The Modern Ovary: Constructions,Meanings,Uses

See Sharpey-Schafer E. , “Endocrine physiology” (The First John Mallet Purser Lecture, Trinity College, Dublin, 26 June 1931), Irish journal of medical science, 6th ser, no. 69 (September 1931), 483–505, p. 484. On Schäfer's career, see Borell Merriley , “Setting the standards for a new science: Edward Schäfer and endocrinology”, Medical history, xxii (1978), 282–90.

Schäfer E. A. , “Address in physiology on internal secretions”, Lancet , 10 August 1895, 321–4, p. 321; idem, “The hormones which are contained in animal extracts: Their physiological effects”, Pharmaceutical journal, lxxix (1907), 670–74, p. 670; and Borell Merriley , “Organotherapy and the emergence of reproductive endocrinology”, Journal of the history of biology, xviii (1985), 1–30, pp. 12–13.

For a survey of the pre-nineteenth-century history of the ovary — Which, if anything, was even more complex than the one I focus on here — See Pinto-Correia Clara , The ovary of Eve: Egg and sperm and preformation (Chicago, 1997).

In addressing these issues, I do my best to avoid the epistemological assumption that physiological models and clinical practices change because of the correction of earlier mistakes and misconceptions through better, steadily incremental research. This is not necessarily wrong but of little use to a historian exploring scientific issues in their specific, historical contexts. Instead of assessing the achievements of past scientists by the criteria of today's medical science — A trait characterizing the work, for instance, of Hans Simmer and his students at the University of Erlangen-Nürnberg on nineteenth-century investigations of ovarian function, which is otherwise among the most comprehensive and historically accurate work ever done on the history of medicine — I concentrate on trying to explain why certain theories and practices may have been prevalent or obsolescent at a particular time and locale.

I shall be using the terms ‘gonad(s)’ and ‘sex gland(s)’ interchangeably, although, strictly speaking, the term ‘gonad’ means an organ producing reproductive cells alone. For an early twentieth-century discussion of such terminological issues, see Lipschütz Alexander , The internal secretions of the sex glands: The problem of the “Puberty Gland” (Cambridge, 1924), 473.

Even though he concentrated exclusively on whatever was relevant to the “endocrine function of the ovary”, George Corner remarked: “It would be easy enough to explain the discovery of some other endocrines, for example insulin or adrenaline, without fear of losing the thread of my discourse; but here we must follow not a single thread, but a whole tangle of them, some of which will end nowhere.” See Corner George W. , “The early history of the oestrogenic hormones”, Journal of endocrinology, xxxi (1964–65), pp. iii–xvii, p. iv.

For a similar argument against presentist history of medicine, see Lawrence Christopher , “‘Definite and material’: Coronary thrombosis and cardiologists in the 1920s”, in Rosenberg Charles E. Golden Janet (eds), Framing disease: Studies in cultural history (New Brunswick, 1992), 50–82, pp. 52–53. The endocrinological version of the tale I try to tell here can be found in Medvei V. C. , The history of clinical endocrinology (Carnforth, Lancs, 1993) and Rolleston Humphry Davy , The endocrine organs in health and disease, with a historical review (London, 1936). A more culturally nuanced historical approach to sex-gland research was called for more than two decades ago by Hall Diana Long , “Biology, sex hormones and sexism in the 1920s”, Philosophical forum, v, nos 1–2 (1973/74), 81–96, a pioneering article that continues to inspire.

The history of the elucidation of menstruation awaits a comprehensive study. See, however, Corner George W. , “Our knowledge of the menstrual cycle, 1910–1950”, Lancet, 28 April 1951, 919–23; and O'Dowd Michael J. Philip Elliot E. , The history of obstetrics and gynaecology (London, 1994), 260–1.

These and many related topics are being explored in Helen Blackman's doctoral thesis in progress at the University of Manchester, “Women, savages and other animals: The comparative physiology of reproduction, c. 1850–1914”.

Much, for instance, has been written by Anglophone scholars on the removal of ovaries in hysteria and ‘nervous’ disorders — But only with respect to American or British practitioners of that operation. The German gynaecologist Alfred Hegar's energetic advocacy of that operation was of great influence in his time not only in Central Europe but also in English-speaking nations. Virtually nothing, however, can be found on Hegar's work in Anglophone scholarship, a few simplistic passages in Thomas Laqueur's monograph, Making sex: Body and gender from the Greeks to Freud (Cambridge, Mass., 1991) representing the only exception.

See Tait R. Lawson , The pathology and treatment of diseases of the ovaries (being the Hastings essay for 1873), 4th edn (Birmingham, 1883), 3.

Oudshoorn Nelly , Beyond the natural body: An archeology of the sex hormones (London, 1994), 19.

See Virchow Rudolf , “Der puerperale Zustand: Das Weib und die Zelle”, in Virchow , Gesammelte Abhandlungen zur wissenschaftlichen Medizin (Frankfurt am Main, 1856), 735–79. On the contexts of the lecture, see Simmer Hans H. , “Zum Frauenbild Rudolf Virchows in den späten 1840er Jahren”, Medizinhistorisches Journal, xxvii (1992), 292–319; and Simmer , “Der junge Rudolf Virchow und die Gesellschaft für Geburtshülfe in Berlin in den Jahren 1846–1848”, Sudhoffs Archiv: Zeitschrift für Wissenschaftsgeschichte, lxxvii (1993), 72–96. All translations in this essay, unless otherwise attributed, are my own.

For Virchow's explanation of his unusual definition of the puerperium, see “Der puerperale Zustand” (ref. 13), 735–36.

On this issue, see Holle Stefanie , “Die Widerlegung des Postulates von der Gleichzeitigkeit der Ovulation und Menstruation bei der Frau: Klinische und histologische Untersuchungen im frühe 20. Jahrhundert” (Inaugural Dissertation, Medical Faculty, University of Erlangen-Nürnberg, 1984).

Unfortunately, there is no comprehensive historical analysis of these important concepts and their contexts and consequences. But see Maulitz Russell C. , “The pathological tradition”, in Bynum W. F. Porter Roy (eds), Companion encyclopaedia of the history of medicine (London, 1993), i, 169–89, pp. 181–4; and Miciotto Robert J. , “Carl Rokitansky: A reassessment of the hematohumoral theory of disease”, Bulletin of the history of medicine, lii (1978), 183–99.

See Maulitz , “Pathological tradition” (ref. 16).

Virchow , “Der puerperale Zustand” (ref. 13), 739–40, 746.

Ibid., 747.

This shift has not been sufficiently explored by historians. But see Walker Anne E. , The menstrual cycle (London, 1997), 34–35.

On Van Helmont, see Simmer , “Zum Frauenbild Rudolf Virchows” (ref. 13), 308–10.

In Europe Central , Theodor Ludwig Bischoff had expressed himself almost identically in 1844. See ibid., 312.

On the cultural importance of sensibility for the nineteenth-century German Bildungsbürgertum, see Radkau Joachim , Das Zeitalter der Nervosität: Deutschland zwischen Bismarck und Hitler (Munich, 2000), 44–45. Cf. the earlier (British) history of the concept in Barker-Benfield G. J. , The culture of sensibility: Sex and society in eighteenth-century Britain (Chicago, 1992).

See Smith-Rosenberg Carroll Rosenberg Charles , “The female animal: Medical and biological views of woman and her role in nineteenth-century America”, in Leavitt Judith Walzer (ed.), Women and health in America: Historical readings (Madison, Wisc., 1984), 12–27, p. 13.

The American surgeon Robert Battey initially described the removal of such ovaries as “normal ovariotomy”. He soon regretted that nomenclature and clarified that “the ovaries removed, and the tubes as well, have presented visible signs of disease — Signs which are evident to the naked eye and palpable to the sense of touch. For the misconception upon this point still existing, my own ignorance of both the histology and pathology of the ovaries is largely responsible in that, during the early history of the operation, I removed ovaries which I erroneously supposed to be healthy, and gave to the operation the unfortunate and now obsolete name of ‘normal ovariotomy’”. He listed the pathological features he began to notice once he had acquired greater knowledge of ovarian histology: Small cysts, sclerosis of the investing tunic, fibrous degeneration of the stroma, salpingitis, hydrosalpinx, and pyosalpinx. See Battey's untitled contribution to Wells T. Spencer Hegar Alfred Battey Robert , “Castration in mental and nervous diseases: A symposium”, American journal of the medical sciences, n.s., xcii (1886), 455–90, pp. 483–90, quoted material on pp. 483–4.

Although nineteenth-century medical usage was not always consistent, in English, ‘oophorectomy’ usually referred to the removal of ostensibly healthy or normal-sized ovaries whereas the etymologically inaccurate term ‘ovariotomy’ was generally reserved for the removal of cystic or otherwise enlarged ovaries. German practitioners almost invariably used the term ‘c(k)astration’ for bilateral oophorectomy. For the sake of clarity, I have followed the English convention throughout, even when referring to German research. For more on terminological issues, see Moscucci Ornella , The science of woman: Gynaecology and gender in England, 1800–1929 (Cambridge, 1990), 157, 239 (n. 1); and Simmer H. H. , “Oophorectomy for breast cancer patients: Its proposal, first performance, and first explanation as an endocrine ablation”, Clio medica, iv (1969), 227–49, p. 240, n. 1. On the history of oophorectomy in general, see Moscucci , The science of woman , 134–64, especially pp. 157–60; Barker-Benfield Ben , “The spermatic economy: A nineteenth century view of sexuality”, Feminist studies, i (1972), 45–74, pp. 60–66; Longo Lawrence D. , “The rise and fall of Battey's operation: A fashion in surgery”, in Leavitt Judith W. (ed.), Women and health in America (ref. 24), 270–84; Laqueur , Making sex (ref. 10), 176–81; Scull Andrew Favreau Diane , ‘“A chance to cut is a chance to cure’: Sexual surgery for psychosis in three nineteenth century societies”, Research in law, deviance and social control, viii (1986), 3–39, pp. 14–26; Simmer H. H. , “Bilaterale Oophorektomie der Frau im späten 19. Jahrhundert: Zum methodologischen Wert der Kastration für die Entdeckung ovarieller Hormone”, Geburtshilfe und Frauenheilkunde, xliii (1983), Sonderheft, 54–59; Shorter Edward , “Medizinische Theorien spezifisch weiblicher Nervenkrankheiten im Wandel”, in Labisch Alfons Spree Reinhard (eds), Medizinische Deutungsmacht im sozialen Wandel des 19. und frühen 20. Jahrhunderts (Bonn, 1989), 171–80, pp. 173–6; Funk Thilo G. , “Uterine Fibromyome und Blutungen als Indikation für eine bilaterale Oophorektomie im späten 19. Jahrhundert”, Medizinhistorisches Journal, xxi (1986), 159–71; and Burger Günter , “Nerven- und Geisteskrankheiten als Indikationen für eine bilaterale Oophorektomie im späten 19. Jahrhundert” (Inaugural-Dissertation, University of Erlangen-Nürnberg, Medical Faculty, 1984). On the use of the operation for mental and ‘functional’ nervous disorders in the German-speaking lands between 1872 and 1892, see Burger , “Nerven- und Geisteskrankheiten als Indikationen” (ref. 26), 24–41, 61–108, and 126–43.

Since the history of the introduction and dissemination of oophorectomy in Britain and America is treated in great detail by the general works cited previously, I shall concentrate on the German oophorectomy saga.

Many did not even agree that the ovaries were at all involved in the process — Robert Battey was, in fact, criticized for his uncritical assumption of this hypothesis. See Longo , “Rise and fall” (ref. 26), 275.

For a concise overview of these well-known themes, see Pfeffer Naomi , The stork and the syringe: A political history of reproductive medicine (Cambridge, 1993), 34–35.

See Longo , “Rise and fall” (ref. 26), 274.

Quoted in Scull Favreau , ‘“A chance to cut’” (ref. 26), 15.

See Goodell William , Lessons in gynecology (Philadelphia, 1890), 394–5; and Morantz Regina Zschoche Sue , “Professionalism, feminism, and gender roles: A comparative study of nineteenth century medical therapeutics”. Journal of American history, xlvii (1980), 568–88.

See Hegar's untitled contribution (transl. by Handfield-Jones Montagu ) to Wells Hegar Spencer Battey , “Castration in mental and nervous diseases” (ref. 25), 471–83, p. 480.

Hegar A. Kaltenbach R. , A hand-book of general and operative gynaecology, transl. anon., vols vi–vii of Grandin Egbert H. , (ed.), Cyclopaedia of obstetrics and gynaecology (Edinburgh, 1889), vi, 303.

See Funk , “Uterine Fibromyome und Blutungen als Indikation für eine bilaterale Oophorektomie” (ref. 26) for a convincing demonstration of the importance of bleeding fibromyomas and the little that could be done for them before the introduction of oophorectomy — Or, for that matter, blood transfusion. As another champion of oophorectomy pointed out once, there was a social component to the popularity of oophorectomy in such cases: The operation was especially suitable, he argued, for those patients whose social status did not permit them the prolonged bed-rest and comprehensive care necessary for the conservative management of profuse uterine bleeding. See Menzel H. , “Beiträge zur Castration der Frauen, I: Castrationen bei Ovarialprolaps, Uterusfibrom, Retroflexio uteri mit Descensus ovariorum und Hysterie”, AfG, xxvi (1885), 36–57, p. 47.

See the overview of cases oophorectomized in Hegar's Freiburg clinic for nervous symptoms: Schmalfuss G. , “Zur Castration bei Neurosen”, AfG, xxvi (1885), 1–35.

See, for instance, Fehling Hermann , “Zehn Castrationen: Ein Beitrag zur Frage nach dem Werthe der Castration”, AfG, xxii (1883), 441–55, p. 455.

See Menzel , “Beiträge zur Castration der Frauen, I” (ref. 35), 50–51.

See, for instance, Flechsig Paul , “Zur gynaekologischen Behandlung der Hysterie”, Neurologisches Centralblatt, iii (1884), 433–9, 457–68, p. 458. Flechsig, incidentally, was a leading psychiatrist and neuroanatomist and has attained a dubious immortality as the persecutor of Daniel Paul Schreber, one of whose beliefs was that Flechsig was out to “unman” him. Morton Schatzman (Soul murder: Persecution in the family (Harmondsworth, 1973), 106–7) argues with reference to Flechsig's paper (above) that Schreber's doctor was undoubtedly capable of that. Schatzman does not, however, note that Flechsig's castration was of a female hysteric. For a comprehensive study of the Schreber case, see Lothane Zvi , In defense of Schreber: Soul murder and psychiatry (New York, 1992).

See Laqueur , Making sex (ref. 10), 177.

On this point, see Burger , “Nerven- und Geisteskrankheiten” (ref. 26) and Bynum W. F. , “The nervous patient in eighteenth- and nineteenth-century Britain: The psychiatric origins of British neurology”, in Bynum W. F. Porter Roy Shepherd Michael (eds), The anatomy of madness: Essays in the history of psychiatry (London, 1985–88), i, 89–102.

See Hegar's contribution to the symposium on “Castration in mental and nervous diseases” (ref. 33), 477.

Hegar Kaltenbach , Hand-book of general and operative gynaecology (ref. 34), vi, 307.

See Stilling Benedikt , Physiologisch-pathologische und medicinisch-praktische Untersuchung über Spinal-Irritation (Leipzig, 1840).

The concept of reflex neuroses was introduced by Moritz Romberg in his influential text, Lehrbuch der Nervenkrankheiten des Menschen, 2nd edn (Berlin, 1851), i, p. 2, 198–223, pp. 210–11. On Hegar's use of the concept (which was consistent in spite of his use of different terms to denote it at different points in his career), see Burger , “Nerven- und Geisteskrankheiten als Indikationen” (ref. 26), 7–9, 154–5. Generally, on ovarian theories of hysteria, see Veith Ilza , Hysteria: The history of a disease (Chicago, 1965), 173, 210, 232; and Micale Mark , “Hysteria male/hysteria female: Reflections on comparative gender construction in nineteenth-century France and Britain”, in Benjamin Marina (ed.), Science and sensibility: Gender and scientific enquiry, 1780–1945 (Oxford, 1991), 200–39, pp. 225–6.

The ovaries still being inaccessible except to surgeons, the uterus was often targeted for treatment in the belief that since the female nervous system was linked intimately with the reproductive system, any intervention in the latter would affect the former. This trend seems to have been particularly strong in Britain, where, in the absence of a strong tradition of ‘office psychiatry’, relatively minor cases of mental or nervous disorders in women were often treated by gynaecologists. See Scull Andrew , The most solitary of afflictions: Madness and society in Britain, 1700–1900 (New Haven, Conn., 1993), 255–9; Showalter Elaine , The female malady: Women, madness, and English culture, 1830–1980 (London, 1987), 55–57; and Mackenzie Charlotte , Psychiatry for the rich: A history of Ticehurst Private Asylum, 1792–1917 (London, 1992), 155–6. The comparative history of the treatment of women's nervous disorders in the various European nations has yet to be written.

[Joseph] Amann , Ueber den Einfluss der weiblichen Geschlechtskrankheiten auf das Nervensystem mit besonderer Berücksichtigung des Wesens und der Erscheinungen der Hysterie, 2nd edn (Erlangen, 1874), p. IV.

Ibid., 73–74.

Ibid., 79.

Ibid. , 86. Not every doctor, however, had lost faith in Romberg's notion. Heinrich Kisch, Privatdozent at the German University in Prague and physician at the Marienbad spa, reiterated that hysteria was a reflex neurosis common during the two great periods of reproductive transition, puberty and menopause. Women who suffered from hysterical symptoms around menopause had almost invariably suffered from similar symptoms around puberty. See Kisch E. Heinrich , Das klimakterische Alter der Frauen in physiologischer und pathologischer Beziehung (Erlangen, 1874), 69, 138.

See Jolly F. , “Hysterie und Hypochondrie”, in Eulenburg A. Nothnagel H. Bauer J. von Ziemssen H. Jolly F. , Handbuch der Krankheiten des Nervensystems II, = xii/2 (1877) of von Ziemssen H. (ed.), Handbuch der speciellen Pathologie und Therapie, 2nd edn (17 vols in numerous parts, Leipzig, 1876–85), 489–709, pp. 495, 501–2.

Ibid., 509.

Rheinstaedter A. , “Ueber weibliche Nervosität, ihre Beziehungen zu den Krankheiten der Generationsorgane und ihre Allgemeinbehandlung”, Sammlung klinischer Vorträge, clxxxviii, Gynäkologie no. lvi (1880), 1493–510, p. 1495.

Döderlein A. Krönig B. , Operative Gynäkologie (Leipzig, 1905), 594.

See ibid., 595–6 and Binswanger O. , Die Hysterie (1904), = xii/1, section 2 of Nothnagel Hermann (eds), Specielle Pathologie und Therapie (24 vols in numerous parts, Vienna, 1894–1908), 59–60, 843–4, 945–6 and, on the degenerative basis of hysteria, 36–44.

Döderlein Krönig , op. cit. (ref. 54), 596–7.

Hegar A. , “Die Castration der Frauen”, in Volkmann Richard (ed.), Sammlung klinischer Vorträge , nos cxxxvi–cxxxviii, Gynäkologie no. xlii (1878), 925–1068, p. 1001.

Hegar Kaltenbach , A hand-book of general and operative gynaecology (ref. 34), vi, 300. For a powerful challenge to Hegar's argument that oophorectomy did not reduce sex drive, see Glaevecke Ludwig , “Körperliche und geistige Veränderungen im weiblichen Körper nach künstlichem Verluste der Ovarien einerseits und des Uterus andererseits”, AfG, xxxv (1889), 1–88, pp. 53–55.

Keppler F. , “Das Geschlechtsleben des Weibes nach der Kastration”, Wiener medizinische Wochenschrift, xxxxi (1891), 1489–92 and 1523–6, p. 1525.

See Hegar's contribution to “Castration in mental and nervous Diseases: A symposium” (ref. 33), 471.

Hegar , “Die Castration der Frauen” (ref. 57), 926–31.

Even the well-known physical changes after menopause he was inclined to attribute at least partly to ageing in general and the mental changes to experience. See ibid., 1002.

Ibid., 1000.

See Hegar A. , “Ueber die Exstirpation normaler und nicht zu umfänglichen Tumoren degenerirter Eierstöcke”, CfG, i (1877), 297–306, pp. 298–9.

Ibid., 305; and “Die Castration der Frauen” (ref. 57), 1004–5.

See Glaevecke , op. cit. (ref. 58), 31–32, 50.

See Blönnigen Jutta , “Die Osteomalazie als Indikation für eine bilaterale Oophorektomie im späten 19. u. frühen 20. Jahrhundert: Ergebnisse und Erklärungsversuche” (Inaugural-Dissertation, Medical Faculty, University of Erlangen-Nürnberg, 1980); and Simmer , “Oophorectomy for breast cancer patients” (ref. 26).

It is the adult equivalent of rickets and shares the same causal factors.

The fewer cases of osteomalacia in men were often considered to be fundamentally different. See Fehling H. , “Ueber Wesen und Behandlung der puerperalen Osteomalakie”, AfG, xxxix (1891), 171–96, pp. 180–1.

On contemporary convictions of endemicity, see, for instance, Thorn W. , “Zur Kasuistik der Kastration bei Osteomalakie”, CfG, xv (1891), 828–31.

See Strümpell Adolf , Lehrbuch der speciellen Pathologie und Therapie der inneren Krankheiten (Leipzig, Vogel, 1883–84), ii, p. 2, 169–72.

See Zweifel Paul , “Zur Discussion über Porro's Methode des Kaiserschnittes”, AfG, xvii (1881), 355–77; idem, “Ein Fall von Osteomalacie, modificirter Porro-Kaiserschnitt, geheilt”, CfG, xiv (1890), 25–29, esp. p. 28.

Blönnigen , “Die Osteomalazie als Indikation für eine bilaterale Oophorektomie” (ref. 67), 10–12. Fehling rejected suggestions that the prevention of pregnancy by tubal ligation would be sufficient to relieve osteomalacia, pointing out that of his eight cases till date, the majority (six) had had their last pregnancies more than two years ago. See Fehling H. , “Zur Frage der Therapie bei Osteomalacie”, CfG, xiv (1890), 73–74.

See Zweifel P. , “Hermann Johannes Karl Fehling”, CfG, xlix (1925), 2866–74; and Franz K. , “Hermann Fehling”, AfG, cxxvii (1926), pp. I–IV.

Fehling H. , “Über Kastration bei Osteomalacie”, Verhandlungen der Deutschen Gesellschaft für Gynäkologie, ii (1888), 311–18. Fehling also reported on two other operations in this paper. In one, the operation had led to immediate improvement but the patient had soon relapsed and the other patient, although apaprently recovering, had been operated upon too recently to be commented upon.

See Blönnigen , op. cit. (ref. 67), 29–39.

A proportion did show some relatively minor (and quite inconsistent) abnormalities such as hypertrophy, atrophy, cysts, hyaline degeneration and chronic oophoritis. See Blönnigen , op. cit. (ref. 67), 31–39.

See Blönnigen , op. cit. (ref. 67), 51.

Fehling H. , “Ueber Wesen und Behandlung der puerperalen Osteomalakie”, AfG, xxxix (1891), 171–96; and idem, “Weitere Beiträge zur Lehre von der Osteomalakie”, AfG, xxxxviii (1895), 472–98.

On support for the neural hypothesis, see Hofmeier M. , CfG, xv (1891), 225–8; Thorn , op. cit. (ref. 70); Eisenhart H. , “Beiträge zur Aetiologie der puerperalen Osteomalacie”, Deutsches Archiv für klinische Medizin, xlix (1892), 156–205; and Rossier Guillaume , “Anatomische Untersuchung der Ovarien in Fällen von Osteomalacie”, AfG, xlviii (1895), 472–98.

von Winckel F. , “Über die Erfolge der Kastration bei Osteomalakie”, Sammlung klinischer Vorträge, n.s., lxxi, Gynäkologie no. xxviii (1893), 657–82, pp. 673–4.

See Blönnigen , op. cit. (ref. 67), 60–61. Fehling (“Weitere Beiträge zur Lehre von der Osteomalakie” (ref. 69), 484–5) pointed out that patients of osteomalacia had never improved after being chloroformed for purposes other than oophorectomy or after taking chloral as a sleeping draught. Oophorectomy even under anaesthesia with ether, on the other hand, had led to striking results.

Senator Hermann , “Zur Kenntniss der Osteomalacie und der Organotherapie”, Berliner klinische Wochenschrift, xxxiv (1897), 109–12, 143–4; and Latzko Wilhelm Schnitzler Julius , “Ein Beitrag zur Organotherapie bei Osteomalacie”, Deutsche medizinische Wochenschrift, xxiii (1897), 587–92.

See, for example, Hoennicke Ernst , “Zur Theorie der Osteomalacie: Zugleich zur Lehre von den Krankheiten der Schilddrüse”, Berliner klinische Wochenschrift, xxxxi (1904), 1154–6; Bossi M. L. , “Die Nebennieren und die Osteomalacie”, AfG, lxxxiii (1907), 505–44; Bab Hans , “Die Behandlung der Osteomalacie mit Hypophysenextrakt”, Münchener medizinische Wochenschrift, lxv (1911), 1814–17; Curschmann Hans , “Über den mono- und pluriglandulären Symptomenkomplex der nichtpuerperalen Osteomalacie”, Deutsches Archiv für klinische Medizin, cxxix (1919), 93–117; and Naegeli , “Uebersicht über die Symptomatik der Osteomalazie als innersekretorischer pluriglandulärer Erkrankung”, Münchener medizinische Wochenschrift, lxv (1918), 585–6.

See, for instance, Döderlein Krönig , Operative Gynäkologie (ref. 54), 540–2.

Hofmeier M. , “Zur Frage der Behandlung der Osteomalacie durch Kastration”, CfG, xv (1891), 225–8, pp. 224, 227. Why removing the ovaries was effective in osteomalacia, however, is a question that cannot, as Jutta Blönnigen emphasizes, be solved even with the aid of today's knowledge of endocrinology, and no consensus was ever reached on the issue in the earlier decades of the century. See Blönnigen , op. cit. (ref. 67), 84.

See Beatson G. T. , “On the treatment of inoperable cases of carcinoma of the mamma: Suggestions for a new method of treatment with illustrative cases”, The lancet , 11 July 1896, 104–7, and 18 July 1896, 162–5. On his life and career, see the obituary by G. H. Edington in the British medical journal, 25 February 1933, 344–5. Beatson's experiments are sometimes presented quite unjustifiably by today's clinicians as pioneering examples of “hormonal cancer therapeutics”. See, for example, Gulliford Tim Epstein Richard J. , “Endocrine treatment of cancer”, Journal of the Royal Society of Medicine, lxxxix (1996), 448–53, quoted phrase on p. 448. A somewhat more nuanced presentation is Leake Robin , “100 years of the endocrine battle against breast cancer”, Lancet, cccxlvii (1996), 1780–1.

Beatson , “On the treatment of inoperable cases of carcinoma” (ref. 87), 106.

Ibid., 106.

Ibid., 106.

Ibid. , 107. In a later article, he stated that thyroid “powerfully affects the metabolism generally of the body cells, raising their tone and improving their vigour, while it acts favourably on the lymphatic system, lessening the chances of dissemination by it”. See Beatson G. T. , “The treatment of cancer of the breast by oöphorectomy and thyroid extract”, British medical journal, 19 October 1901, 1145–8, p. 1147.

Beatson , “On the treatment of inoperable cases of carcinoma” (ref. 87), 163.

Beatson , “The treatment of cancer of the breast by oöphorectomy and thyroid extract” (ref. 91), 1146.

Beatson , “On the treatment of inoperable cases of carcinoma” (ref. 87), 163.

Ibid. , 164. Beatson thought that the testicles probably had a similar influence on cancer in men: “I am making inquires as to the existence of cancer amongst eunuchs, for if my view is correct they should not suffer from it” (ibid.). In the late nineteenth century, many theories of cancer argued that it was a parasitic disease. On these, see Wolff Jacob , The science of cancerous disease from earliest times to the present, transl. by Ayoub Barbara (Canton, Mass., 1989), 431–590.

See Simmer , “Oophorectomy for breast cancer patients” (ref. 26), 232–3.

Beatson G. T. , “Remarks on the etiology of carcinoma: Has it a physiological function in the body?”, British medical journal, 29 April 1905, 921–5, p. 924.

Boyd Stanley , “On oophorectomy in the treatment of cancer”, British medical journal , 2 October 1897, 890–6. Boyd did not, however, use thyroid extract until the oophorectomy had obviously failed to bring about any improvement. He later explained that “when endeavouring to ascertain the effect of one mode of treatment based upon highly theoretical considerations it is surely unwise to combine it with another method resting on still more shadowy grounds”. Even when he used thyroid in the failing cases, he noticed no beneficial effects. See Boyd S. , “On oophorectomy in cancer of the breast”, British medical journal, 20 October 1900, 1161–7, p. 1166.

Boyd , “On oophorectomy in the treatment of cancer” (ref. 98), 895.

Ibid., 896.

Boyd , “On oöphorectomy in cancer of the breast” (ref. 98).

Ibid., 1166.

Ibid., 1166.

Less well-known, even in its time, was the 1874 report of physiologist Friedrich Goltz (1834–1902) that a bitch with her spinal cord transected at the level of the first cervical vertebra had gone into oestrus, mated (with a male toward whom she had previously been antagonistic), and became pregnant with triplets. It had long been known that oestrus did not occur in the absence of the sex glands but Goltz's experiment began to indicate how the sex glands might affect the brain to produce the mating urge characterizing oestrus. In an intact animal, Goltz argued, one could assume that centripetal nerve fibers from the sex glands stimulated the brain to produce oestrus but that hypothesis was obviously inapplicable to an animal whose spinal cord had been completely separated from the brain. Goltz, therefore, concluded that the sex glands exerted their effect on the brain by releasing specific chemical substances into the blood during oestrus. See Goltz F. Freusberg A. , “Ueber den Einfluss des Nervensystems auf die Vorgänge während der Schwangerschaft und des Gebärakts”, Archiv für die gesammte Physiologie, ix (1874), 552–65. If one refused to surrender the neural perspective, the only available option, said Goltz, was to assume that the sex glands and the brain were not connected through the spinal cord but through that portion of the autonomic nervous system, which originated from the spinal cord above the level of transection and did not ‘travel’ with it. Such a hypothesis was plausible but the chemical theory, he believed, was more reasonable. Hans Simmer has pointed out that despite its acuity, Goltz's hypothesis was virtually ignored. This, says Simmer, may have been caused by the lack of a theoretical basis, which became available only after Brown-Séquard's expansion of Claude Bernard's concept of internal secretion into a system of regulation akin to the nervous system. See Simmer , “Bilaterale Oophorektomie der Frau” (ref. 26), 57. This is certainly true for the 1870s but why was Goltz's work not resurrected and celebrated in the 1890s? Because, I would suggest, the 1890s was the heroic age of gynaecological research on the ovaries: The vast majority of researchers were clinical gynaecologists and the bulk of their research was conducted with explicit clinical motivations. They may not even have been aware of a physiologist's study (even though it was published in the leading physiological journal of the era) that had raised few ripples within physiological circles. The only turn-of-the-century instance of an enthusiastic recognition of the implications of Goltz's experiment that I know of was not of a scientist but that of the well-informed, idiosyncratic Viennese philosopher Otto Weininger (1880–1903). On Weininger's use of Goltz's experiment and other early reports on the origin and nature of sex, see Sengoopta Chandak , Otto Weininger: Sex, science, and self in Imperial Vienna (Chicago, 2000), 74–76.

Evans H. M. , “Present position of our knowledge of anterior pituitary function”, Journal of the American Medical Association, ci (1933), 425–32, p. 425. Evans specifically mentioned Brown-Séquard and the controversial physiologist of the 1920s, Eugen Steinach (1861–1944). On the former, see Borell Merriley , “Origins of the hormone concept: Internal secretions and physiological research, 1889–1905”, Ph.D. thesis, Yale University, 1976. On Steinach, see below.

See Borell Merriley , “Organotherapy and the emergence of reproductive endocrinology”, Journal of the history of biology, xviii (1985), 1–30.

Bainbridge W. S. , “Transplantation of human ovaries: Present status and future possibilities”, American journal of obstetrics and gynecology, v (1923), 493–8, pp. 493–4.

Bainbridge was neither the first gynaecologist nor the only one to express similar views. In 1902, for example, another American gynaecologist had written: “That the removal of healthy tissue is bad surgery has always been an axiom among operators. Many have reproached the gynecologist for being the most marked offender in this regard, and certainly it would seem that there has been some truth in the charge … in the early days of operative gynecology, not so many years ago, the removal of diseased structures previously considered as beyond the province of the surgeon was looked upon as leaving but little to be desired. Careful study of the after histories of operative cases soon showed however, that although the patient might recover from the immediate operation, she might still be the victim of symptoms of a subjective nature, which made her life miserable. These symptoms were soon rightly attributed to the castration, and conservative gynecology owes its existence to the attempt to escape the results of the operative menopause”. See Nicholson W. R. , “A review of the literature of ovarian transplantation”, University of Pennsylvania medical bulletin, xiv (1901–2), 401–7, p. 401. Nicholson was Instructor in Gynaecology at the University of Pennsylvania.

See Borell Merriley , “Brown-Sequard's organotherapy and its appearance in America at the end of the nineteenth century”, Bulletin of the history of medicine , 1 (1976), 309–20; and idem, “Organotherapy, British physiology, and discovery of the internal secretions”, Journal of the history of biology, ix (1976), 235–68.

See Corner , “Early history” (ref. 6), p. vi.

See Simmer H. H. , “Organotherapie mit Ovarialpräparaten in der Mitte der neunziger Jahre des 19. Jahrhunderts: Medizinische und pharmazeutische Probleme”, in Hickel Erika Schröder Gerald (eds), Neue Beiträge zur Arzneimittelgeschichte (Stuttgart, 1982), 229–64.

Corner , “Early history” (ref. 6), p. vi.

See Lesky Erna , The Vienna Medical School of the 19th century, transl. by Williams L. Levij I. S. (Baltimore, 1976), 427–33. Quoted material on pp. 427 and 487.

See Chrobak R. , “Über Einverleibung von Eierstocksgewebe”, CfG, xx (1896), 521–4.

See Borell , “Organotherapy, British physiology and discovery of the internal secretions” (ref. 109).

Chrobak , “Ueber Einverleibung von Eierstocksgewebe” (ref. 114), 522. Chrobak referred to an earlier report by Mainzer F. , “Vorschlag zur Behandlung der Ausfallserscheinungen nach Castration”, Deutsche medizinische Wochenschrift, xxii (1896), 188. Mainzer had reported on the successful treatment of post-oophorectomy symptoms in one patient with ovarian extracts and had proffered the same analogy with thyroid extracts. The sequelae of thyroidectomy were well-documented by the 1880s, and were being treated with thyroid extracts by 1891: This has often been seen as “the first generally recognized success of organotherapy”. See Medvei , History of clinical endocrinology (ref. 7), 160–62, quote from p. 162.

He reported having administered powdered ovarian substance to eight patients in all, with no controls and sometimes no follow-up. Of those, three patients reported a significant diminution of symptoms — Of the others, one had dropped out and the rest had only very recently been put on the treatment. The powder had not caused any negative symptoms in any of the patients. Chrobak admitted that his uncontrolled experiments did not permit any conclusions about the efficacy of the treatment or its mechanism of action. See Chrobak , “Ueber Einverleibung von Eierstocksgewebe” (ref. 114), 523–4.

It is interesting to compare this with the independent introduction of oophorectomy by three surgeons in the United States, Britain, and Germany in 1872. See Simmer , “Bilaterale Oophorectomie der Frau” (ref. 26).

The two were Theodor Landau (1861–1932) of Berlin and Richard Mond (b. 1867) of Kiel. Landau's idea was tested in the gynaecological clinic of his elder brother Leopold Landau by the latter's assistant, Ferdinand Mainzer. Mainzer's preliminary report was published before Chrobak's and was cited by the latter. See Simmer , “Organotherapie mit Ovarialpräparaten” (ref. 111). The analogy between the thyroid and the ovary was also used, albeit less frequently, to justify the use of ovarian extracts in women suffering from hypothyroidism. See Moreau René , De l'opothérapie ovarienne dans la maladie de Basedow chez la femme (Paris, 1899).

See Simmer Hans H. , “Innere Sekretion der Ovarien als Ursache der Menstruation: Halbans Falsifikation der Pflügerschen Hypothese”, in Ganzinger Kurt Skopec Manfred Wyklicky Helmut (eds), Festschrift für Erna Lesky zum 70. Geburtstag (Vienna, 1981), 123–48, p. 124.

Corner , “Early history” (ref. 6), p. vi.

Many medical scientists, beginning with Moritz Schiff in 1884, had reported that thyroid grafting was feasible and effective in removing symptoms of thyroid deficiency, especially those following thyroidectomy. See Medvei , History of clinical endocrinology (ref. 7), 136, 160–2.

Chrobak and Knauer were apparently unaware then that ovarian transplantations were being attempted on humans by the American surgeon Robert T. Morris (1857–1945), who, too, was interested in allaying the sequelae of oophorectomy and influenced by reports of successful thyroid grafting. Unlike the former, however, Morris also believed that ovarian grafts might facilitate pregnancy in women whose fallopian tubes were blocked and, therefore, unable to convey the ovum from the ovary to the uterus. If ovarian tissue could be grafted on to the uterus itself, the fallopian tubes would not be required any more. Morris reported on two patients, one of whom soon became pregnant but then had a miscarriage. By 1901, Morris had performed twelve ovarian transplants. And in 1906, one of his transplantees had a baby. For further information, see Morris R. T. , Lectures on appendicitis and notes on other subjects (New York, 1895), 156–9; idem, “The ovarian graft”, New York medical journal, lxii (1895), 436–7; Simmer Hans H. , “Robert Tuttle Morris (1857–1945): A pioneer in ovarian transplants”, Obstetrics and gynecology, xxxv (1970), 314–28; and Biggers J. D. , “In vitro fertilization and embryo transfer in historical perspective”, in Trounson Alan Wood Carl (eds), In vitro fertilization and embryo transfer (London, 1984), 3–15, pp. 5–6 (my thanks to Dr Biggers for alerting me to his article). Another early report on ovarian transplantation in humans also came from the U.S. See Glass James , “An experiment in transplantation of the entire human ovary”, Medical news, lxxiv (1899), 523–5. Glass (1854–1931) was well acquainted with the work of Knauer but not with that of Morris! In his first report in 1896, Knauer referred to experimental transplantations of the testes but declared that he did not know of any experimental transplantations of the ovaries. See Knauer E. , “Einige Versuche über Ovarientransplantation bei Kaninchen: Vorläufige Mitteilung”, CfG, xx (1896), 524–8, p. 528. Later, in his detailed 1900 paper, Knauer referred to the reports of Morris and Glass. See Knauer , “Die Ovarientransplantation: Experimentelle Studie”, AfG, lx (1900), 322–75, pp. 323–4.

The other gynaecologists who noticed the occurrence of premature menopause after oophorectomy were equally silent on the possibility that the ovary produced an internal secretion affecting the female reproductive organs. Their theories relied mostly upon nervous or vascular links. See Simmer , “Organotherapie mit Ovarialpräparate” (ref. 111), 243–5. Simmer suggests that this might have been due to the disrepute into which Brown-Séquard's rejuvenation claims had fallen. For Knauer's dismissal of nervous and vascular theories, see “Die Ovarientransplantation: Experimentelle Studie” (ref. 123), 351–3.

See Knauer , “Einige Versuche über Ovarientransplantation bei Kaninchen: Vorläufige Mitteilung” (ref. 123); idem, “Über Ovarientransplantation,” Wiener klinische Wochenschrift, xii (1899), 1219–22; and idem, “Die Ovarientransplantation: Experimentelle Studie” (ref. 123). For an attempted refutation of Knauer's claims, see Arendt E. , “Demonstration und Bemerkungen zur Ovarientransplantation”, CfG, xxii (1898), 1116–17, and for a rebuttal, Knauer , “Zu Dr. Arendt's ‘Demonstration und Bemerkungen zur Ovarientransplantation’ auf der 70. Versammlung deutscher Naturforscher und Ärzte zu Düsseldorf”, ibid. , 1257–60. On Knauer, see Knaus Hermann , “Emil Knauer, Graz”, AfG, clix (1935), 429–31.

See Knauer , “Über Ovarientransplantation” (ref. 125), 1220.

See Knauer E. , “Zur Ovarientransplantation (Geburt am normalen Ende der Schwangerschaft nach Ovarientransplantation beim Kaninchen)”, CfG, xxii (1898), 201–3.

Knauer pointed out that rabbits generally experienced menopause in 5–6 years and his experimental animal was already over a year old at the time of the transplantation. See Knauer , “Die Ovarientransplantation: Experimentelle Studie” (ref. 125), 340.

Knauer , “Über Ovarientransplantation” (ref. 125), 1222.

On Halban's career and research, see Köhler Robert , “Josef Halban”, CfG, lxi (1937), 1458–66; Simmer H. H. , “Josef Halban (1870–1937): Pionier der Endokrinologie der Fortpflanzung”, Wiener medizinische Wochenschrift, cxxi (1971), 549–52; idem, “Innere Sekretion der Ovarien als Ursache der Menstruation” (ref. 120); and Pecher Norbert , “Halbans Lehre von der protektiven Wirkung der Sexualhormone: Eine frühe Konzeption über den Wirkungsmechanismus der Hormone” (Inaugural-Dissertation, Medical Faculty, University of Erlangen-Nürnberg, 1985).

See Halban J. , Discussion on E. Knauer, “Über Ovarientransplantation”, Wiener klinische Wochenschrift, xii (1899), 1243–4. In his final, comprehensive report on his transplantation experiments published in 1900, Knauer referred for the first time to the internal secretions almost in identical words. See Knauer , “Die Ovarientransplantation” (ref. 123), 354.

See Nicholson , “A review of the literature of ovarian transplantation” (ref. 108).

Many of them were by biologists who seemed intent on demonstrating the mere possibility of ovarian transplantation and finding ever more sophisticated techniques for the operation. See, for example, Grigorieff Woldemar , “Die Schwangerschaft bei der Transplantation der Eierstöcke”, CfG, xxi (1897), 663–8; Ribbert Hugo , “Über Transplantation von Ovarium, Hoden und Mamma”, Archiv für Entwickelungsmechanik der Organismen, vii (1898), 688–708; Basso G. L. , “Über Ovarientransplantation”, AfG, lxxvii (1906), 51–62; and Higuchi Shigeji , “Über die Transplantation der Ovarien”, ibid., xci (1910), 214–42. For a review of these experiments, see Castle W. E. Phillips John C. , On germinal transplantation in vertebrates (Washington, DC, 1911), 2–6; and Sand Knud , “Transplantation der Keimdrüsen bei Wirbeltieren”, in Bethe A. von Bergmann G. Embden G. Ellinger A. (eds), Handbuch der normalen und pathologischen Physiologie (18 vols in 25, Berlin, 1925–32), xiv, p. 1, 251–92, pp. 274–92.

There was also a strong body of opinion which held that the so-called “ablation symptoms are due to a breaking of the utero-ovarian harmony, and that if the uterus is removed the retention of ovarian tissue in situ or by transplantation is of little physiological value”. See Martin Franklin H. , “Ovarian transplantation: I. Brief abstract of articles published in 1917 to 1921 inclusive. II. Summary of abstracts arranged by subjects. III. Author's conclusions. IV. Exhaustive bibliography”, Surgery, gynecology and obstetrics, xxxv (1922), 573–85, pp. 573, 582.

See, for instance, the negative opinion of Unterberger F. , “Hat die Ovarientransplantation praktische Bedeutung?”, Deutsche medizinische Wochenschrift, xliv (1918), 903–4. Many researchers accepted that tissue antagonisms between donor and recipient were the likely cause of graft failures. See Martin Franklin H. , “Ovarian transplantation: A review of the literature and bibliography up to and including the earlier months of 1915”, Surgery, gynecology and obstetrics, xxi (1915), 568–78, p. 572.

Nussbaum M. , “Innere Sekretion und Nerveneinfluss”, Ergebnisse der Anatomie und Entwickwlungsgeschichte, xv (1905), 39–89, pp. 78–80.

Lipschütz , Internal secretions of the sex glands (ref. 5), 92.

Corner , “Early history” (ref. 6), p. xi. Corner added that in 1924, there were powerful voices — Neither uninformed nor unsympathetic to endocrine physiology — That were even more sceptical than he was himself. See Carlson A. J. , “Physiology of the mammalian ovaries”, Journal of the American Medical Association, lxxxiii (1924), 1920–3.

See obituary in Nature, cxiv (1924), 904.

Simmer Hans H. , “The first experiments to demonstrate an endocrine function of the corpus luteum: On the occasion of the 100. birthday of Ludwig Fraenkel (1870–1951)”, Sudhoffs Archiv, lv (1971), 392–417.

Prenant A. , “La valeur morphologique du corps jaune, son action physiologique et thérapeutique possible”, Revue générale des sciences pures et appliquées, ix (1898), 646–50.

See Simmer H. H. , “On the history of hormonal contraception, I: Ludwig Haberlandt (1885–1932) and his concept of ‘hormonal sterilization’”, Contraception, i (1970), 3–27, pp. 5–9.

See Simmer , “The first experiments to demonstrate an endocrine function of the corpus luteum” (ref. 140). Fraenkel had been trained in gynaecology by, among others, Alfred Hegar ( ibid. , 403). Born's idea was also tested by another of his students, the Norwegian neurosurgeon Vilhelm Magnus (see Simmer Hans H. , “The first experiments to demonstrate an endocrine function of the corpus luteum, Part II: Ludwig Fraenkel versus Vilhelm Magnus”, Sudhoffs Archiv, lvi (1972), 76–99).

Quoted by Simmer , “The first experiments” (ref. 140), 399.

For a comprehensive report of Fraenkel's experiments and his suggestions on clinical applications, see Fraenkel L. , “Die Funktion des Corpus luteum”, AfG, lxviii (1903), 438–545. For a briefer presentation of his conclusions and comments by other scientists of the time, see Fraenkel L. , “Weitere Mitteilungen über die Funktion des Corpus luteum”, CfG, xxviiii (1904), 621–36, 657–68.

Fraenkel , “Weitere Mitteilungen” (ref. 145), 624.

It was Vilhelm Magnus's less acclaimed research that indicated that other portions of the ovary might produce their own, different internal secretions. See Simmer , “The first experiments to demonstrate an endocrine function of the corpus luteum, Part II” (ref. 143), 80.

See Fraenkel , “Die Funktion des Corpus luteum” (ref. 145), 439.

For Halban's comments, see Fraenkel , “Weitere Mitteilungen” (ref. 145), 628–32, and for Schauta's, ibid., 660–1.

Simmer , “The first experiments to demonstrate an endocrine function of the corpus luteum, Part II” (ref. 143), 82.

Fraenkel , “Die Function des Corpus luteum” (ref. 145), 439.

Ibid., 489.

Ibid., 489–91.

Ibid., 496.

Ibid. , 492. Fraenkel provided the address of a chemist from whom Lutein could be obtained at the rate of 4.50 Marks for 100 tablets. See ibid., fn (1). Fifteen brief case histories were included in the paper: See ibid., 492–5.

Fraenkel , “Die Function des Corpus luteum” (ref. 145), 496.

Ibid., 497; “Weitere Mitteilungen” (ref. 145), 622.

Fraenkel , “Die Function des Corpus luteum” (ref. 145), 498–9.

See Fraenkel , “Weitere Mitteilungen” (ref. 145), 621–2.

Ibid. , 627–8. The Beard-Prenant hypothesis, of course, had claimed that it was the corpus luteum that prevented ovulation and the experimental work of Leo Loeb had shown in 1909 that the corpus luteum was one of the important agencies for preventing ovulation (see Loeb L. , “The experimental production of the maternal placenta and the function of the corpus luteum”, Journal of the American Medical Association , 30 October 1909, 1471–4, p. 1472), which was confirmed by other researchers. Hence, it was actually more logical to use the corpus luteum (or, indeed, the ovary as a whole) to prevent pregnancy and this was attempted successfully in the 1920s by the Innsbruck physiologist Ludwig Haberlandt, who assumed that the corpus luteum and other internal secretory cells of the ovary might inhibit ovulation. Haberlandt transplanted ovaries of pregnant rabbits in non-pregnant animals which resulted frequently in temporary sterilization. For further information, see Simmer H. H. , “On the history of hormonal contraception, I” (ref. 142), and idem, “On the history of hormonal contraception, II: Ottfried Otto Fellner (1873–19??) and estrogens as antifertility hormones”, Contraception, iii, no. 1 (1971), 1–20.

Biedl Artur , The internal secretory organs: Their physiology and pathology, transl. by Forster Linda (London, 1913), 398–410. This was a translation of the first edition of Biedl's Innere Sekretion: Ihre physiologischen Grundlagen und ihre Bedeutung für die Pathologie (Berlin, 1910).

Green-Armytage V. B. , “The rise of surgical gynaecology”, in Munro-Kerr J. M. Johnstone R. W. Phillips Miles H. (eds), Historical review of British obstetrics and gynaecology 1800–1950 (Edinburgh, 1954), 357–69, p. 363.

For biographical accounts, see Peel John , William Blair-Bell: Father and founder (London, 1986); and Power D'Arcy Le Fanu W. R. , Lives of the Fellows of the Royal College of Surgeons of England 1930–1951 (London, 1953), 85–87.

Bell saw gynaecology as “a science limited no longer … to the ‘region below the belt’, but embracing many aspects of medicine and surgery, to both of which, indeed, it has itself largely contributed. Nevertheless, physicians and surgeons in the past … have treated gynaecology and obstetrics rather disdainfully as an offshoot, and not as a partner of equal rank. Our art, which is as old as theirs, and which has also attained to the position of a high biological science … has its own individuality and ideals, which must find expression at the hands of its own exponents”. W. Blair-Bell, Letter to British medical journal, 23 March 1929, 572, quoted in Shaw William Fletcher , Twenty-five years: The story of the Royal College of Obstetricians and Gynaecologists, 1929–1954 (London, 1954), 31–33.

In a new, historical introduction written for the last edition of his textbook of gynaecology, Bell observed: “Many of us look forward to that day when knowledge of the whole of the Genital System in Woman — Its morphology, physiology and pathology — Will be included in the word ‘gynaecology’, and when ‘obstetrics’ will form a natural subdivision only of the inclusive subject”. See Blair-Bell William , The principles of gynaecology: A text-book for students and practitioners, 4th edn, rev. with the assistance of M. M. Datnow and Arthur C. H. Bell (London, 1934), 1.

Ibid.

Blair-Bell W. , “The Arris and Gale Lectures on the genital functions of the ductless glands in the female”, Lancet, i (1913), 809–16, 937–44, p. 809, emphasis added.

Blair-Bell W. , The sex complex: A study of the relationships of the internal secretions to the female characteristics and functions in health and disease (London, 1916), 22.

The generalist–specialist debate was fundamental to nineteenth-century British medicine and although no longer as heated in Bell's time as it had been some decades earlier, many general physicians and surgeons still considered specialists (of whom gynaecologists were a particularly controversial group) to be ignorant of all bodily parts or functions save the one they claimed to know. See Peterson M. Jeanne , The medical profession in mid-Victorian London (Berkeley, 1978), 273–5, 277–9; Bynum William F. , Science and the practice of medicine in the nineteenth century (Cambridge, 1994), 191–6; and Moscucci , The science of woman (ref. 26), 57–59, 72–81.

In 1891, the eminent British surgeon Thomas Spencer Wells defined the ovary as “the nucleus of gynaecological science and the source of gynaecological practice”. See Moscucci , The science of woman (ref. 26), 158. For some discussion of the influence of other ductless glands on sex, see Marshall Francis H. A. , The physiology of reproduction, 2nd edn (London, 1922), 379–86.

Blair-Bell , “Arris and Gale Lectures” (ref. 167), 809.

Blair-Bell , Sex complex (ref. 168), p. vii (emphasis in the original), 5.

Ibid. , 23. With regard to the corpus luteum, he remarked: “Although it is well known that the corpus luteum in the ovary of the pregnant female is considerably larger than in the non-pregnant, it is not certain that this hyperplasia has any more importance than an epiphenomenon” (ibid.).

Blair-Bell , Sex complex (ref. 168), 30–35, 46–47.

Ibid., 35. “Any influence”, Bell added, “the ovary may have over the general metabolism is … related to and dependent on its primary reproductive functions. I do not believe that this organ influences the metabolism except in so far as this special function is concerned”. See ibid., 97.

The thyroid vesicles were distended with colloid after oophorectomy and the colloid was no longer acidophilic as it was in normal conditions. It was likely, however, that this colloid was a storage secretion of no great physiological significance. See ibid., 37.

Ibid., 39–41.

Ibid., 48–55.

See Blair-Bell W. , “The pituitary body and the therapeutic value of the infundibular extract in shock, uterine atony, and intestinal paresis”, British medical journal, ii (1909), 1609–13; and idem, The pituitary: A study of the morphology, physiology, pathology, and surgical treatment of the pituitary, together with an account of the therapeutical uses of the extracts made from this organ (London, 1919).

Blair-Bell W. Hick Pantland , “Observations on the physiology of the female genital organs”, British medical journal, i (1909), 517–22, 592–7, 655–8, 716–18, 777–83. The uterine effect of posterior pituitary extract had previously been noted by Henry H. Dale, who had supplied Bell with the extract (ibid., 779).

It was realized only subsequently that the extract was separated into pressor and oxytocic fractions. See Kerr J. M. Munro , “Labour”, in Kerr Johnstone Munro Phillips (eds), Historical review of British obstetrics and gynaecology (ref. 162), 97–98; idem, “The haemorrhages”, ibid. , 104–14; and Medvei , History of clinical endocrinology (ref. 7), 262–4.

He added, however: “I do not use the word ‘invade’ in any derogatory sense, for we warmly welcome their aid, which has so long been withheld, but rather because the whole scientific basis of our subject — Embryological, morphological, psychological, and physiological, including the biochemical and hormonal, and pathological — Has been established by practising obstetricians and gynaecologists here and in other countries”. See Blair-Bell W. , “Lloyd Roberts Lecture on the present and the future of the science and art of obstetrics and gynaecology”, British medical journal, 9 January 1932, 45–50, p. 45.

Ibid., 45.

Ibid., 49.

Ibid., 49.

Moscucci , The science of woman (ref. 26), 206.

Porter Roy Hall Lesley , The facts of life: The creation of sexual knowledge in Britain, 1650–1950 (New Haven, Conn., 1995), 173.

Blair-Bell , Sex complex (ref. 168), 106, 109.

Blair-Bell W. , “Disorders of function”, in Eden Thomas Watts Lockyer Cuthbert (eds), The new system of gynaecology (London, 1917), i, 287–415, pp. 373, 300.

Ibid., 401.

Blair-Bell , Sex complex (ref. 168), 108.

Blair-Bell , “Lloyd Roberts Lecture” (ref. 182), 45.

Lawrence Chris , Medicine in the making of modern Britain, 1700–1920 (London, 1994), 60–61.

Steinach's work awaits comprehensive exploration — Historians of endocrinology have virtually ignored him, probably because of his involvement in projects considered to be dubious according to the disciplinary dogmas of current endocrinology. (We recall that Herbert Evans's comment on the obstetric deformation of endocrinology at birth implicated not merely Brown-Séquard but also Steinach.) See, however, Benjamin Harry , “Eugen Steinach, 1861–1944: A life of research”, Scientific monthly, lxi (1945), 427–42; Klein Marc , “L'oeuvre de Steinach dans l'histoire de la biologie de la reproduction”, in Lesky Erna (ed.), Wien und die Weltmedizin (Vienna, 1974), 204–13; Sengoopta Chandak , “Glandular politics: Experimental biology, clinical medicine, and homosexual emancipation in fin-de-siècle Central Europe”, Isis, lxxxix (1998), 445–73; Stoff Heiko , “Die hormonelle und die utopische Geschlechterordnung: Verjüngungsoperationen und der neue Mensch in den zwanziger Jahren”, in Ferdinand U. Pretzel A. (eds), Verqueere Wissenschaft? Zum Verhältnis von Sexualwissenschaft und Sexualreformbewegung in Geschichte und Gegenwart (Munich, 1998), 245–60; and idem, “Vermännlichung und Verweiblichung: Wissenschaftliche und utopische Experimente im frühen 20. Jahrhundert”, in Pasero Ursula Braun Friederike (eds), Wahrnehmung und Herstellung von Geschlecht: Perceiving and performing gender (Opladen, 1999), 47–62. I am currently working toward a comprehensive study of Steinach's work and its contexts, entitled (thanks to Roy Porter!) “A new body for a new age: Eugen Steinach, sexual biology and the regeneration of humanity”. Meanwhile, Steinach's self-serving but factually detailed autobiography, Sex and life: Forty years of biological and medical experiments (New York, 1940) remains indispensable for an overview of his long, complex and controversial career and should be supplemented with the perceptive discussions in Hall Long , “Biology, sex hormones, and sexism” (ref. 7) and Fausto-Sterling Anne , Sexing the body: Gender politics and the construction of sexuality (New York, 1999).

In order to study sexual development, it was necessary, of course, to select sexually immature animals; glandular manipulations might lead to visible changes in the sexually mature adult, too — And Steinach's later work would be founded in that fact — But only in prepubertal animals could the ensuing changes be attributed clearly and unequivocally to the experimental procedure.

See, for instance, these two foundational texts: Biedl Artur , Innere Sekretion: Ihre physiologischen Grundlagen und ihre Bedeutung für die Pathologie , 2nd edn (Berlin, 1913), ii, 199–343; and Marshall , The physiology of reproduction , 2nd edn (ref. 170), 320–92. Fausto-Sterling , Sexing the body (ref. 194) is alone among recent works in its recognition of Steinach's historical role in the establishment of endocrine theories of sexuality and the contexts and ambiguities of his research.

Steinach was nominated for the prize in 1921 by J. H. Zaaijer (Leiden), in 1922 by Y. Sakaki (Fukuoka), in 1927 by L. Haberlandt (Innsbruck), in 1930 by H. H. Meyer, S. Klein and E. Pick (Vienna), in 1934 by A. Durig (Vienna), and in 1938 by J. Bock et al. (Copenhagen). My thanks to the Nobel Committee for supplying me with this information.

Steinach E. , “Untersuchungen zur vergleichenden Physiologie der männlichen Geschlechtsorgane insbesondere der accessorischen Geschlechtsdrüsen”, Archiv für die gesammte Physiologie, lvi (1894), 304–38, pp. 337–8; Steinach E. , “Geschlechtstrieb und echt sekundäre Geschlechtsmerkmale als Folge der innersekretorischen Funktion der Keimdrüse”, Zentralblatt für Physiologie, xxiv (1910), 551–66.

Although this very hypothesis had previously been argued by the anatomists Paul Ancel and Pol Bouin from Strasbourg, it was Steinach's espousal of it and his experimental demonstrations that created a controversy, particularly in Central Europe. On the history of this controversy, see Klein Marc , “Sur les interférences des sciences fondamentales et de la clinique dans l'essor de l'endocrinologie sexuelle”, Clio medica, viii (1973), 31–52, pp. 40–41.

This hypothesis was argued most vocally by Josef Halban. See Halban J. , “Die Entstehung der Geschlechtscharaktere: Eine Studie über den formativen Einfluss der Keimdrüse”, AfG, lxx (1903), 205–308, pp. 260–1. On Halban, see Simmer H. H. , “Josef Halban (1870–1937): Pionier der Endokrinologie der Fortpflanzung” (ref. 130); and Pecher Norbert , “Halbans Lehre von der protektiven Wirkung der Sexualhormone” (ref. 130).

Steinach E. , “Willkürliche Umwandlung von Säugetier-Männchen in Tiere mit ausgeprägt weiblichen Geschlechtscharakteren und weiblicher Psyche”, Pflügers Archiv für die gesammte Physiologie, cxxxiv (1912), 71–108, pp. 76–77.

Steinach E. , “Pubertätsdrüsen und Zwitterbildung”, Archiv für Entwickelungsmechanik, xlii (1917), 307–32.

The relevant section is as follows: “[Meine] fem. masc. hermaph.-Versuche sind keine Geschlechtsbestimmungen, sondern nur Geschlechtsbeeinflussungen im Sinne der zünftigen Biologen. (Weil das Geschlecht durch die Chromosomen vorausbestimmt sei: In praxi nutzt diese ‘Bestimmung’ aber nichts, da wir das Geschlecht oder wenigstens die Geschlechtsmerkmale umstimmen können.)” See Steinach's letter to Harry Benjamin dated 28 February 1923, in Eugen Steinach-Harry Benjamin Correspondence, The New York of Academy of Medicine Historical Collections. (All letters in this collection are filed by date and henceforth, will be cited either as “ES to HB” or “HB to ES”, followed by the date.) My thanks to the Academy for making this collection available to me. On the collection's history, see Harms Ernest , “Forty-four years of correspondence between Eugen Steinach and Harry Benjamin”, Bulletin of the New York Academy of Medicine, xlv (1969), 761–6, and on the career of Benjamin, see the contributions to “Memorial for Harry Benjamin”, Archives of sexual behavior, xvii, no. 1 (1988), 3–31.

On the contexts, connotations, implications and consequences of Steinach's concept of sex-gland antagonism, Hall Long , “Biology, sex hormones and sexism” (ref. 7); and Fausto-Sterling , Sexing the body (ref. 194), 159–69.

Steinach E. , “Künstliche und natürliche Zwitterdrüsen und ihre analogen Wirkungen: Drei Mitteilungen”, Archiv für Entwickelungsmechanik der Organismen, xlvi (1920), 12–37, p. 25; idem, “Pubertätsdrüsen und Zwitterbildung” (ref. 202), 328–30.

Steinach E. Lichtenstem R. , “Umstimmung der Homosexualität durch Austausch der Pubertätsdrüsen”, Münchener medizinische Wochenschrift, lxv (1918), 145–8; Steinach E. , “Histologische Beschaffenheit der Keimdrüse bei homosexuellen Männern”, Archiv für Entwickelungsmechanik, xlvi (1920), 29–37. For a contextual analysis, see Sengoopta , “Glandular politics” (ref. 194).

Steinach , Sex and life (ref. 194), 22–23.

Such endocrine analogies of senility were not unique to Steinach; nor were they confined to the sex glands alone. The signs of hypothyroidism — Dry skin, loss of hair, diminished energy — Were often considered to be analogous to senility, and there was a proposal to prevent the ravages of old age by administering thyroid extracts prophylactically to women from the age of 35 and to men from the age of 40. For a brief review of this topic, see Rolleston Humphry , Medical aspects of old age, being a revised version of the Linacre Lecture, 1922 (London, 1932), 79–83.

The breed of rats used in the experiment rarely lived beyond 30 months and began to show signs of senility between 18 and 23 months. See Steinach E. , Verjüngung durch experimentelle Neubelebung der alternden Pubertätsdrüse (Berlin, 1920), 15.

Steinach Eugen , “Untersuchungen über die Jugend und über das Alter” (1912), appendix to idem, Verjüngung (ref. 209), 61–63.

Steinach , Verjüngung (ref. 209), 53–60.

Ibid., 54–55.

For reviews and excerpts of case reports, see Haire Norman , Rejuvenation: The work of Steinach, Voronoff, and others (New York, 1925); Schmidt Peter , The theory and practice of the Steinach operation with a report on one hundred cases (London, 1924); and idem. The conquest of old age: Methods to effect rejuvenation and to increase functional activity (New York, 1931).

“Gland treatment spreads in America”, New York Times, 8 April 1923, sec. 9, p. 2, cols 6–7.

Steinach , Sex and life (ref. 194), 170–1; Sengoopta Chandak , ‘“Dr Steinach coming to make old young!’: Sex, rejuvenation and the future of humanity”, forthcoming.

Tissue culture experiments, associated most famously with Alexis Carrel, also suggested that tissues could survive for much longer when cultivated in an artificial environment where their wastes could be washed away. See Hall G. Stanley , Senescence: The last half of life (New York, 1922), 285–95.

Schmidt , Conquest of old age (ref. 213), 27–28.

Paul Kammerer believed that the revitalized gonad exerted a stimulatory effect on the other ductless glands: It was the entire, revivified endocrine system that produced the signs of rejuvenation. See Kammerer Paul , Rejuvenation and the prolongation of human efficiency: Experiences with the Steinach-operation on man and animals (London, 1924), 219–26. A Prague physiologist reported that the Steinach operation inhibited the progressive ‘thickening’ of cellular fluids that occurred with ageing ( Ruzicka Vladimir , “Die Protoplasmahysteresis und das Verjüngungsproblem”, Deutsche medizinische Wochenschrift, xlviii (1922), 931–2).

Steinach , Sex and life (ref. 194), 24–25.

Holzknecht was a member of the “world's first independent roentgen department” and, along with his colleagues Robert Kienböck and Leopold Freund, “founded radiology as an independent discipline”. See Lesky , The Vienna Medical School of the 19th century (ref. 113), 303–4.

Steinach E. Holzknecht G. , “Erhöhte Wirkungen der inneren Sekretion bei Hypertrophie der Pubertätsdrüsen”, Archiv für Entwicklungsmechanik der Organismen, xxxxii (1917), 490–507.

Ibid., 500, where the exact dose of radiation and other technical details can also be found.

Ibid., 501. Steinach felt far more confident in identifying the hormone-secreting cells of the ovary than other scientists of the time. On the complexities of ovarian histology, as perceived by Steinach's contemporaries, see Lipschütz , The internal secretions of the sex glands (ref. 5), 211–83.

See HB to ES, 12 February 1922; on Benjamin's interest in female rejuvenation, see also HB to ES, 27 February 1922. The strong financial incentives attracted Steinach, without completely overpowering him: In 1924, Benjamin sent him a woman for the rejuvenative treatment. Noticing that she had severe anaemia, Steinach sent her home with a prescription for iron and asked her to come back after a year for consideration of further treatment. See ES to HB, 17 May 1924.

See, for instance, Fraenkel Manfred , “Die Wirkung der Röntgenstrahlen im Hinblick auf Vererbung und Verjüngung”, Archiv für Frauenkunde und Eugenetik, vii (1921), 254–63; idem, “Zur Theorie der zellfunktionerhöhenden Röntgenstrahlen”, Deutsche medizinische Wochenschrift, xlviii (1922), 1136–7; Grödel F. , “Die Röntgenbehandlung klimakterischer Erscheinungen”, Münchener medizinische Wochenschrift, lxix (1922), 423–5; and Thaler Hans , “Über Röntgenbehandlung der Amenorrhöe und anderer auf Unterfunktion der Ovarien beruhender Störungen”, CfG, xlvi (1922), 2034–43. For Holzknecht's rejection, see Holzknecht G. , “Gibt es eine Reizwirkung der Röntgenstrahlen?”, Münchener medizinische Wochenschrift, lxx (1923), 761–2.

See Benjamin H. , “The influence of Röntgen rays on the endocrine glands with a contribution to the problem of rejuvenation in women”, Medical journal and record, cxx (1924), 585–9.

Ibid., 586.

He also used the radiation technique in men who would not consent to the Steinach operation or could not, for some medical reason, be operated upon. The results were unimpressive. See HB to ES, 20 February 1924.

Benjamin , “The influence of Röntgen rays” (ref. 226), 586.

See Benjamin H. , “The Steinach method as applied to women”, New York medical journal and medical record, cxviii (1923), 750–3, p. 751. Benjamin wrote in identical terms to Steinach, adding the crucial thought that psychological factors may have aided in her improvement: “Obgleich Frau A eine sehr nuechterne und durchaus nicht histerische [sic] Dame ist, kann ich eine psychiatrische Beeinflussung nicht ausschliessen” (HB to ES, 31 May 1922).

Benjamin , “The Steinach method as applied to women” (ref. 230), 752. With another patient, a professional dancer in her late forties, the treatment worked so well that “her husband said she looked as she did twenty years ago. He was so impressed by the change in her appearance that he himself, a man of sixty-one, decided to have the Steinach operation performed” (ibid., 752–3).

Atherton G. , Adventures of a novelist (London, 1932), 538. A virtually identical sentence appears in Atherton's novel Black oxen (New York, 1923), 135. On Atherton, see Forrey Carolyn , “Gertrude Atherton and the New Woman”, California Historical Society quarterly, lv (1976), 194–209; and Gullette Margaret Morganroth , “Creativity, aging, gender: A study of their intersections, 1910–1935”, in Wyatt-Brown Anne M. Rosen Janice (eds), Aging and gender in literature: Studies in creativity (Charlottesville, Virginia, 1993), 19–48, pp. 21–22.

Atherton , Adventures of a novelist (ref. 232), 539.

Ibid., 540.

Apart from the frank admission in her autobiography, see also “Rejuvenation: 78-year-old novelist feels 30 years less”, Newsweek, 14 December 1935, 40; and Atherton , Black oxen (ref. 232).

Atherton , Adventures of a novelist (ref. 232), 542.

“Mrs. Atherton causes amusement in Berlin: Newspapers ridicule her suggestion for rejuvenation of all Germany's supermen”, New York Times, 6 April 1924, Sec. II, p. 7.

See ES to HB, 27 October 1923, offering free diathermy treatment to Atherton but warning Benjamin not to reveal the name or the nature of the new treatment to her; see ES to HB, 20 August 1934, for Steinach's appreciative comments on Atherton's referrals. When Steinach began to use his hormonal preparation Progynon for rejuvenating women, Benjamin, on his advice, treated her with high doses of it (see HB to ES, 14 September 1934 and ES to HB, 25 August 1937). There are records of other women patients (at least one of whom was quite well-known) in the Benjamin-Steinach correspondence but for ethical reasons I have avoided discussing their cases here. Atherton's own open avowals of her treatment(s), of course, free me from such considerations.

Benjamin , “The influence of Röntgen rays” (ref. 226), 587; HB to ES, 26 November 1923. Steinach was extraordinarily secretive about his diathermy technique and never published on it, in spite of Benjamin's advice to do so in order to secure priority (HB to ES, 26 November 1923). The letters do not contain much detail either (with the partial exception of ES to HB, 23 October 1923) but are full of warnings from Steinach about maintaining utter secrecy: See, for instance, ES to HB, 11 September 1923, and for Benjamin's promise to maintain strict silence, HB to ES, 5 October 1923. After a trip to Vienna in 1923, however, Benjamin was obviously well-versed in the technique: One can assume, therefore, that he had been trained in person by Steinach himself. See HB to ES, 17 August 1923. The shroud of secrecy was never lifted by Steinach, although his Berlin disciple Peter Schmidt published an enthusiastic account of the diathermy technique in his 1928 book on rejuvenation, which was translated in 1931 as The conquest of old age (ref. 213) (92–98). Diathermy was often combined with the administration of very small doses of yohimbine and radium, which, Steinach believed, heightened the response of the glandular tissue. See ES to HB, 11 September 1923.

See HB to ES, 24 April 1924; HB to ES, 12 November 1924. Steinach was none too happy about Benjamin's adventurousness in applying the x-ray treatment. In March 1922, he wrote sharply, warning him that he was not experienced with x-rays clinically or theoretically — Only two or three people were really well-versed in the demanding art of choosing appropriate cases for x-ray rejuvenation and administering the treatment. It was only too easy to bring about total castration and hormonal deficiencies if the dosage was even slightly beyond that required. He himself had not yet had too many impressive cases (ES to HB, 29 March 1922). Benjamin soothingly replied that he was administering the treatment under the guidance of first-class radiologists: See HB to ES, 21 April 1922.

Schmidt , Conquest of old age (ref. 213), 97–98.

See Corners George F. [pseudonym of George Sylvester Viereck], Rejuvenation: How Steinach makes people young (New York, 1923), 82; and Wolf William , Endocrinology in modern practice, 2nd edn (Philadelphia, 1939), 230.

Schmidt , Conquest of old age (ref. 213), 31–32, 291.

“In the future, aging enchantresses, desirous of retaining their charms, will combine the [Steinach irradiation] treatment with plastic surgery”, predicted the Steinach enthusiast George Viereck. “Each complements the other. The plastic surgeon accomplishes his end more quickly than the slow process of nature set in motion by the revived Puberty Gland. On the other hand, the natural reserves invoked by the x ray, make the effect of his operation more lasting”. See Corners , Rejuvenation (ref. 242), 83. The link between rejuvenation and plastic surgery seems to have been close in the 1920s: A pioneer cosmetic surgeon of London described his fat-injection technique as “facial rejuvenation”, comparing it with glandular surgery. See Armstrong Tim , Modernism, technology and the body: A cultural history (Cambridge, 1998), 100; and Margetson Elizabeth , Living canvas: A romance of aesthetic surgery (London, 1936). On the history of plastic surgery in general, see Gilman Sander L. , Making the body beautiful: A cultural history of aesthetic surgery (Princeton, NJ, 1999).

Benjamin Harry , “The story of rejuvenation”, American Mercury, December 1935, [2]. Cited from independently paginated reprint in the Benjamin–Steinach correspondence (Box: “Eugen Steinach, biography, photographs, articles, letters 1920–1927”; Folder: “Biographies of Steinach”).

Atherton , Black oxen (ref. 232), 176.

See Stoff , “Die hormonelle und die utopische Geschlechterordnung” (ref. 194), 246–7.

Spackman Barbara , Decadent genealogies: The rhetoric of sickness from Baudelaire to D'Annunzio (Ithaca, NY, 1989), 30.

On these themes, see Sengoopta , Otto Weininger (ref. 104); idem, “Glandular politics” (ref. 194).

On the German discourse, see Bloch Iwan , Das Sexualleben unserer Zeit im Lichte der modernen Kultur (Berlin, 1908), 41–56; Wettley Annemarie Leibbrand Werner , Von der ‘Psychopathia sexualis’ zur Sexualwissenschaft (Stuttgart, 1959), 70–76; and Sulloway Frank J. , Freud, biologist of the mind: Beyond the psychoanalytic legend (New York, 1979), 158–60, 292–6. On the British discourse, see Moscucci Ornella , “Hermaphroditism and sex difference: The construction of gender in Victorian England”, in Benjamin Marina (ed.), Science and sensibility: Gender and scientific enquiry (Oxford, 1991), 174–99. For a suggestive analysis of the theme of universal androgyny, see Birken Lawrence , Consuming desire: Sexual science and the emergence of a culture of abundance, 1871–1914 (Ithaca, NY, 1988); and for a comprehensive exploration of one conceptually and clinically crucial theme, see Dreger Alice D. , Hermaphrodites and the medical invention of sex (Cambridge, Mass., 1998). I am presently working on a comprehensive history of the concept and its contexts with the working title “Between the sexes”.

I say “almost” because there was some ambivalence about the desirability of complete sexual differentiation within certain clusters of discourse, notably the homosexual emancipationist discourse associated with the German homosexual doctor Magnus Hirschfeld. Briefly, the work of Hirschfeld and his associates was characterized by the claim that male homosexuals were biologically feminized and, therefore, they were neither ill nor vicious in desiring intercourse with other men. Homosexuals, Hirschfeld insisted, simply represented a somewhat extreme instance of universal ‘bisexuality’: Pure masculinity or pure femininity were theoretical ideals — All existing individuals were ‘bisexual’, mixtures of male and female qualities in degrees that varied from individual to individual. Nevertheless, even Hirschfeld's work was pervaded by the acceptance of the categories of male and female in their traditional, normative terms. For a detailed analysis of Hirschfeld's ambivalence and its wider contexts, see Sengoopta , “Glandular politics” (ref. 194).

Kraus K. , “Ich las es so”, Die Fackel, cccc–cccciii (1914), 68–69; and Hirschfeld Magnus , “Die Untersuchungen und Forschungen von Professor E. Steinach über künstliche Vermännlichung, Verweiblichung und Hermaphrodisierung”, Vierteljahresberichte des Wissenschaftlich-humanitären Comitées/Jahrbuch für sexuelle Zwischenstufen, xvii (1917), 3–21. On Mrs Steinach's opinion, see Corners , Rejuvenation (ref. 242), 27–28 and Viereck George Sylvester , Glimpses of the great (New York, 1930), 256.

See Stoff , “Die hormonelle und die utopische Geschlechterordnung” (ref. 194), 331.

See Kammerer Paul , Rejuvenation and the prolongation of human efficiency (ref. 218), 189; and Corners , Rejuvenation (ref. 242), 94–95.

The Schering website seems to be the only prominent locus where the name of Steinach is still remembered with appreciation. See http://www.schering.de/unternehmen/Historie/ChronikderScheringForschung2.htm (my thanks to Angela Dahrmann and Christine Berghausen of the Schering Museum for their assistance).

Corner , “Early history” (ref. 6), pp. ix–x. See also Simmer H. H. , “On the history of hormonal contraception, II: Ottfried Otto Fellner (1873–19??) and estrogens as antifertility hormones”, Contraception, iii, no. 1 (1971), 1–20. Iscovesco as well as Fellner are remarkably elusive figures; neither Corner nor Simmer succeeded in discovering much about their lives or their work, beyond that reported in their published papers.

Corner , “Early history” (ref. 6), p. xi.

Ibid.

Süß J. , “Die Ein-Hormon-Hypothese: Eine aufschlußreiche Episode in der Geschichte der Ovarialendokrinologie”, Geburtshilfe und Frauenheilkunde, xlvii (1987), 134–7.

Süß , ibid., 135.

HB to ES, 3 November 1939. See also Hall Long , “Biology, sex hormones and sexism” (ref. 7).

Viereck , Glimpses of the great (ref. 252), 264.

See Price Dorothy , “Feedback control of gonadal and hypophyseal hormones: Evolution of the concept”, in Meites J. Donovan B. T. McCann S. M. (eds), Pioneers in neuroendocrinology (New York, 1975), i, 217–38. As Price emphasized, the feedback theory developed from the biologist Carl Moore and her own efforts to disprove Steinach's concept of sex-gland antagonism. For a recent, astute analysis, see Fausto-Sterling , Sexing the body (ref. 194), 164–69.