Where does that come from? A regular column that examines the history and origins of a particular medical topic.

One of the better known one-liners in medical history occurred during the 1960 trial of Penguin Books which had been charged under the Obscene Publications Act of 1959 for publishing the unexpurgated version of D.H. Lawrence's famous book Lady Chatterley's Lover. The prosecuting counsel, Mr Mervyn Griffith-Jones QC, artlessly asked the jury if this ‘was the kind of book you would wish your wife or servants to read?' His query belonged to a bygone era of tales of fallen women and Dickensian households. The question may have held some weight in 1877 at another not dissimilar trial which involved an obscene publication.

What was that earlier tabloid titillator trial all about then?

The affair really started in 1832 when a Dr Charles Knowlton, a militant free-thinker from Massachusetts, published his book Fruits of Philosophy: or The Private Companion of Young Married People. Though fairly innocuously titled, it was in fact the first popular tract on birth control to be written by a physician. It contained nothing salacious, was from a respectable source but nonetheless the author was prosecuted under the State's obscenity statute.

The publication was only 40 pages long and comprised four chapters, but it was the last two, ‘Of Promoting and Checking Conception' and ‘Remarks on the Reproductive Instinct' which were considered controversial, if not inflammatory. Withdrawal, condoms or a vaginal sponge attached to a ribbon were recommended in the first, and desire ‘controlled by reason and chastened by good feelings' and with ‘restraint shown until 18 in females and 20 in males for their health's sake', was the cruncher in the second. Maybe pretty heady stuff then, it all seems innocuous now, but it earned Knowlton three months' hard labour.

The case would have passed into well-deserved obscurity had not a free-thinking English couple, Annie Besant and Charles Bradlaugh, republished it in London in 1876. At sixpence (or 5 cents) it was well within the scope of all to buy, including hormone-driven lads and lasses about town. It was released in a bout of missionary zeal, mainly to challenge the then-current laws regarding obscenity which threatened doctors who wrote about sexual health.

The desired and foreseen heavy-handed effect was immediate. The publishers were brought to trial before the exalted presence of the Lord Chief Justice of England himself, no less. Even the prosecution was lead by the government's Solicitor General. The accused conducted their own defence, a chancy exercise on such a stage, but done to gain a highly visible and widely publicised platform.

Mrs Besant was born Annie Wood and, though assertive and feisty, had received a strict religious upbringing. Surprisingly she married a shy clergyman, Frank Besant. They were ill matched from the start, and her reactionary disposition led to separation and to her abandoning the church and embracing atheism. She took to writing pamphlets attacking the religious hierarchy and it was while attending a meeting of like-minded people that she met Charles Bradlaugh.

At the time Bradlaugh was a high-profile leader of the nation's free-thinkers movement, editor of its journal, The National Reformer, an impassioned speaker, fervent Republican and staunch follower of Thomas Malthus, the over-population doomsday man of the early 19th century. When he met Annie he was separated from his wife and children, but their attraction must have been on a cerebral plane only because though Annie's husband had her followed, he could never prove adultery.

Fatefully, all this coincided with the prosecution of a Bristol bookseller for displaying Knowlton's 30-year-old inflammatory book Fruits of Philosophy. He was found guilty and given two years; the law did not mess about in those days. As we have seen, Knowlton's book was identified with causes which Besant and Bradlaugh held dear, population control and women's rights. So, determined to make a test case, they printed their own sixpenny edition of the embattled book. Within 20 minutes of hitting the shelf, 500 copies had been sold. To milk the moment, Bradlaugh at once notified the police of their action. Inexplicably it was six weeks before they were arrested, by which time 13,3000 copies had been sold.

Eventually the trial was set for June 1877 before Lord Chief Justice Alexander Cockburn. The charge was for ‘wickedly, knowingly.... to publish and utter.... a certain indecent, lewd, filthy, bawdy and obscene book.... thereby vitiating and corrupting morals'. They don't write such powerful arraignments nowadays, more's the pity. Obscenity as then defined was ‘to deprave and corrupt those whose minds are open to such immoral influences and into whose hands a publication of this sort may fall'.

To save himself the embarrassment of reading bits out and so perhaps corrupting his own seemingly undefiled mind, the Solicitor General furnished each juror with a copy. Presumably he did not mind tarnishing 12 other supposedly unsullied minds. However, the judge was not to be put off and the mortified lawyer was later to express his pain at having been instructed to actually read the inflammatory stuff. It was recounting the signs of pregnancy which most troubled him. He averred it was designed to deprave the minds of young people and possibly gratify their passions.

For the next three days a fervent Annie Besant cited schoolbooks which had illustrations of genitalia, adding explicit passages from Shakespeare, Sterne and even the Bible. Her well-researched presentation was actually commended by the judge and applauded by her followers. Bradlaugh argued that sexual knowledge was essential to limit population and increase marital happiness. Another speaker, a female medical student (in 1877 she must have been one of the very first) dilated on the effects of grinding poverty on the lives of people with large families. A Dr Drysdale provided light relief with views regarding the dubious worth of lactation and coitus interruptus as preventative measures.

The judge gave what was regarded as a favourable summing up but the jury, doubtless steeped in Victorian conservatism and having been suitably appalled as they leafed through the febrile book, concluded it was patently and obviously meant to deprave, but generously exonerated the defendants from any corrupt motives. A bemused Cockburn said that amounted to guilt and sentenced both to six months and a fine of £200.

Common sense prevailed in the end and the defendants were released on appeal, which was won on a technicality that the prosecution had not ‘expressly set out their case'.

Bradlaugh became a Member of Parliament, though prevented from sitting for five years because he would only affirm and not take the oath. Where was common sense then? He died in 1891.

Annie became a close associate of author George Bernard Shaw, took up mysticism and in 1907 became president of the Theosophical Society. She went to live in India, convinced that she had been there in a previous incarnation, and died in 1933 aged 86.

Whatever one's views about these two odd enthusiasts, they hold an important place not just in the history of medicine, but in women's rights and free speech itself.

ACSM #37