sexual

function," says Amundsen. Just as doctors routinely ask men who have had prostate surgery about their erections, they should ask female patients who have had comparable operations about any changes in their sexual function, she says. Now the nerves' pathways are known, it should also be possible to modify at least some operations to reduce the risk of sexual dysfunction. "There have been tons of studies about how to prevent impotence after radical prostectomy," says John DeLancey, an expert on gynaecological anatomy at the University of Michigan in Ann Arbor. Anatomically speaking, a radical hysterectomy for cancer of the cervix is similar to a radical prostectomy. "Given this beautifully detailed knowledge of the interrelationship between the female urethra and sexual organs," it should be possible to develop similar nerve-sparing operations for women, he says. Victorian prudes So why have anatomists routinely got the clitoris wrong? Part of the problem may be a Victorian prudishness about examining women's sexual organs in detail. Then there's the fact that most of the clitoris is hidden inside, shielded by lots of fat and the arch of the pubic bone. Another obstacle to accuracy is that anatomical studies are usually done on the bodies of women in their 80s and 90s. Just as muscle and bone wither with age, so does the mass of erectile tissue in the clitoris. In men, shrinking erectile tissue is less of a problem, at least for the anatomist. More men die in accidents, so young bodies routinely find their way to the dissection table. And as the erectile tissue of the penis is mainly on the outside in one compact piece, it's easier to spot . O'Connell had two cadavers of women under forty. The older bodies had much smaller clitorises (although still far larger than in the textbooks), but once O'Connell had identified the erectile tissue in the younger women it was easy to find in the older ones. "We lucked out," she says, "one of our cadavers was 36 years old. She looked like an Amazon." O'Connell is now studying the cellular structure of the clitoris, urethra and vagina. Amundsen, meanwhile, suggests another topic for research: "We have Viagra. We know anatomically what's going on [in the clitoris]. We need some studies on erectile dysfunction in women." ---Susan Williamson is assistant editor at Today's Life Science in Sydney, Australia.

Transcript and further information for "Body of Knowledge"

On air: Thursday 22 October

Female body

Narration: Scientists have been studying the human body for such a long time, you'd think that by now every square inch would have been more than covered. In library with textbook Rae Fry: "This is Gray's Anatomy 38th Edition. Books like these rest on a 450year tradition of anatomists peeling away the surface of the human body and just basically drawing what they see inside. "So you'd be amazed if some scientist suddenly came out and said, 'Oh, penises are actually twice as large as we thought,' or, 'Hmmm, there's this part of the brain we never knew about before.' "Well, be amazed - be very amazed." Female body Narration: Because new Australian research has just brought out of hiding the body's most mysterious organ - the clitoris. Dr Helen O'Connell, Melbourne Private Hospital "I think if you're of the thought that the tip is the whole, well my idea is that it's quite a bit bigger than that." Dr Helen O'Connell performing surgery Narration: What lies beneath the surface of our skin is something Dr Helen O'Connell makes it her business to know. She's a urological surgeon at Melbourne Private Hospital, and for years she's been concerned that when operating on women, she could be cutting through nerves to the clitoris that she didn't even know were there. Dr Helen O'Connell: "As a urology trainee I was aware that we were taking special care while we were removing the prostate in men with prostate cancer to preserve their sexual function. And I was unaware of there being, similar work having been done in women." Brownless Biomedical Library, University of Melbourne

Narration: So Helen O'Connell went back to the textbooks. But she found that when it came to the clitoris, they had little to say. Dr Helen O'Connell: "There were glaringly obvious defects in some books - like the book that I learnt anatomy from when I was training for my surgical exams just had no description at all." Men in academic gowns at university Rae Fry: "A patriarchal conspiracy? Well, maybe partly - but the lack of attention to the clitoris goes back a long way - right back to the Renaissance, which is when anatomy really got started. There weren't any women in the universities then - and there weren't many female bodies to study, either." Drawings from Renaissance anatomy text Narration: Most of the bodies available for dissection were executed criminals mainly men. In fact women's anatomy in the first major text was based on only three females. Julie Egan, Museum Victoria: "One of them was a six-year-old child, who'd been exhumed from a grave, one of them was a woman who'd been hanged, and they'd been snatched from the gallows, and one of them was a woman who, they'd carried out a post-mortem on her. So it was fairly rare for women to be available, partly of course because as today, you know, less women are executed." Narration: The learned gentlemen of the Renaissance didn't miss the clitoris completely. But they were much more interested in trying to prove a classical theory that women's genitals were just an inside-out version of men's. Julie Egan: "And the result was that when anatomists were looking at female bodies they were in a way more interested in looking at the correspondence with male organs than for trying to look at what was specific and different about women." 19th century painting of anatomy class Narration: By the 19th century, anatomy was a bit more scientific. But Victorian morality considered the clitoris unsuitable for serious research. Julie Egan: "I suppose the clitoris then was thought of as a bit of extra tissue, but it's not actually essential to reproduction so we don't have to worry about it so

much. And there was much more then emphasis on female anatomical organs in terms of their child bearing." Dr Helen O'Connell with large pile of books Narration: Helen O'Connell found that a detailed study of the clitoris and the nerves that supplied it had never been done. Dissecting room, Dept of Anatomy & Cell Biology, University of Melbourne Narration: So she and her colleagues went back to the basics of anatomical research - dissection of human cadavers. And got a big surprise. Helen O'Connell: "We discovered that things were looking different to the standard pictures in the anatomy textbooks." Female body Narration: What most of us think of as the clitoris - if, of course, we think about it at all - is just the bit that rises above the surface. Narration: Inside, it's a much larger structure that wraps around the vagina and the urethra. The external 'head' is attached to a 'body', two 'arms', and a mass of erectile tissue, called the bulbs - which, like the penis, swell with blood when aroused.

Before these new dissections, no-one had ever realised that the bulbs were actually part of the clitoris. And, the whole structure is a lot bigger than the textbooks show. Rae Fry: "And yes, size does matter. Because it means that the clitoris goes right back into the body and is very much tied up with the other organs. So during any kind of pelvic surgery, the nerves that stimulate the erectile tissue could be in danger."

Helen O'Connell: "I guess the common operations that may put these structures at risk would be hysterectomy and incontinence surgery, and maybe even prolapse surgery - to be honest we don't know." Female body Narration: The team is still mapping the detail of the nerves, in order to design more careful operations. In the meantime, there's no guarantee of surgery being risk-free. Dissecting room Narration: Describing the full anatomy of the clitoris is really only the beginning. Botanic gardens with statue of female body Rae Fry: "There's still heaps to learn about the nature of how it works. Now, Helen O'Connell says the science of sex is not her field of expertise. But I had to ask if she was prepared to speculate about a couple of burning issues - like does this clear up that old debate about the vaginal versus the clitoral orgasm?" Helen O'Connell: "I think if you're trying to separate out the two then it's probably, you know, like barking up the wrong tree - I think they're clearly one and the same structure." Rae Fry: "And what about the elusive G spot? Apparently, some French researchers did some measurements trying to find it a few years ago. Well Helen O'Connell thinks the spot that they found might have owed its sensitivity to the clitoris." Helen O'Connell: "Interestingly, they found it to be the area of the external urethral sphincter, or the valve mechanism of the urethra, [laughs] which is quite unusual. And my feeling is that it's probably because of the erectile tissue on the outside of the urethra that that was found to be such a hot spot." Old anatomy drawings/Female body Narration: Our picture of the human body is constantly evolving. In the case of the clitoris, it's taken a scientist willing to step outside the traditional view to move things forward. But perhaps there are still bits of our bodies that remain a mystery.

Further information

Helen O'Connell's research on the anatomy of the clitoris was first reported in New Scientist, 1 August 1998, pp. 34-35, by Susan Williamson and Rachel Nowak. The full text of the article is online. The scientific paper was published in the Journal of Urology: Helen E. O'Connell, John M. Hutson, Colin R. Anderson and Robert J. Plenter, "Anatomical relationship between urethra and clitoris", Vol. 159, June 1998. It's drawn attention worldwide: you can read articles on the web by the Toronto Star, the San Jose Mercury News and the Nando Times. The research was done at the University of Melbourne's Department of Anatomy and Cell Biology, in collaboration with John Hutson, Colin Anderson, and Robert Plenter. Research on the nerve pathways is continuing. The first major anatomy text mentioned in the story is "The Fabric of Man", by Vesalius, published in 1543. Two original editions of this book are part of the Cowlishaw Collection of rare medical books owned by the Royal Australasian College of Surgeons. The following is a summary of Dr. Helen O Connells presentation given at the 2003 International Society for the Study of Womens Sexual Health Conference in Amsterdam.

Female Sexual Anatomy: Discovery and Re-Discovery Helen OConnell, M.D.

Dr. Helen OConnell is the Chief of NeuroUrology and Continence at the Royal Melbourne Hospital. Her research has examined the structure of the clitoris through the use of dissection, histology (which is the microscopic study of the form and structure of various tissues), and magnetic resonance imaging (MRI).

Although over the centuries anatomical authorities have attempted to describe the anatomy of the clitoris, present day anatomical textbooks still fall short in their descriptions. Dr. OConnells research has focused on the structure of the clitoris,

encompassing such issues as whether or not the bulbs of the vestibule should be included in clitoral anatomy; the vascular and neural inputs along the autonomic pathways; the relationship of the clitoris to other structures such as the urethra and vagina; the histology (define this again) of the clitoris; the connective tissues that support it; the use of objective media to study clitoral anatomy, such as MRI and serial photography of dissections, and reviewing historical and modern texts to determine a more precise and accurate description. The clitoris is much larger than originally thought, up to 9 cm. in length and 6 cm. in width in younger women. Multi-dimensional views of the clitoris are not possible in textbooks, where images are rendered in one plane or as a flat structure. With the use of MRI, the multi-planar view of clitoral anatomy can be seen within the body of a living woman. This MRI view is a very different representation of clitoral anatomy than the traditional source of medical dissection with donor tissue from elderly women which may have atrophied. Dr. OConnell has also helped to distinguish the relationship between the urethra, distal vaginal wall and the clitoris, and the autonomic nerves in her research. The lay public as well as the healthcare community may be most surprised to know that through Dr. OConnells research, it is now believed that the current anatomical textbooks, including Grays Anatomy, is very deficient in representing the true anatomical structure of the clitoris; this includes textbooks used to teach medical students. Through Dr. OConnells work, science is gaining a new perspective and more accurate understanding of the anatomy of the clitoris. Lisa Martinez For more information on Dr. OConnells work, see the following sources: O'Connell HE, Hutson JM, Anderson CR, Plenter RJ. Anatomical relationship between urethra and clitoris. J Urol. 1998 Jun;159(6):1892-7. PMID: 9598482 [PubMed - indexed for MEDLINE] Rees MA, O'Connell HE, Plenter RJ, Hutson JM. The suspensory ligament of the clitoris: connective tissue supports of the erectile tissues of the female urogenital region.

Clin Anat. 2000;13(6):397-403. PMID: 11111889 1: J Pediatr Endocrinol Metab. 2004 Apr;17(4):581-7. Related Articles, Links

Anatomical studies of the female genitalia: surgical reconstructive implications. Baskin LS. Pediatric Urology, UCSF Children's Medical Center, University of California, Children's Hospital, San Francisco, CA 94143, USA. lbaskin@urol.ucsf.edu Surgery for patients with genital ambiguity must be based on an accurate diagnosis, thorough understanding of the genital anatomy and realistic expectations for the patient, family and treating multi-specialty team. The goal is to create a functional and cosmetic outcome consonant with the gender assignment with the least amount of morbidity to the patient and family. An understanding of the normal genital neuroanatomy is essential for a successful surgical approach and outcome. Based on fetal human specimens, we have refined the three-dimensional relationship of the dorsal nerve of the clitoris, the female cavernosal nerve and the vaginal plexus. The surgical approach to patients with severe clitoral virilization should preserve erectile function and the neural innervation of the clitoris. When indicated, surgery should be performed in infancy to minimize psychological trauma and surgical complications from scarring. Herein, we review the neuroanatomy of the female genitalia and the implications for the rare patient who needs surgical reconstruction. Publication Types: * Review PMID: 15198288 [PubMed - indexed for MEDLINE]

The Clitoris: historical myths and facts

I'm still collecting these! These are a few of my own notes plus information supplied in response to a request on the Histsex list. If you have anything to contribute, please e-mail me. Article on the clitoris in history

*** The spotted hyena female has a very large clitoris, such that it is often mistaken for the male. In fact, in ancient natural histories the hyena is described as an animal which changes back and forth between the two genders. Two Aesop fables are based on this idea. In Babrius and Phaedrus (Loeb Classics) 242 & 243 (p 470) a fox remarks that it doesn't greet the hyena because it doesn't know whether to address it as a male or female, and when one hyena propositions another the second replies, "Alright, but what you do to me someone else will do to you." The Epistle to Barnabus 10.7 in the Apostolic Fathers also remarks on the Hyena sex change. The reason for the enlarged clitoris is the high levels of androgens in the female pup. The androgens are necessary to keep the female pup as aggressive as her brothers; otherwise she probably wouldn't survive their aggression in the close confines of the den. *** Bernadette Brooten, Love Between Women, has a good section on ancient medical literature dealing with the clitoris and clitoridectomies to cure tribadism (pp 162-171). Also, there is a curious epigram by Martial (7.67) in which he describes a tribad who penetrates both boys and girls. With what does she penetrate them? The epigram does not say, but implies she has a penile-like clitoris. *** The 'discovery' of the clitoris by Renaissance anatomists: 1559: Realdo Columbo discovers clitoris ('so pretty and useful a thing') (De re anatomica); 1561: Gabrielle Fallopio disputes Columbo's priority *** Sinistrari, a Roman inquisitor of the early sixteenth century, fantasized about women with elongated clitorises raping men. He also claimed that only women with excessively large clitorises could engage in 'sodomy' with one another. If a charge was brought against a woman, competent midwives should examine her to ascertain if her clitoris was enlarged. *** John Thomlinson (young clergyman) diary entry for 3 March 1717 'Sir John Brownlow's lady abused other women with her clitoris etc...' (excluded from the published edition) (cited in Jeremy Black, review of A. Vickery The Gentleman's Daughter in Archives 101) *** 'By the late eighteenth century, scientific interest in the clitoris was spurred on the by debunking of human hermaphrodites, that is, the debunking of the existence of humans with both sets of genitalia. What medical men had mistaken for the penis was actually an

enlarged clitoris, an enlargement that many medical men had to explain away by pathologizing the clitoris through masturbation, or lesbianism, or the uterine furor, or racialized categories, or physiological monstrosity. In the midst of a lecture on the female organs of generation, William Hunter, for example, felt compelled to state "it is impossible [for] a woman with a large clitoris can [sic] copulate with another, because the skin does not go around the clitoris, as it does around the penis, but ties it down so that it can never be detached like the penis." What drives this need to insist that sex/penetration between women is physiologically impossible? Because the clitoris might, even to a trained eye, pass for a penis, it had to be disciplined by pathology. The force of this discipline stems from the fact that the enlarged clitoris violates a key physiological law, the accepted translation of form into function. Although the enlarged clitoris is visually like a penis, its visual similarity does not betoken similarity of function. Either physiology is founded upon a error or the clitoris must be made monstrous, an example of form that has no function except to deceive.' Richard C. Sha, 'Scientific Forms of Sexual Knowledge in Romanticism', in Romanticism on the Net, special issue on Romanticism and Sexuality *** Isaac Baker Brown, in Surgical Diseases of Women (3rd edition, 1866) claimed that 'The deplorable effects of this baneful habit [self-abuse], both on the physical and mental health, have been less considered in the case of females than of males, and yet they are of equal gravity, and probably as prevalent. The radical cure of the habit is, however, fortunately in our hands'. He went on to add 'The necessity for the excision or amputation of the clitoris, when much enlarged, has been recognised by surgeons generally; but I would go further and say, that this operation should be resorted to in all cases where that organ is found in a abnormal state, and where constitutional symptoms are traceable to its irritation''A long experience of cases in which self-induced irritation of the clitoris was an exciting or aggravating cause of disease' convinced him that 'cauterization, actual or potential, could not be depended upon as a remedial agent.... I was thus led to the more frequent use of excision'. He performed clitoridectomies at his London Surgical Home, 1860s, claiming that this cured epilepsy, hysteria etc, and was drummed out of the London Obstetrical Society after an acrimonious meeting and much flak in the medical press. (Would the average Victorian doctor have been able to locate the clitoris in the first place?). The subject more or less vanished from medical literature, though I was recently informed that references have been found to clitoridectomies being performed on women patients for persistent self-abuse in at least one lunatic asylum in Scotland, *** 1880's: Mary Putnam Jacobi, early US woman doctor, makes a number of comments about why it is important for women to have orgasms during sex. ***

C19th concept that a supposedly 'enlarged' clitoris signified various forms of female moral degeneracy: nymphomania, masturbation, tribadism (lesbian activity). However in 1897 Havelock Ellis notes in Sexual Inversion that lesbians do not necessarily have large clitorises. From his own rather restricted (3 cases in which he had 'precise information') observations and the works of Krafft-Ebing and Magnus Hirschfeld he concluded that 'the clitoris is more usually small than large' and in some instances even 'more or less underdeveloped', adding that this was corroborated by the observation of ParentDuchatelet that 'women with a large clitoris... seem rarely to be of masculine type.' *** 1905: Freud works towards differentiation of clitoral/vaginal orgasms (the latter being defined as the 'mature' version); this is further worked out in 1925 essay: 'Female Sexuality" (or was that 1930?) *** W Blair Bell, in his chapter on 'Disorders of Function', in Thomas Watts Eden & Cuthbert Lockyer's The New System of Gynaecology (1917), in the section on 'Psychical Disturbances of Puberty', advocated excision to protect girls' health from the ills of masturbation in certain cases - 'the girl who is not suffering with excessive sexuality, but rather, with the fascination of a bad but pleasant habit, to the detriment of her moral and physical equilibrium' - giving details of one particular case in which he had successfully applied it. This is a rather curious example, given that in other works Watts Eden and Lockyer, e.g. Gynaecology for Students and Practitioners (1916 and subsequent edition) themselves specifically did not recommend clitoridectomy in cases of hypertrophied clitoris. Blair Bell claimed elsewhere in the same chapter that 'In adult women, before the menopause, the changes towards masculinity associated with suprarenal hyperplasia and neoplasia may be most marked. Menstruation ceases, the breasts shrink, the clitoris enlarges, hair grows on the face and on the body with masculine distribution, the voice deepens, and last but not least, profound psychical changes have been shown to occur, a previously gentle woman becoming rough and aggressive.' *** The 1918 'Cult of the Clitoris' Case: 'Maud Allan [ a dancer enacting Wilde's Salome] had taken exception to the linking of her name with the heading "Cult of the Clitoris" [in Noel Pemberton Billing's journal Vigilante and sued him for libel]. What was implied here by the term "clitoris"? From late eighteenth-century through into the early twentieth century, one of the most consistent medical characterizations of the anatomy of the lesbian was the claim of an unusually large clitoris. Not only was the clitoris associated with female sexual pleasure separate from reproductive potential, but lesbians were assumed to be masculinized, and the supposed enlarged clitoris was one signifier of this masculinity. In presenting lesbians'

bodies as less sexually differentiated than the norm more masculine - it was inferred that they were atavists - throwbacks to an earlier evolutionary stage and thereby "degenerates". It was held that progressive differentiation of the sexes was one of the hallmarks of evolutionary progress. An enlarged clitoris or the inference of deviant genitalia was also given as the signifier of black women's sexuality and of nymphomania. Lesbians, black women and nymphomaniacs were all grouped together as possessors of a 'primitive' sexuality. By the late nineteenth century, a number of sexologists were questioning some of these assumptions.... Many doctors, however, still held to the older belief.' .... 'But she was discredited still further through being deemed to have inappropriate sexological knowledge. Pemberton-Billing asked her if she was acquainted with the term "clitoris". She answered: "Yes, but not particularly"' He then informed the court that out of twenty-four people to whom he had shown the libel, only one, a barrister, knew what it meant. Dr Cooke said that he had shown it to fifty or sixty friends of his and none of them had known what it meant. (One hopes they were not doctors.) When Pemberton Billing called Captain Spencer as a witness, he was asked about the "Cult of the Clitoris" title. He replied that he had tried to find a title "that would only be understood by those whom it should be understood by". Spencer had telephoned a village doctor and was given the term "clitoris' and told that it 'was a superficial organ that, when unduly excited or overdeveloped, possessed the most dreadful influence on any woman, that she would do the most extraordinary things". He added 'An exaggerated clitoris might drive a woman to an elephant.".... "Of course, clitoris is a Greek word", announced Dr Cooke, "it is a medical term [...] nobody but a medical man or people interested in that kind of thing, would understand the term."' Lucy Bland, 'Trial by Sexology? Maud Allan, Salome, and the "Cult of the Clitoris" Case' in Lucy Bland and Laura Doan (eds.) Sexology in Culture: labelling bodies and desires *** Literary reference: In episode 15 of Joyce's Ulysses, the protagonist Bloom, worried about the troubles a drunken younger man might encounter in the red-light district, has followed him into a bordello. At one point, about halfway through the episode (about 15.2340 in the Gabler edition), Bloom's father, whose last name was originally Virag, "appears" to Bloom and gives him sexual advice about the prostitutes in the bordello's sitting room. Among other things, Bloom's father "says": VIRAG (cynically, his weasel teeth bared yellow, draws down his left eye with a finger and barks hoarsely ) Hoax! Beware of the flapper and bogus mournful. Lily of the alley. All possess bachelor's button discovered by Rualdus Columbus. Tumble her. Columble her. Chameleon. [ The sentence "All possess..." contains the "C.F.," of course.... ] ***

According to Edna St Vincent Millay's sister Norma, one night when they were living together in Greenwich Village the poet came in and went into her sister's room. There 'without any conversation that I can remember, she told me that I had a little piece of flesh between my legs and that I should rub it back and forth. And when I thought I couldn't stand it anymore, then I should keep on rubbing it'. Norma claimed that 'I had no idea what a clitoris was', and attributed Floyd Dell, her sister's then lover, as the source of the information. (quoted in Nancy Milford, Savage Beauty: the Life of Edna St Vincent Millay, 2001), Though another biography of Millay, Daniel Mark Epstein, What Lips My Lips Have Kissed: The Loves and Love Poems of Edna St Vincent Millay, 2001, strongly implies that Millay was well-acquainted with the potential of the clitoris (from affairs with both women and men) before she ever met Dell. *** Importance given to need for clitoral stimulation by interwar British feminist writers of sex advice connected with the birth control movement (and well into the 1950s): Marie Stopes, Married Love (1918): 'Woman has at the surface a small vestigial organ called the clitoris, which corresponds morphologically to the man's penis, and which, like it, is extremely sensitive to touchsensations. This little crest, which lies anteriorly between the inner lips round the vagina, enlarges when the woman is really tumescent, and by the stimulation of movement it is intensely roused and transmits this stimulus to every nerve in her body.' Helena Wright, The Sex Factor in Marriage (1930): 'In the centre in front, is a small round body, about the size of a pea, movable to a slight extent, and coated with delicate membrane, which is always more or less moist. Its anatomical name is the clitoris. This little organ is capable of giving the most acute sensations; the tissue of which it is made is similar to that of the penis, and during sex stimulation it has the same power of filling with blood, and thereby becoming larger and harder than it is in an inactive state. The only purpose of the clitoris is to provide sensation; a full understanding of its capabilities and place in the sex-act is therefore of supreme importance.' Helena Wright, More about the Sex Factor in Marriage (1947): 'It is no exaggeration to say that since the clitoris is the essential organ of sexual sensation in women, and that rhythmic friction is the only stimulus to which it can react, orgasm failure at the outset of sexual experience is unavoidable if the clitoris is not discovered and correctly stimulated.' With detailed instruction as to how to locate and identify the clitoris and experiment with stimulation to find the best. Joan Malleson ['Medica'], Any Wife or Any Husband (1950): 'The majority [of women] find their greatest sexual feeling is situated in the front and

outer part of the vaginal passage, at the sensitive small area which is medically termed the clitoris..... The only purpose of these external parts is that when they are stimulated by gentle stroking with the finger tips, the woman's sexual feeling will be roused. Nature has placed them there entirely for this purpose - indeed, this is their only use - and the person who thinks that they are not to be enjoyed or touched is defying natural laws. Many wives are aware that the full use of the outer clitoral area will alone bring them satisfaction, yet they are too afraid either to ask, or to allow their husbands to touch this part of their body in the proper way.' *** 'The famous Professor Halban of Vienna who, Vachet had noted, had performed sex change operations on men had also performed sexual surgery on women. His efforts in this area were praised by Marie Bonaparte in a 1932 paper which she presented on the problem of frigidity. Freud, she pointed out, had demonstrated that normal women gave up the clitoris as their chief source of sexual pleasure and moved on to experience the mature vaginal orgasm. Unfortunately, therapists found that for many women the clitoris remained regrettably eroticized. The psychoanalytically enlightened had to recognize this lag as a sign of women's infantilism if not their bisexuality. Bonaparte conceded that for some the problem was due to the fact that their clitoris was too far from the vagina. The answer to such a fixation clitoridienne, she suggested, was surgical intervention to cut and move the clitoris to a more suitable locale so that the excitement it engendered would aid rather than detract from genital penetration. Bonaparte concluded her amazing essay, which came complete with disturbing photographs of the procedure, by hailing the modern surgeon's ability to aid the psychoanalyst.' Angus McLaren, Twentieth Century Sexuality: A History (1999) *** Risque blues song by Lil Johnson: Press My Button (Ring my Bell) (1936): 'I said, "Give it to me baby, you don't understand Where to put that thing Where to put that thing Just press my button, give my bell a ring!"' Full version at Harry's Blues Lyrics Online ***

From Joan Wyndham, Love is Blue: A wartime journal (1986): 'I don't know whether it's Hans's fault or mine, but I don't feel a thing. Of course, I just love being in bed with him and kissing him, but apart from that nothing happens.' ' I know a doctor,' Oscar said, 'a friend of mine went to him who had the same problem as us, and it seems we've got a thing called a clitoris, which makes us have an orgasm.' ' Yes,' I said, 'I've heard about that before.' 'Well, Dr Schliemann says they're very often not big enough, and he gives you some kind of ointment to make them grow.' This thought so inspired us that we looked up Dr S in the phone book, and made an appointment to see him that very afternoon. The consulting room was rather depressing, with a faint smell of antiseptic. A greenish light filtered through the blinds on to the huge mahogany desk. It was like being in an aquarium. A small, balding chap with glasses came in and said cheerily, 'Well, who's the first victim?' Oscar went to sit in the waiting-room, and I was laid out on a couch and examined in a most embarrassing way. Aha!' said Dr Schliemann, peering through his bifocals, 'I see you haven't got a man in your boat!' He sounded rather pleased at this discovery. Then he went on to explain about the clitoris being a kind of magic trigger, but not to worry if I hadn't got one because he would give me a special cream to rub on every night. It costs thirty bob, and in no time at all he guarantees that I will have a clitoris 'long enough and strong enough to hang a copper kettle on'! I duly forked out the thirty bob and received a small silver tube with printed instructions on it. .... Oscar and I had been rubbing away like mad with the magic cream for over a week now. She does it when I'm in the bath, and vice versa. Neither of us has noticed any appreciable difference in the length of our clitorises (clitori?) but we're certainly having plenty of orgasms! In fact we find orgasms are quite easy to have provided there aren't any men around, doing all the wrong things. ***

Something which sheds some light on the above: according to Chandak Sengoopta, 'Transforming the Testicle: Science, Medicine and Masculinity, 1800-1950', in Medicina nei Secoli arte e scienza Journal of the History of Medicine, 3/3 (2001): 'It was suspected that the male hormones increased the sensitivity and vascularization of the [female] external genitals. Their enlarging effect on the clitoris was especially striking and they were soon being recommended for the treatment (preferably by 'by the gentle inunction of an androgenic ointment') of frigidity due to clitoral insensitivity.' Though he adds 'The enhancement of female desire, needless to say, was not a comfortable topic for doctors of the mid-twentieth century.' *** Masters & Johnson in Human Sexual Response (1966) note that any sort of orgasm is OK, and that there is no physiological difference. *** Reported in the New Scientist 1 Aug 1998, the 'discovery' by Helen O'Connell, urology surgeon in Melbourne, that the clitoral nerve system extends much further than the visible external tip of the clitoris. Her article, O'Connell and others, 'Anatomical Relationship Between Urethra and Clitoris', was published in the Journal of Urology, Vol 159, 1998: abstract: We investigated the anatomical relationship between the urethra and the surrounding erectile tissue, and reviewed the appropriateness of the current nomenclature used to describe this anatomy. A detailed dissection was performed on 2 fresh and 8 fixed human female adult cadavers (age range 22 to 88 years). The relationship of the urethra to the surrounding erectile tissue was ascertained in each specimen, and the erectile tissue arrangement was determined and compared to standard anatomical descriptions. Nerves supplying the erectile tissue were carefully preserved and their relationship to the soft tissues and bony pelvis was noted. The female urethra, distal vaginal wall and erectile tissue are packed into the perineum caudal (superficial) to the pubic arch, which is bounded laterally by the ischiopubic rami, and superficially by the labia minora and majora. This complex is not flat against the rami as is commonly depicted but projects from the bony landmarks for 3 to 6 cm. The perineal urethra is embedded in the anterior vaginal wall and is surrounded by erectile tissue in all directions except posteriorly where it relates to the vaginal wall. The bulbs of the vestibule are inappropriately named as they directly relate to the other clitoral components and the urethra. Their association with the vestibule is inconsistent and, thus, we recommend that these structures be renamed the bulbs of the clitoris. A series of detailed dissections suggest that current anatomical descriptions of female human urethral and genital anatomy are inaccurate. Though perhaps not found in Gray's Anatomy or other medical textbooks, this 'secret of nature' was certainly already known in the late 1980s (if not earlier) and mentioned in John Bancroft's Human Sexuality and its Problems (2nd edition 1989). ***

Perceptions of a different culture. From Moris Farhi, 'Lentils in Paradise: A true and nostalgic account of my visits, as a little boy, to the Women's Baths in Ankara'. 'In Turkey, as in most Muslim countries, the ancient Bedouin tradition whereby women, upon their marriage, shave their pubic hair, has almost acquired the dimensions of a hygienic commandment'. This activity took place in the women's Hamam (public baths), to which children, girls and boys, were admitted free with the women. As for clitorises, it is common knowledge that, like penises, they vary in size. The Turks, so rooted in the land, had classified them into three distinct categories, naming each one after a popular food. Small clitorises were called "susam", "sesame"; "mercimek", "lentils" distinguished the medium sized ones - which, being in the majority, were also considered to be "normal"; and "nohut", "chick-peas", identified those of large calibre. Women in possession of "sesames" were invariably sullen; the smallness of their clitorises, though it seldom prevented them from enjoying sex to the full, inflicted upon them a ruthless sense of inferiority; as a result, they abhorred children, particularly those who were admitted to the Baths. Women blessed with "lentils" bore the characteristics of their namesake, a staple food in Turkey. Hence, the "lentilled" women's perfect roundness were not only aesthetically pleasing, but also extremely nourishing; in effect, they offered everything a man sought from a wife: love, passion, obedience and the gift for cooking. Those endowed with "chick-peas" were destined to ration their amorous activities since the abnormal size of their clitorises induced such intense pleasure that regular sex invariably damaged their hearts; restricted to conjoining only for purposes of conception, these women were to find solace in a spiritual life. And they would attain such heights of piety that, during labour, they would gently notch, with their "chickpeas", a prayer-dent on their babies' foreheads thus marking them for important religious duties. *** Much more about the clitoris: The-Clitoris.com Thanks to Ivan Crozier, Greg Downing, David Greenberg, Jonathan Katz, Jim Miller, Florence Binard, Malcolm Shifrin.