§ 38.
In the preceding Sections we have become acquainted with the various influences capable of favouring or counteracting the rise of diseases consequent upon the use or misuse of the genitals in Antiquity. At the same time we have shown how a multitude of affections of the most different kinds attacked, as a result of the unnatural gratification of sexual desire, those parts which under these circumstances had to undertake the rôle of the genital organs of the one or the other sex. Thirdly we have brought forward in the course of the enquiry at any rate some examples, proving beyond a doubt that the sexual parts themselves too under favourable external conditions sometimes became diseased as the consequence of indulgence in sexual intercourse. Still these results were for the most part based on the evidence of non-medical Writers, for of set purpose we abstained as much as possible from calling the professional Writers into Court on these points, so as to be able to treat in their proper mutual connexion whatever statements these latter have left us as to the maladies in question. This course appeared to us all the more necessary, as it is precisely the medical evidence which the opponents of the existence of Venereal disease in Antiquity believe themselves able to utilize in justification of their opinions.
But before we proceed to the detailed examination of the actual statements, it would seem expedient to get an answer to the following question: whether indeed the Physicians of Antiquity generally were in a position to acquire an adequate knowledge of the bodily consequences of vicious living? In fact on the correct answer to this question obviously depends the correct appreciation of the medical Writings as sources for the History of Venereal disease. Only under the condition that this question may be answered in the affirmative, can the evidence supplied by the Physicians be regarded as satisfactory for their own period. That it cannot of course be so for all periods, has been pointed out already in our examination of the authorities for Antiquity generally. Indeed for long periods of time Physicians had no special locus standi, inasmuch as each individual in the case of the most usual maladies endeavoured to help himself, and if the family recipes left him stranded, then betook himself with prayers for assistance to the Gods and their intermediaries on earth, the Priests. This still continued, even after the Physicians had won their recognition as a special profession, and we find accordingly throughout Antiquity popular, sacerdotal, and professional or medical medicine, if we may be allowed the expression, continuing to exist simultaneously side by side, and not a trace anywhere of the ridiculous limitation according to which no man has a right to be well without the help of a doctor.
Now having made it clear by what we have said, that in order to gain knowledge of a disease in Antiquity it is by no means enough to go to the Physicians only, even when such existed, that the latter should never be regarded as sole possessors of whatever was known from the point of view of pathology and therapeutics, we are bound to apply the same rule in the case of diseases consequent upon vicious habits. Of this the foregoing Sections contain amply sufficient proofs. It has there been shown how the genital organs were under the protection of special deities. Diseases affecting them were ascribed to the vengeance of the said deities, as at Athens to Dionysus, at Lampsacus to Priapus. To them sufferers had recourse to win by their prayers the removal of the divine anger, as well as its consequences; and all this happened not only in times when Physicians did not as yet exist, but no less when they did and in defiance of them, as the poems of the Priapeia sufficiently prove.[270] How long these ideas lived on is shown by the pictures Philo (p. 315) and Palladius (p. 318) draw of their times, while the XVth. and XVIth. Centuries reproduced the same scenes.
The most obvious reason for this no doubt was the enigma presented by the origin of diseases of the genitals, particularly for any one unacquainted with the existence of contagions and their modes of activity. The man who with a healthy penis had accomplished coition, observed some days afterwards, though without resenting the fact, a mucous discharge to have been set up, or an ulcer, pustule, or what not, to have appeared. The cause of these affections he sought for in vain, for of course the mere act of coition was the very last thing he was likely to regard as such. Rather accustomed, wherever the cause of any phænomenon was unknown to him, to ascribe it to the intervention of the deity, he saw in his complaint likewise the Θεῖον (divine) as eventual cause. Naturally therefore it was divine assistance, and not human, that would avail to relieve him of his pain. Long after this time moreover, when men had ceased to refer all diseases to the vengeance of the gods, and now discovered natural causes for maladies of the genitals, as for other diseases, anything rather than just the act of coition was looked upon as cause of the observed effects, as indeed is the case to this day among the Turks,[271] and as the earliest Writers on Venereal disease abundantly show to have been so in their time. That the Physicians were no exceptions to this rule, we shall show on a later page.
A much more weighty reason however why the patient attacked by some affection of the genitals turned not to men (Physicians) for help, but to the Gods, and the Priests who represented them, was the feeling of shame. Since first Adam and Eve had recourse to the fig-leaf, it has ever been a habit among all peoples of the ancient as of the modern world to withdraw the procreative parts from the view of others by covering them. But above all did the Ancients regard the exposure of these parts[272] one of the severest trials to which modesty could be exposed; and rightly enough therefore designate them by the name of pudenda, αἰδοῖα, the parts of shame. Neither the wide extension of Phallic worship, nor yet the compulsory exposure of the Ephebi[273] and the naked exercises of maidens and youths at Sparta[274], can fairly be cited in this connexion as proofs to the contrary.
In our own day the most accomplished voluptuaries are in no wise shocked at undertaking in secret the most shameful doings, but yet when it comes to showing the Physician the diseased instruments of their bestial lusts, often put this off so long as to run great risks of entirely losing the signs of their manhood; and without a doubt it was the same at the period when habitual depravity had reached its culminating point of enormity. Even Priapus himself asks (Carm. 3):
Nec mihi sit crimen, quod mentula semper operta est.
(Nor let it be laid as a crime against me, that my member is ever covered up.) If with this is compared the poem from the Priapeia quoted on p. 74 of Vol. I., no one can fail to agree with us when we say that the field of observation open to Physicians in Antiquity with regard to diseases of the genitals can never have been at all extended. Even the Priests, at any rate in later times, were only resorted to in the more serious instances; but even so their journals of cases, supposing them ever to have kept such, would have been a far better source of information than those of the Physicians. We find a confirmation of this in the Mosaic Books of the Law, which contain the earliest and clearest delineations we possess of affections of the genital organs both in men and women.
But if men were so reluctant, how much more so must women have been, who were universally held to have committed a crime if they had given any part of their body to the eyes of a stranger. Just as the assistance of the Physician was disdained in childbirth, and to account for the fact the fable of Agnodicé invented, in the same way in complaints of the genitals women hesitated to submit themselves to the inquisition of the Physician. But seeing the female sexual organs are pre-eminently the home and breeding place of Venereal disease, this closed what was precisely the most direct way to a correct understanding of maladies of the genitals. The ancient Physicians, like our own forefathers, could at best make leucorrhœa the universal scape-goat; and accordingly even Galen, as we shall find presently, laid no stress on the circumstance, and drew no inference from it, that wherever men were attacked by gonorrhœa, the women with whom they had had coition likewise suffered from the complaint.
Further, to this general sense of shame was added a certain timidity before the professional status of real Physicians as a class, as well as the pretty universally prevalent idea of the ignominiousness of a sickness brought on by a person’s own fault, at any rate among the educated part of the population. This comes out in the following passage of Plato,[275] where he says: “Does it appear to you disgraceful to stand in need of medical help, when it is not wounds at all or such sicknesses as depend on the seasons that have befallen, but when a man through indolence and a way of life such as we have noted (i.e. a very luxurious one), is filled full of fluxes and accumulations of wind like a sea, giving occasion to the noble sons of Asclepius to designate these complaints by the names of superfetations and catarrhs?” This was more than a mere expression of individual opinion; there is no doubt affections of the genital organs, more especially if their relation to sexual intercourse was known, belonged to the class of diseases held to be most disgraceful,[276] and the Poet is justified in saying:
Diis me legitimis nimisque magnis
Ut Phoebo puta, filioque Phoebi
Curatum dare mentulam verebar.
(To the lawful gods, deities too exalted for me, such for instance as Phoebus, and Phoebus’son, I feared to entrust my member for cure.) Thus it was not to the “noble sons of Asclepius”, in other words the Physicians, who treated freemen only, that patients resorted for help, but to the gods, or else to the medical underlings (ὑπηρέται τῶν ἰατρῶν,—subordinate assistants of the physicians), to the slave-doctors and quacks, who plied their trade in the doctor’s shops,—establishments where, as we have seen above, paederasts and pathics foregathered. Exactly the same state of things prevailed down to the middle of the last Century; and to this day a majority of such sufferers rarely as a matter of fact come under any other hands.
The knowledge and observations of these Cullers of simples and Compounders of balsams, if indeed as a rule they really possessed the former, or knew how to make the latter, necessarily perished on their decease, or at best were passed on by tradition to their successors in the doctor’s shops, without professional Physicians or medical Science being one whit advantaged. To such men it was a matter of perfect indifference what was the origin of the disease for which they sold their powders and decoctions, for as Plato (De legg. IV. 720) says, they paid no attention to the existing conditions of disease, and did not care to give a thought to any such thing. But at any rate,—and this was the chief point,—the patient was spared a humiliating confession, and was glad enough to buy the privilege even at the cost of possible ruin to his health. We must further remember that the “filles de joie” in Greece and at Rome were mostly slave-women, who from the very fact of their status could make no claim to treatment by free-born physicians, and that during the flourishing period of Greek medicine under the Hippocratic school it was chiefly persons of the lowest station or else sailors and foreign traders and the like who sought enjoyment in the arms of prostitutes. Such men by their constant change of abode made all continued observation a simple impossibility, so that the very imperfect knowledge possessed by the scientifically trained Physicians with regard to diseases of the genitals and their consequences need occasion little surprise.
It is true of course that at the period of universal degradation of morals Physicians must have found no lack of opportunities for observation; but the great majority of them were incapable of utilizing these, actually blocked the way of set purpose, as we shall see presently, that led in the direction of more accurate investigation, or else troubled their heads little about the cultivation of Science or the systematic record of observations. The latter, if they had published them, whether in writing or orally, could only have been detrimental, particularly in the case of physicians of the character of Charidemus’ medical attendant,[277] to their own interests. In fact they were bound to call all their subtlety into play for the express purpose of concealing the true cause of diseases of this type, a circumstance which no doubt we have to thank for a large number of the extravagant and often more than ludicrous statements regarding the origin of Venereal disease in the XVth. and XVIth. Centuries.
But as a matter of fact the public itself was no less careful to guard the secret, as we gather from Martial,[278] as well as from the fact that Galen felt himself constrained even in his day to compose a special Treatise on dissimulated diseases. This sort of intentional deception on the part of patients was so much the easier, as Physicians in those times, as said above, in virtue of their pathological views,—some of which indeed may very well have originated in this way,—were little accessible to the truth. For these reasons they deserved, at any rate to some degree, the satiric lash of Martial; and were very generally ridiculed by the more discerning of the laity. This comes out in the important words of Appuleius (Metamorph. X. 211.) as follows: “Crederes et illam fluctuare tantum vaporibus febrium: nisi quod et flebat: Heu medicorum ignavae mentes! Quid venae pulsus, quid caloris intemperantia, quid fatigatus anhelitus et utrimque secus iactatae crebriter laterum mutuae vicissitudines? Dii boni! Quam facilis, licet non artifici medico, cuivis tamen docto venereae cupidinis comprehensio, cum videas aliquem sine corporis calore flagrantem.” (Could you imagine her so tempest-tossed by the vapours of mere fever,—not to mention that she kept forever crying: “Oh! the sorry wits of doctors!” What means the throbbing vein, the excessive temperature, the labouring breath, and the hurried interchange of heaving flank, panting now on one side now on the other? Great heavens! how easy the diagnosis, not of course for a medical expert, but for any one learned in the symptoms of love, when you see a person burning, yet without bodily fever-heat).
But does all this justify us in casting a stone at our medical colleagues of Ancient times? For the last three hundred years we imagine ourselves clearly acquainted with Venereal disease and all its forms; yet how many a bubo has been mistaken for a strangulated hernia, anal callosity, or the like, how many a case of vaginal gonorrhœa for simple fluor albus (white discharge, leucorrhœa), how many a condyloma on the posteriors for hæmorrhoidal swellings, and accordingly not treated as the physician in Juvenal, medico ridente (the physician grinning the while), treated them,—that is duly cut away or ligatured?
Lastly to all these reasons was added further the mildness and absence of danger characterizing the disease itself, at any rate in the majority of instances,—as proved in our earlier investigations. To our own day genuine amateurs of Love, thanks to those who supply “advice, direction and information” on these subjects, endeavour as a rule, at any rate in the earlier stages, to cure without assistance the wounds received in the fight. This was equally so in Antiquity, as the following significant passage of Galen[279] shows: “This is pretty well all I have to say at present as to ephemeral fevers. For patients who have contracted fever consequent upon a bubo, do not consult physicians as to what they must do; but after first treating the ulcer which occasioned the bubo and then the bubo itself, bathe after the abatement of the severity of the attack. After that if any one says a word as to the “diatriton” (fast till the third day), all laugh and declare him a precisian: I suppose because they are of the opinion that nothing must be resigned to nature that is not invariably there.”
We know quite well that the Ancients called all glandular swellings buboes, and that they were perfectly well acquainted[280] with those glandular swellings in the arm-pits and the groin which follow upon ulcers of the fingers and toes; but this in no way justifies us in referring the above passage, which is certainly written in a general sense, solely to suchlike buboes and not equally to those in the soft tissues; more particularly as Galen, in the place where he is dealing expressly with the treatment of buboes and the phlegmonous affections preceding them and occasioning ulcers (loco citato p. 881), explicitly mentions phlegmonous symptoms as κατὰ αἰδοῖον (affecting the privates) and γυναικὶ κατὰ μήτραν ἢ αἰδοῖον (in women affecting womb and privates),—loco citato p. 893. Hence we think ourselves justified in drawing attention to the passage as containing an indication of the reason why ulcers of the genital organs pursued a milder course and admitted of an easier cure in Antiquity, because the ephemera evidently facilitated the assimilation and elimination of the contagion, this taking place either at the point primarily attacked, or else occurring because it (the ephemeral fever) led to an enhanced activity of the cutaneous glands by provoking an exanthematous eruption.