Notes about Sexuality and Religion

by Jacquart, Danielle. 1988.
Original French version 1985

https://archive.org/details/sexualitymedicin0000jacq

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Sexual activity was linked to fear in the medieval West – and not only the fear inspired by moral or religious law, the transgressing of which filled men and women with the terror of the sacred. On a more prosaic level, anyone who reads the medical texts with care can discover at every step, lying in wait, the obsessions of medieval people; any impairing of their organisms could arouse fear – whether it was fatigue, physical disability, or growing old.

The most dangerous moment was when man encountered woman: so many moralists had warned him of the dangers he was running! Woman was the creature of discontinuous time; she was a threat during menstruation, often out of bounds during pregnancy and the nursing period and prohibited on holy days. The union of man and woman became almost an adventure.

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Henry of Mondeville repeats the same kind of description, but in less detail: ‘Towards the middle of the cervix one can find, in virgins, veins which are torn at the moment of deflowering.’97 Mondino de’ Luzzi claims that only one membrane acts as a sign of virginity: ‘The surface [of the entrance to the womb] is in virgins covered by a subtle and venous membrane; at the moment of deflowering, it breaks, and women bleed.’98 The word ‘hymen’ is not used by the anatomists of the fourteenth century; we come across it in the fifteenth century when, in his Practica,

Michael Savonarola takes up Mondino’s description: ‘The cervix is covered by a subtle membrane called the hymen, which is broken at the time of deflowering, so that the blood flows.’99

The external female organs are no longer absent, as they were in the Salernitan texts, but the anatomists and surgeons of the end of the Middle Ages still show a strange lack of precision. In Mondino, we find this description of the labia:

At the end of the vulva there are two small flaps of skin which open and close over the orifice to prevent air and foreign bodies from entering the cervix or the bladder; they are like the small flaps of skin of the prepuce which protect the urethra, and that is why they are called by Avicenna the prepuces of the womb.100)

This description is repeated word for word by Michael Savonarola in the fifteenth century, but the expression attributed by Mondino to Avicenna is ascribed to the author of the Pantegni, which is more correct.101 In the work of the famous surgeon Guy of Chauliac, we also come across an organ similar to the prepuce, but it is probably not the labia:

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[The womb] is large forsothe as the yerde [penis] turned ayen or putte withynne, in 7° De Vtilitate Particularum. It hath, forsothe, above, two cellede armes with prive stoones, as it were the purse of the prive stones. It hath a comune wombe in the myddel, as the parties of the schar bone. It hath a nekke, holow withynne, as the yerde. It hath also the prive schappe or chose [vulva] as a hellynge and mytre [glans penis and urethra]. It hath also a prive poynte [in Latin, tentigo] as the hole in the yerde [i.e., the prepuce].102

So it here seems to be the clitoris which is compared to the prepuce, as the use of the word tentigo – a word whose fortunes from the time of late Latin civilization onwards are not easy to follow – would seem to suggest.103 There is a metonymic relation between this organ and the sexual ardour of women in general, which makes it difficult to interpret certain texts. With reference to the exterior orifice of the womb, Henry of Mondeville gives us the following description of the tentigo:

[The orifice] is made in such a way that it can open and close at any time; it is called vulva or cunt (vulva vel cunnus). In its middle it has a brawny membrane which hangs out somewhat and which is called by Rhazes, in the second [book] of the al-Mansuri, chapter seven, tentigo. There are two reasons for the creation of this membrane: first, it is meant to act as a passage for urine so that the latter does not spill out into the whole vulva; secondly, when the woman is sitting with her thighs parted, it affects the air entering the womb, as the uvula does for air entering the mouth.104

The two analogies mentioned by Mondino, Henry of Mondeville and Guy of Chauliac are Galenic in origin; in the De Usu Partium, the labia are compared to the prepuce, whereas a protective role similar to that of the uvula falls to the clitoris or ‘nymph’.105 On the other hand, the confusion with the end of the urethra is not Galenic. To try to explain the mistake made by the surgeon Henry of Mondeville, one can point out the inaccuracy of the sources he was using: he did not have access to the translation from Greek into Latin of the De Usu Partium, and furthermore, the Arabic texts are not very explicit on this topic. We have seen that ‘Ali ibn al-‘Abbas seems to confuse the clitoris with the labia; Rhazes is elliptic, while Avicenna and Albucasis only refer to the organ as a protuberance that has to be corrected by surgery.106 Of course, the different names given to the clitoris did not help it to be recognized as such: Constantine the African transcribed the Arabic word as badedera; likewise, Gerard of Cremona sometimes used the term tentigo, sometimes batharum.107 The explanation given by the Synonyms of Simon of Genoa (fourteenth century) for this Latin translation is enlightening:

‘Batharum in Arabic is a fleshy protuberance in the vulva of certain women which is sometimes so large that it is comparable to the penis,

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Moschion called it landica.’108

Since it appeared only in the form of a hypertrophy, the organ was doomed to clitoridectomy.

The example of the clitoris seems to us revealing – on the one hand of the place occupied by anatomy in medieval medical science, and on the other hand of the vision of woman put into circulation by that science.

It would be naive to deduce, from the absence of any description of the clitoris, or from the imprecision of such a description, that doctors were totally ignorant of woman’s sensitivity. Apart from the fact that Albert the Great reports cases of masturbation, one of which very probably involves the clitoris,109 a phrase from the Conciliator of Pietro d’Abano seems to us explicit: ‘Likewise [women are driven to desire] especially by having the upper orifice near their pubis rubbed; in this way the indiscreet (? curiosi) bring them to orgasm. For the pleasure that can be obtained from this part of the body is comparable to that obtained from the tip of the penis.’110

This merely goes to confirm what we have had several occasions to note. Anatomical description was more often than not enslaved to a teleological interpretation, in which physiology reigned supreme, and such description was cut off not only from all observation, but from any real perception of the body – a perception other types of discourse could well show, however, even within medical discourse.

It was not until the Renaissance, and more precisely Gabriel Fallopio, that the link between a particular area of sensitivity in the female body and the presence of an organ was to be demonstrated clearly. The great Italian scientist gives us his own explanation of his predecessors’ ignorance: ‘This pudendum is so small and hidden in the fattest part of the pubis that it never attracted the attention of anatomists; it is so hidden that I was the first to discover it, several years ago.’!11 Gabriel Fallopio is here exaggerating his merits somewhat: the clitoris, as we have seen, was not completely absent from all descriptions; but it is true that, for centuries, anatomical science and lived experience never came into contact with each other.

It could also be claimed, to put it in an altogether modern way, that the medical text stuck to the limits of an exhaustively male discourse, that the model pre-existed the description of reality. The theory of the inverse symmetry of organs, as suggested by Galen, could not cope with the additional problem of the clitoris, which would upset an account in which the equivalent of the penis was the ‘cervix of the uterus’; female sensitivity seemed solely vaginal. To explain the clitoris, another analogy was required, one also suggested by Galen. The opening of the woman’s body constituted a danger and something to protect it was imagined;

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the air which entered the body had to be tempered by an organ supposed to play the same part as that attributed to the uvula in the act of breathing. But this evident rationalization does not perhaps give a full enough idea of the image woman had in the Middle Ages; she was in league with the air and the wind. This theme, taken from the Arab world, was well received by the Middle Ages, which enjoyed repeating again and again Avicenna’s example of mares being impregnated by the wind; and, in the same spirit, Albert the Great mentioned the case of a woman who derived a particular pleasure from the caress of a breath of air.112 Certain themes represented in folklore would illustrate this female aptitude for absorbing influences and letting them circle upwards through the body. The medical practice of fumigation does not contradict this particular detail. The case of the clitoris also shows that a scientific spirit, when faced with a fact that lay outside strict logical causality, allowed to surface, or even accepted without discussion, ideas which corresponded to the deep structure of the imagination.

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The acceptance of haematogenesis did not succeed, cither, in completely effacing every reminiscence of the theory that located the origin of the sperm in the brain: too many beliefs relative to sexual excess were involved in it, beliefs that were circulated by the most eminent scholars.

Thus Albert the Great, in one of the Questions on Animals, attempted to decide whether sperm, a residuc of the final digestion, came more from one part of the body than from another.23 After examining the arguments pro and contra, he maintained that sperm came more from the principal members, and especially from the brain, whose substance, in its whiteness, softness and moistness, corresponded to that of semen. In support of this conclusion, he related an experiment and an anecdote. The former demonstrated the close relation linking the brain to the testicles; bathing the genitals of a drunken man brought him round from his drunken stupor. The anecdote that followed this ‘experiment’ may be considered as an exemplum designed to arouse fear in the debauched. Albert the Great specified that it was reported to him by master Clement of Bohemia: so we are not dealing with a first-hand eyewitness account, but the story struck Albert as sufficiently veracious to be mentioned, all the more since it most likely concerned a monk from a rival order. This man, described as ‘half-starved’, dicd after having ‘desired’ a beautiful lady seventy times before matins was rung. The autopsy, carried out

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because of the nobility of the family the monk came from, revealed the emptiness of his brain, which had been reduced to the size of a pomegranate, and the fact that the eyes had been destroyed. Albert the Great concluded: ‘This is the sign that coitus drains, above all, the brain.’

The vulnerability of the eyes, organs closely linked to the brain, formed another topos of medieval medical literature to which the authority of Aristotle gave all its force. This theme was expressed not only in the Problems,24 but also in the authentic treatise Generation of Animals. For Aristotle, the residue which formed the sperm was not supplied uniformly from all parts of the body:

For of all the regions in the head the eyes are the most seminal, as is proved by the fact that this is the only region which unmistakably changes its appearance during sexual intercourse, and those who overfrequently indulge in it have noticeably sunken eyes. The reason is that the nature of the semen is similar to that of the brain; its matter is watery whereas its heat is a mere supplementary acquisition.25

Aristotle seems thus to have lent his authority to an argument that was particularly effective in repressing sexuality. One cannot fail but think of the alleged blindness brought on by masturbation, a spectre that certain nineteenth-century doctors summoned up a little too frequently. In the Middle Ages, the deterioration of the eyesight was constantly being mentioned as part of the damage caused by coitus – both in scientific treatises and in works of a more popularizing kind; thus the Problemata Varia Anatomica, written in the fifteenth century, claims: ‘Coitus destroys the eyesight and dries up the body.’26

Restricting ourselves as we are to the field of sexuality, we cannot tackle the important medical and philosophical debates that stood out as milestones in the history of theories of reproduction. So we will merely point out the different types of questions that were thrown up when people reflected on the nature of sperm, and the effects this thinking had on the role ascribed to each of the two sexes. It is interesting to survey the state of knowledge in the person who often, in his doxographies, brought together the most information. Citing Aristotle as his authority, Vincent of Beauvais repeated the different ideas that we have already been drawing on. But he added the following: ‘That is why the warmth of the sun and animal warmth are present in sperm.’27

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Aristotle even replies to the objections of the supporters of female sperm: ‘There are some who think that the female contributes semen during coition because women sometimes derive pleasure from it comparable to that of the male and also produce a fluid secretion. This fluid, however, is not seminal; it is peculiar to the part from which it comes in each several individual.’42
This secretion is specific to those women who are ‘fair-skinned’ and docs not take place ‘in dark women of a masculine appearance’. The categories of physiognomy enable one to explain both the presence of

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an emission whose nature is not completely specificd, and also its absence. Aristotle’s procedure consists in treating the phenomenon as if it were a variable, dependent as much on the individual woman as on her diet. In the Middle Ages the full force of this doctrine evidently coincided with the appearance of translations of Aristotle’s works, in the middle of the thirteenth century.

An important element in the resistance to this opinion is Hippocrates’ clear and unambiguous position on the subject: ‘The woman also ejaculates from all her body, sometimes in the womb – and the womb becomes moist – sometimes outside if the womb is open wider than should be the case.”43

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This argument, repeated several times, in particular by Vincent of Beauvais, makes it appearance in the course of a long argument, of great importance for the history of sexuality in the Middle Ages. A precondition of the woman’s being fertile is pleasure, which leads to the emission of seed and thus to impregnation: ‘For prostitutes who have sexual relations for money alone, and who take no pleasure during the act, have no emission and thus do not conceive.’48

The prostitute who loves only one man can again enjoy pleasure and can once more become fertile – though this is rare, adds the author. It would be difficult to give a better explanation of sterility, doubtless a punishment for repeated infections. Let us turn to cases of rape: the women involved have had no pleasure during the act, and have not emitted any seed – and yet it sometimes happens that they conceive.

To this objection, William of Conches replies with a theologically inspired pessimism that could be seen as a terrible masculine cynicism: ‘Although in rape the act is distressing to begin with, at the end, given the weakness of the flesh, it is not without its pleasures.’49

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If the rediscovery of Aristotle marked a regression in the understanding of the role played by the woman, it nonetheless, thanks to the important debates that followed it, showed up the inadequacy of the word ‘sperm’. Three different roles could be ascribed to this improperly named substance, depending on who was writing – or sometimes even in the work of one and the same
writer: it could play a part in conception by transmitting the maternal characteristics; it could enable the male seed to be better received; and it could act as a sign of the woman’s pleasure. Three processes were thus confused: ovulation, cervical secretion and vaginal lubrication.

Albert’s evident attempts to understand the situation show that for a mind desiring to reconcile experience and rational explanation, the Aristotelian solution appeared over-simplistic, while the Galenist position, even apart from the philosophical obstacle that it represented, could only propose equally inadequate physiological models.

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The theory of the female seed was to survive long after the Middle Ages. The casuistry of the fourteenth century founded, on an assertion as imprecise as this, a distinction between the sinful act and the permissible act.66 The sexual act that led to an emission in the woman was considered as illicit. The casuists here wielded a weapon that was particularly efficient in repressing female pleasure because of its very lack of a basis in physiological reality.

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In the Speculum Medicinae, Arnald of Villanova proposes a subtler analysis of the effect which the faculty located in the median ventricle of the brain has on the body.114 It can influence the state of members or organs in two ways: either indirectly, via the passions – and thus via the heart – or directly, as when it judges that an object is pleasant or harmful. This last mode of action finds its realization in two similar functions; after a mental inclination has led one to pursue a particular pleasure, the reproductive organs prepare for coitus; likewise, at the sight of something repugnant, nausea sets in.

We again find the analogy between vomiting and coitus; in Albert the Great it served to account for the phenomenon of expulsion following a spasm, whereas Arnald of Villanova uses it, in a more philosophical context, to explain the physical effects of two sensations of the same degree, although opposite in quality – disgust and desire. The estimative virtue, which we will call judgement for simplicity’s sake, operates not only at the time of the decision, but during the progress of the act. This realization supports the ancient belief, according to which the images that present themselves to the spirit in the course of conception influence the form of the embryo. In connection with this, a Salernitan question cites the case of adulterous relationships which can give birth to a child resembling the deceived husband and not the natural father; the explanation is that shame brings to mind during the act the image of the absent man.115

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The defining of what was allowed in sexual behaviour was followed – or even superseded – by the desire to establish a norm in conjugal sexuality and to investigate the legitimacy of pleasure even in this context. Gratian had suggested that ‘Those who copulate not to procreate offspring but to satisfy lust seem to be not so much spouses as fornicators.’

Certain authors took this tendency even further and proposed that even pleasure in the act of procreation was a sin: to act without sin and still have children, the ‘holy man’ suffered the pleasure, ‘just as one eating honey to feed himself might suffer the sweetness of the honey’. This comparison, put forward by William of Auxerre, shows the furthest point reached in the repression of pleasure.

There is, as we have said, a flagrant contradiction between the growing mass of prohibitions laid down by theologians, and the influx of information relating to contraception. From the high Middle Ages up to the fifteenth century, manuscripts presented, either one after the other, or else intercalated between the principal texts, innumerable isolated prescriptions; among these prescriptions, often on the borderline between magic and medicine, it is rare not to find a piece of advice ut mulier non concipiat [‘so that a woman does not conceive’].7

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If the behaviour alluded to was indeed as described, courtly love seems to have led to a rediscovery of and demand for clitoral stimulation, to the use of the man as an erotic stimulant – and thus to a sexuality that was active, specific and, what is more, recognized and even exalted as such by an aristocracy of the sensibility and the intelligence. Taking its cue perhaps from Arab erotic lore,24 although this is a controversial question, intellectual life was for the first time associated with women’s demands.

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Certain questions are referred to bluntly in the text, such as the insatiability of some women. The lines can be quoted without further commentary.

N’aies dont de tel fame cure
Se tu ne pues tant tribouler
Que tu la puisses saouler.35

Do not bother over such a woman,
If you cannot work away
Enough to make her satisfied.

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“Lustful old woman,” said the hermit, “why do you criticize your son for his debauchery, but not your daughter for hers?”’70 Raymond Lull gives her this reply:

The old woman replied that her son was consuming his body and spending his money on [indulging his] lust, whereas her daughter earned money. Furthermore, her daughter indulged her lust before her very eyes, which her son never did.

Finally, she could speak about lust without shame to her daughter, to whom she recounted the pleasures that she had experienced with men, pleasures that she was ashamed to tell her son about.

The old woman takes a certain pride in her own life of debauchery; it has enabled her to assert her liberty. But this brief dialogue also proves that the art of loving is transmitted by women and that men play no part in it, even within the family. The information that a boy learns from his elders will only create complexes: and this information will be riddled with errors if he learns it from companions of his own age. In the field of communication and of sexual initiation, the text reveals that a young man and a young woman are not in the same situation. Perhaps there is, in this extreme case presented to us by Raymond Lull, a revelation of the way information works in the midst of the family structure. The woman who speaks of her pleasure has in fact learnt all about the art of love, whereas the male has only ever been initiated into the function of reproduction.

One can thus wonder whether the frustration of the male, his inability to understand – something that is, furthermore, translated by a title like the Secrets of Women – will not be a component part in the creation of the character of the witch. This developing belief focuses specifically on the older woman, who is accused of procuring abortions. If the person accused of black magic is often a woman, this is because there has been an increasing lack of communication between men and women, aggravated by male fantasies and by a feeling of guilt.

Standing in as a substitute for direct communication between the two sexes, the alleged witch fulfils the deadly role of a go-between, and the only means that a male society possesses of expressing its terror, is to send her straight to the stake.

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Trotula mentions two accidents which may occur after coitus: a swelling of the vulva, as well as a slipping down of the womb caused by the excessive size of the virile organ. One also finds the recipe for a remedy capable of giving back the appearance of virginity,
but the reason is honourable, since the dilation of the vagina could prevent conception. Trotula then registers the physiological disturbances that can occur in widows or in people who have taken a vow of chastity.

The delicacy with which specifically gynaecological problems are treated, as well as the understanding shown towards the female condition, are such exceptional attitudes in the Middle Ages that we cannot avoid mentioning them.

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Eroticism regained

Although the preservation of some Latin translation or other does not enable us to presuppose a direct acquaintance with the Arab treatises we have just discussed, most of the medical sources that the latter were based on were known in the West. First and foremost there was the Canon of Avicenna which was in the widest circulation in university and medical circles from the earliest years of the thirteenth century onwards.

In it, the usefulness of coitus for keeping oneself physically and mentally healthy was reasserted; in the same period, the fear of death that a woman might feel at the idea of another pregnancy was included among the arguments put forward in favour of contraception.

But above all, through Avicenna’s influence, the consensus of doctors regarding the existence of female sperm was maintained; even in authors who granted it only a restricted role, the link between fecundity and a female emission was preserved. This enabled medical preoccupations to be displaced and created the possibility of making room for the beginnings of an erotic art: the quest for pleasure as such was to be one of the components of every discourse on the conditions for performing the sexual act, since in the background loomed the necessity of encouraging conception. Sterility and frigidity became synonymous. All of these factors led to the notion of sin being forgotten when this was necessary, and to the possibility of a freedom in thought and behaviour which might have struck us as irreversible, were it not for the opposing current transmitted by the Aristotelian vision of woman and the failure of the centuries that followed the Middle Ages to follow up this vision of freedom.

The necessity for the man and the woman to reach a simultaneous emission, and so to share their pleasure, gave doctors an ‘excuse’ for
tackling certain problems:

There is no shame in the doctor speaking about the increase in the size of the penis, or the narrowing of the receptive organs, or of the woman’s pleasure, since these are factors that play a part in reproduction. For the small size of the penis is often a hindrance to climax and emission in the woman. Now, when the woman does not emit any sperm, conception cannot take place.92

Avicenna thus granted doctors freedom of expression with, in addition, a justification that could not be neglected in a society that made sexual intercourse serve the sole end of reproduction. Medieval writers backed Avicenna’s assertion with an aphorism from another author writing in Arabic: ‘You must not be ashamed to ask the patient about everything.’93

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John of Gaddesden takes up Avicenna’s description of foreplay, adding several details which show that he is taking into consideration the woman’s erogenous zones, although no reference is made to the specific role played by the clitoris.99

What is more surprising is that he envisages the woman’s taking the initiative if the first attempt has met with failure, that is, if the woman has not experienced any pleasure and her partner is showing signs of difficulty in managing a second attempt. So, he recommends that the man lie on his back (a position which makes erection easier) and that the woman performs a series of movements designed to arouse male desire.100 We do not know in what position the act is to be performed.

This text contains one of the rare examples to show the woman as capable of taking the initiative, something that presupposes her knowing the right technique. The art of the kiss is also discussed in detail, following a tradition we have already encountered in Trotula.

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Despite the licentious character that the Speculum took from its subject-matter, there is no trace of obscenity in it. Set firmly within a medical framework, it even appears to be particularly ‘healthy’; while it mentions different positions, the natural paths are the only ones envisaged and no technique for retention is disclosed. In that, the Speculum differs from its Eastern counterparts and sticks to the opinions expressed in medical works of the Latin world. Although this treatise constitutes at present the sole representative of a hitherto unknown genre, one can make a case for its not being completely exceptional. Although they avoided alluding to different positions, doctors found room in their works for a great deal of advice which diverged from anatomical or physiognomical description and bore a closer resemblance to an erotic science. In it could be discerned the manifestation of a medical reaction against the dangers that threatened civilization. Epidemics of the plague increased falls in the population, and the last centuries of the Middle Ages were
characterized by the rise of an apocalyptic vision; fanatical preachers foretold the end of the world. Doctors were led to denounce the danger of such influences123 and to praise the joys of life rather than to act repressively. From the same point of view, Jacques Despars, in the fifteenth century, declared firmly that nobody should blush about their sexual life, and underlined the happiness that procreation could bring:

[The man who suffers from a diminution of coitus] should become used to not blushing about the sexual act, or about listening to stories about it. Books discussing carnal love, the acts of Venus and their figures should be read in his presence, so that he will not blush either at talking about it openly, or at hearing it discussed, or at performing coitus when he so decides. He must frequently imagine the pleasures of love and he must bear in mind that to beget one’s fellow-creatures constitutes for living beings an entirely natural task; he must remember that without coitus, the human species would be extinguished, and it is pleasant to have children who will produce others and keep the world going. 124

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The spermatic form was considered to be the consequence of a burdensome chastity, and so the expulsion of the retained sperm appeared
to be necessary. To obtain this, massaging the genitals with the help of

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ointments was recommended; Galen described a case of spontaneous cure obtained in this way.25 Doctors in the Middle Ages recommended
the same practices: Arnald of Villanova recommended massage for widows and nuns, and the placing in the vagina of substances designed
to lead to assuagement.26 Here is the advice given by John of Gaddesden:

If the suffocation comes from a retention of sperm, the woman should get together with and draw up a marriage contract with some man. If she does not or cannot do this, because she is a nun and it is forbidden her by her monastic vow or because she is married to an old man incapable of giving her her due, she should travel overseas, take frequent exercise and use medicine which will dry up the sperm …. If she has a fainting fit, the midwife should insert a finger covered with oil of lily, laurel or spikenard into her womb and move it vigorously about.7

Marriage was the best remedy for chronic suffocation. In cases where this was impossible and other procedures met with failure, masturbation had to be considered, whether practised by the patient herself or by the midwife. For the seed to be expelled, pleasure had to be experienced.

According to Avicenna the cure was efficacious only if the sensations of coitus, that is, pleasure and pain, were felt. Medieval doctors generally omitted to refer to this aspect of the treatment when recommending recourse to manipulation; yet it was evident that female ‘seminal’ discharge accompanied orgasm. Medical discourse repeated this fact again and again on other occasions. Jacques Despars was one of the rare writers to pose the religious problem clearly: ‘This practice is only excused and exempted from being counted a sin against nature on condition that it is necessary in order to prevent death. On this point one must consult the theologians so as not to lose one’s soul by taking excessive care of the body’.28

Gynaecological diseases often required manual relief. In his Commentary on the Sentences, Albert the Great stated the distinction between manus polluens and manus medicans:

The hand which defiles leads to flabbiness or sodomy, but the hand which cures does not, as we say for women who suffer from a fall in the position of the uterus: it is prescribed that this be put back in place by means of the hand and we say that the hand does not defile nor corrupt these women, but rather cures them.29

May the same reasoning be applied to the treatment of suffocation of the womb, in which ‘defilement’ does indeed have to play a part? Doctors in the Middle Ages seemed to suggest as much, but it must be pointed out that they mentioned either individual manual relief, or else the hand of a midwife. At no time was the intervention of a practitioner of the

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male sex envisaged.
…

If evil spells were sometimes mentioned in order to account for cases of impotence caused by a disordered imagination, the hysterical malady was entirely ‘rationalized’ by doctors: female nature was sufficient to explain it, because of woman’s unbridled sexual appetite and the imperfection of the substances she produced. It is thus hardly any cause for astonishment that writers did not retain the possibility of a male ‘hysteria’, although this was suggested by Galen.