Sex and Medieval Medicine

In the Middle Ages sex was considered, as it is now, to be a normal and natural part of life. Most authorities agreed that it was not inherently sinful because God would not have made such a necessary activity taboo (without sex one cannot have children and fulfill the command to "increase and multiply, and fill the earth" given in Genesis 9:1).

Natural though it was, however, sex was also morally fraught because of the pleasure associated with sexual activity. When engaged in for strictly defined right reasons, sex was sinless.

However, humanity being fallen as it was, human intent was scarcely ever free of the lust that could taint sex, rendering a natural activity unnatural. Therefore, writers who discussed sex had to walk a very fine line between portraying human nature and human sin. That line was, of course, itself debated, as many writers disagreed on the point at which nature ended and sin began.

To further confuse the issue, the Middle Ages had writers who used allegorical and satirical styles of writing (much like some writers and publications in our own time) that could be easily misread, as well as "shock jocks" who thoroughly disagreed with commonly held notions of moral behavior and who did their best to cause controversy with their behavior and writings. The following pages detail some of the more commonly used modes of discussing and depicting sex and sexual behavior from medical to moral to literary. Moral authorities grudgingly acknowledged sex to be not inherently sinful, but very strictly delineated the ways in which sex could be used without spiritual consequences. Medical authorities, by contrast, considered sex to be an essential part of bodily health, noting that abstention could lead to a dangerous buildup of the "seminal humor."

As a preventative measure, physicians recommended regular, but not excessive, sexual intercourse (too little being as bad as too much). However, they took into account that not all people had a morally acceptable way of engaging in sex, and to this end recommended masturbation, drawing on the authority of Late Classical writers such as Galen, who suggests that physicians or midwives "place hot poultices on the . . . genitals" of a celibate woman and "cause [her] to experience orgasm, which would release the retained seed" (Murray, 201). Unfortunately, this was an area in which the medical and the moral definitely clashed.

Moral authorities such as the theologian Thomas Aquinas considered masturbation (also known as "onanism" from the Biblical story of Onan; see Genesis 38:7-10) to be "the sin of uncleanliness, which some call voluptuousness" and an "unnatural vice" because it is "contrary to the natural ordering of the sexual act that is proper to human beings" (Summa Theologica 154.5). The only way that moral authorities would excuse masturbation was when it was unintentional, as was the case with nocturnal emissions, because "there [may be] an excess of the seminal humor in the body" which needed to be expelled in order to keep the body in balance. Thomas assumes that the body will take care of this balance itself, and lumps all intentional masturbation under the rubric of voluptuousness.