Gynaecologists in 19th-century Europe and the United States removed the clitoris to treat insanity and masturbation.[113] British doctor Robert Thomas suggested clitoridectomy as a cure for nymphomania in 1813.[114] The first reported clitoridectomy in the West, described in The Lancet in 1825, was performed in 1822 in Berlin by Karl Ferdinand von Graefe on a 15-year-old girl who was masturbating excessively.[115]