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Medicine and Anatomy

351. Comparison of male and female anatomy. Pergamum, 2nd cent. A.D. (Galen, On the Usefulness of the Parts of the Body 14.6-7, exc. Tr. M.T. May. G)

Galen, born and educated in Pergamum, the great Hellenistic seat of learning in Asia Minor, was philosopher, physician, and eclectic dogmatist. He began his career as a gladiators' doctor, but eventually became physician to the Emperor Marcus Aurelius. His pathology was speculative and based on the doctrine that health depended on the balance of the four humours (black bile, yellow bile, blood and phlegm). His reliance on philosophical premise and astrological prognostication has little connection with modern scientific technique. Some of his anatomical conclusions are based on inaccurate comparisons between animals, which he dissected, and humans, whom he did not. But he made significant contributions to diagnosis and prognosis.[1]

The female is less perfect than the male for one, principal reason because she is colder, for if among animals the warm one is the more active, a colder animal would be less perfect than a warmer. A second reason is one that appears in dissecting ...

All the parts, then, that men have, women have too, the difference between them lying in only one thing, which must be kept in mind throughout the discussion, namely, that in women the parts are within [the body], whereas in men they are outside, in the region called the perineum.[2] Consider first whichever ones you please, turn outward the woman's, turn inward, so to speak and fold double the man's, and you will find them the same in both in every respect. Then think first, please, of the man's turned in and extending inward between the rectum and the bladder.

If this should happen, the scrotum would necessarily take the place of the uteri, with the testes lying outside, next to it on either side; the penis of the male would become the neck of the cavity that had been formed; and the skin at the end of the penis, now called the prepuce, would become the female pudendum [the vagina] itself. Think too, please of the converse, the uterus turned outward and projecting. Would not the testes [the ovaries] then necessarily be inside it? Would it not contain them like a scrotum? Would not the neck [the cervix], hitherto concealed inside the perineum but now pendent, be made into the male member? And would not the female pudendum, being a skinlike growth upon this neck, be changed into the part called the prepuce? It is also clear that in consequence the position of the arteries, veins, and spermatic vessels [the ductus deferentes and Fallopian tubes] would be changed too. In fact, you could not find a single male part left over that had not simply changed its position; for the parts that are inside in woman are outside in man. You can see something like this in the eyes of the mole, which have vitreous and crystalline humours and the tunics that surround these and grow out from the meninges, as I have said, and they have these just as much as animals do that make use of their eyes. The mole's eyes, however, do not open, nor do they project but are left there imperfect and remain like the eyes of other animals when these are still in the uterus ...

So too the woman is less perfect than the man in respect to the generative parts. For the parts were formed within her when she was still a foetus, but could not because of the defect in the heat emerge and project on the outside, and this, though making the animal itself that was being formed less perfect than one that is complete in all respects, provided no small advantage for the race; for there needs must be a female. Indeed, you ought not to think that our creator would purposely make half the whole race imperfect and, as it were, mutilated, unless there was to be some great advantage in such a mutilation.

Let me tell what this is. The foetus needs abundant material both when it is first constituted and for the entire period of growth that follows. Hence it is obliged to do one of two things; it must either snatch nutriment away from the mother herself or take nutriment that is left over. Snatching it away would be to injure the generant, and taking left over nutriment would be impossible if the female were perfectly warm; for if she were, she would easily disperse and evaporate it. Accordingly, it was better for the female to be made enough colder so that she cannot disperse all the nutriment which she concocts and elaborates ... This is the reason why the female was made cold, and the immediate consequence of this is the imperfection of the parts, which cannot emerge on the outside on account of the defect in the heat, another very great advantage for the continuance of the race. For, remaining within, that which would have become the scrotum if it had emerged on the outside was made into the substance of the uteri, an instrument fitted to receive and retain the semen and to nourish and perfect the foetus.

Forthwith, of course, the female must have smaller, less perfect testes, and the semen generated in them must be scantier, colder, and wetter (for these things too follow of necessity from the deficient heat). Certainly such semen would be incapable of generating an animal, and, since it too has not been made in vain, I shall explain in the course of my discussion what its use is: The testes of the male are as much larger as he is the warmer animal. The semen generated in them, having received the peak of concoction, becomes the efficient principle of the animal. Thus, from one principle devised by the creator in his wisdom, that principle in accordance with which the female has been made less perfect than the male, have stemmed all these things useful for the generation of the animal: that the parts of the female cannot escape to the outside; that she accumulates an excess of useful nutriment and has imperfect semen and a hollow instrument to receive the perfect semen; that since everything in the male is the opposite [of what it is in the female], the male member has been elongated to be most suitable for coitus and the excretion of semen; and that his semen itself has been made thick, abundant, and warm ...

It is clear that the left testis in the male and the left uterus in the female receive blood still uncleansed, full of residues, watery and serous, and so it happens that the temperaments of the instruments themselves that receive [the blood] become different. For just as pure blood is warmer than blood full of residues, so too the instruments on the right side, nourished with pure blood, become warmer than those on the left ... Moreover, if this has been demonstrated and it has been granted that the male is warmer than the female, it is no longer at all unreasonable to say that the parts on the right produce males and those on the left, females. In fact, that is what Hippocrates meant when he said, 'At puberty, whichever testis appears on the outside, the right, a male, the left, a female.'[3] That is to say, when the generative parts first swell out and the voice becomes rougher and deeper-for this is what puberty is-Hippocrates bids us observe which of the parts is the stronger; for of course, those that swell out first and have a greater growth are the stronger.


Notes:

1. See number 352, and Scarborough 1977. Cf. Jackson 1988, 86-111.

2. This notion may go back to the third-century B.C. doctor Herophilus of Alexandria, Galen On Seed 2.1= F 61 (von Staden 1989).

3. On Common Diseases 6.6.21.

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