Pleasure of Her Sex, Part 5

Part 5

On the other hand…

That said, not all discussions about the importance and benefits of sexual intercourse and a women’s right to pleasure came to the same conclusion. And sometimes one author would express two different views in different types of texts. One example of this is clearly illustrated in Peter Pormann’s article “Al-Razi on the Benefits of Sex: A Clinician Caught Between Philosophy and Medicine.” In this essay, Pormann notes the two different stories al-Razi tells about the effects of sexual intercourse on the body in his philosophical book on Spiritual Medicine and on his medical treatise On Sexual Intercourse. The former, Pormann notes, “warns against the harmful effects of sexual intercourse” (134); al-Razi writes that it “‘weakens the eyesight, wrecks and exhausts the body, speeds up aging, senility, and withering, damages the brain and the nerves, and renders the [bodily] strength weak and feeble, in addition to many other conditions which would take too long to mention’” (as quoted in Pormann, 134). In contrast, On Sexual Intercourse “list[s] various diseases and debilities which can result from having sex, they also stress, in various degrees, its benefits” (134). 

     While the benefits described seem largely to be for men (or not explicitly indicated), al-Razi also addresses specific benefits for women: “Moreover, the pain called ‘suffocation of the womb (ikhtinaq al-arham) occurs in women only because of the loss of sexual intercourse (fuqdan al-jima), and no remedy is better than it [sex]” (136). Pormann also notes a late ninth-century Christian (of Greek origin, living in Syria) author, Qusta b. Luqa, wrote a precursor to al-Razi’s. His texts (he wrote two treatises on the subject of sexual intercourse) also address the diseases that benefit from sexual intercourse (and of course the pleasure derived), as well as those that occur from abstaining. Of particular interest to the point of women’s right (and by necessity) to pleasure from intercourse is Qusta b. Luqa’s note that “women suffer more than men from not having sex because they are afflicted by the suffocation of the womb (ikhtinaq al-rahim) and apnoes (butlan al-nafas) because of excess semen” (140). Pormann suggests that Qusta b. Luqa “seems to have had a particular concern for the sexual health of women” (141), which we also see in the tenth-century Provisions noted above. 

      Al-Razi also notes that, generally speaking, sex is “extremely useful against madness and melancholy, and a powerful remedy for diseases caused by phlegm…and improves their digestion” (136). The benefits noted in al-Razi’s texts are clearly physical (and psychological), but unlike Ibn al- Jazzār and the later al-Ghazali’s “Book of Marriage” and al-Jawziyya’s Medicine of the Prophet, al-Razi separates the physical benefits of pleasure in sexual intercourse from the spiritual—in part perhaps because he takes an opposing view on sexual intercourse in Spiritual Medicine: “this desire [ladhadha i.e., for sex] is the one which deserves most to be rejected, for it is not necessary for staying alive as food and drink are” (as quoted on Pormann, 139). There is a general sense here that desires generally are problematic, but none, perhaps more so than sexual desire, which isn’t, in this text anyway, required for health. These seemingly contradictory positions give us a tantalizing view into the complicated and nuanced cultural negotiation between certain medical and spiritual texts.

Pleasure of Her Sex, Part 4

Part 4

Medical Philosophy and Practice

Medical philosophy and practice, perhaps not surprisingly, also addressed the importance of sexual satisfaction to maintaining health, and this included health of the spirit as well as the body. For example, in Ibn Sina’s early eleventh century “A Treatise on Love” he explores “sacred and profane” love, treating the different types of love and the objects of love, including “higher” or divine love and love “in the animal substances” (211). It should be noted that in this treatise, Ibn Sina often quotes the Prophet as part of his discourse, including in relation to animal desire which, when expressed, can result in “vice and is harmed in his rational soul.” That said, whenever “he loves a pleasing form with an intellectual consideration…this this is to be considered as an approximation to nobility and an increase in goodness” (221). This particular text expresses the philosophical nature of the hierarchy of love which we find in other texts that address the “art of love” (including Ibm Hazm’s Ring of the Dove, among others). He establishes a hierarchy in which divine love, of course, ranks highest, but he also articulates that “every single being loves the Absolute Good with an inborn love, and that the Absolute Good manifests Itself to all those that love it” (225), which suggests that all expressions of love, including animal “substance” and “faculty” (211) are ultimately of the highest order. 

     In terms of treatment and practice, we find in Ibn al-Jazzār’s tenth century Zād al-musāfir wa-qūt al-ḥāḍir, Provisions for the Traveler and Nourishment for the Sedentary, Book 6, a treatise significant to the history of sexuality. Ibn al Jazzār was a Tunisian born physician, from a family of physicians, who trained with famous Jewish physician and philosopher Ishaq b. Sulayan al-Isra’ili. He worked as a physician and authored numerous books, many on medicine. This particular series of texts is, contrary to its title, “ a systematic medical handbook, discussing the different diseases and their treatment a capite ad calcem (from head to toe) in a concise form” (Bos, 5-8). His work was translated into Latin by Constantine the African in 1124 (Viaticum peregrinantes), and this was later adopted by the famous medical school of Salerno (in the thirteenth century), and became “one of the most influential medical handbooks in medieval Europe” (Bos 10). Ibn al Jazzār’s chapter on melancholy and its discussion of ‘ishq (passionate love) and, I suggest, his work on sexual desire and women’s diseases, had a significant influence not only on Western gynecological medicine and treatments of lovesickness, but also on literary representations of lovesickness.

     Ibn al Jazzār’s Book 6 addresses a range of topics related to the sexual body over the course of twenty chapters. They included sexual diseases among men (chapters 1-8) and women (chapters 9-18), and sciatica (chapter 19) and gout (chapter 20). While Book 6 of Ibn al Jazzār’s Provisions largely focuses on assuring male potency through aphrodisiacs and other remedies that cure impotence, it also recognizes women’s right to pleasure. The chapters on women’s sexual disease focus on issues related to menstruation, hysterical suffocation, and other gynecological subjects, including, interestingly, contraception (which itself has, as we have seen, a relationship to women’s right to pleasure). 

     Of interest to the questions of a woman’s right to pleasure is in his introductory chapter when he describes the purpose and importance of pleasure in intercourse:

          When the Creator, to Whom belong glory and greatness, wanted [to ensure] the survival of the species of animals,           He created procreative organs for all of them, which provided with an innate power characteristic to them and                   creating delight. [By this] He evoked in the soul which has these organs at its disposal, the love and ardent desire             to use them. He endowed the act of sexual intercourse with an unfailing and never absent sense of great pleasure,             so that the species of animals would survive, and mankind would not hate sexual intercourse. (Bos 239)

Of note here is the idea of “innate power” found in the procreative organs, and the “delight” and the “unfailing and never absent sense of great pleasure” that comes along with sexual intercourse. This “innate” characteristic for pleasure is present in both sexes, and in fact, as is also found in Ibn Sina’s “Treatise on Love” and al-Jawziyya’s later Medicine of the Prophet, is also connected to the soul’s desires: “He [God] evoked in the soul which has these organs at its disposal, the love and ardent desire to use them” (239) (this description is based on Galen’s description of pleasure in sexual intercourse in is De usu partium (The Usefulness of Parts) (Bos 19).

Ibn al Jazzār notes that, in addition to the various medical recipes to aid in the stimulation of sexual desire (in men), there are 

          other means as well which, when applied together with the remedies mentioned by us above, strengthen the sexual           lust and increase [sexual] activity, such as to relieve the heart of anxiety and to be always joyful…for he [Firasa]             said that there are various incentives which excite sexual lust…these include affectionate words showing passion,           kissing the cheeks, fondling with the hand, licking with the tongue, joy over the sight of the beloved, expressing               one’s devotion to the beloved and refraining from dwelling on grievances [against her]. (Bos 249)

While this is clearly intended as aid and remedy for the man, it does, as we saw in al-Ghazali’s text, ultimately benefit the women in also having pleasure (he’s describing what we have come to call “foreplay”). 

     And this pleasure in intercourse is not entirely for the purpose of procreation as is indicated by chapter (17) devoted to contraceptives and abortifacients. Bos notes that, based on Chapter 17 and another work, Tibb al-fuqara, Ibn al Jazzār projects a “neutral” attitude towards contraception and abortifacients (60-61), and that this attitude “is in conformity with that of Islam, since the use of contraceptives and abortifacients as a way of birth control was permitted in Islamic society, and was sanction by Islamic law” (61). The “numerous discussions of contraception and abortion in different genres of Islamic literature, such as medical, legal, erotic, and popular, are clear proof of this” (Bos 61). One might argue that this is also the case with a women’s right to pleasure, that the many places where discussions about the importance of sexual pleasure generally, and women’s pleasure in particular (either explicitly or implicitly), suggest that it was largely accepted in the culture.

The Pleasure of Her Sex, Part 3

Part 3

Jurists and Prophetic Medicine

B.F. Musallam, in his book Sex and Society in Islam, explores medieval Muslim women’s right to sexual pleasure in the context of birth control, in specific, coitus interruptus: “The Muslim jurists generally based their permission of contraception on the free woman’s consent because she had a right (1) to children, and (2) to complete sexual fulfillment…” (28), and they “never denied, rejected, or overruled her right to sexual fulfillment” (31). And, unlike, Christian rules regarding intercourse, legitimate sex within marriage “was not bound by procreative purpose” (33), and even masturbation was permitted (to avoid illegitimate intercourse) (33). There are other examples of a woman’s right to pleasure found in Prophetic Medicine (hadith, or the sayings of the Prophet specifically related to the care of the body and medicinal remedies), medical and magical texts, etiquette manuals and “art of love” treatises, and, of course, literary texts.

       Abu Hamid al-Ghazali, a twelfth-century jurist, writes in his “Book of Marriage” (from the Revival of the Religious Sciences) when and how a man and woman should have intercourse, and comments upon the importance of female pleasure: “Once the husband has attained his fulfillment, let him tarry until his wife also attains hers. Her orgasm (inzal) may be delayed, thus exciting her desire; to withdraw quickly is harmful to the woman…Congruence in attaining a climax is more gratifying to her because the man is not preoccupied with his own pleasure, but rather hers…” (as quoted in Roded, 162).

       There is also evidence of views on a woman’s right pleasure in a body of works known as the the Medicine of the Prophet, also known as Prophetic Medicine, which in some ways can be seen as a hinge between Muslim practices and medical philosophy and practice. Prophetic Medicine is a collection of hadith, or sayings attributed to the Prophet Mohammed to address sickness and hygienic practices. There are approximately 25 books in this genre, dating mostly from the 10^th-18^th centuries, the earliest known is from the 9^th century. Prophetic Medicine aimed to collect and explicate Muslim traditions of medicine and medical topics, but were not collected by physicians, so they differ from Islamic Medicine in many respects. That said, these texts were produced in the context of Greek and Arabic medical philosophy and practice, and were meant as an alternative to “Greco-Arabic art of healing for which Muslim religious scholars had certain reservation…” (Bummel 332-333).  One could argue that these texts combined the medical philosophy of the time with the religious, modifying it to be in concert with Islam. 

       Penelope Johnston writes in her translation to al-Jawziyya Medicine of the Prophet that “it is a compilation and systemization of an aspect of the Prophet in the domain of diet, health and illness complementing the legal, intellectual and spiritual dimensions of the legacy he left to he Islamic community through his sunna or wonts and traditions” (xvii) (al-Jawziyya himself was a practicing physician as well as a theologian). In his text, al-Jawziyya addresses all manner of health and healing, treatments and preventatives, philosophy and practical applications of herbs (Part I addresses Medicine, Part II, Simple Drugs and Foods). In Chapter 36 he offers “The Prophet’s guidance on sexual intercourse (jima).” In the course of this guidance we learn a bit about the purpose of sexual intercourse (jima) and marriage (bah), “through which health is preserved, pleasure and the soul’s gladness are complete, and the aims, for which it was instituted are attained” (181). Of the three matters for which sexual intercourse was originally created, he notes that the first is the preservation of progeny, the second is the “expulsion of fluid (ma) which if restricted would harm the entire body,” and the third is “fulfillment of desire, attainment of pleasure and the enjoyment of God’s bounty” (181). Sexual pleasure is intimately (so to speak) linked with the “soul’s gladness.” In fact, of the three, only pleasure “is the benefit which will remain in Paradise; for there is no procreation there, nor any bodily retention to be evacuate by the descent of fluid” (181); this is one other way in which the purpose of sexual intercourse (pleasure!) is separate from procreative necessity. Further, B.F. Musallam, in discussing Islam’s “sexual morality,” notes that among other things “Maritial intercourse needed no justification by procreative purpose, and was also based on the right to sexual fulfilment” (11)—both men’s and women’s. And, as we’ve seen in al-Ghazali’s writing, certain attention was paid to guaranteeing that fulfillment. 

The Pleasure of Her Sex: Part 2

Part 2

Religious Discourse

What does the Qur’an have to say about a woman’s Right to Pleasure (2.187; 2.223)? 

Yasmin Amin in The Oxford Encyclopedia of Philosophy, Science, and Technology in Islam writes under the the heading “Sexuality” that, 

                      The Qurʾān allows sexual pleasure and does not simply view sex as a means for                                    procreation, but rather as a natural urge and a comfort for both partners (Qurʾān 2:187)                        …Foreplay is highly recommended, as is mutual satisfaction and not rushing the act. A                        wife who discards shyness when with her husband but returns to it after intercourse is                          highly praised, as there is nothing wrong with a woman being active and responsive                              during licit sex.

Rafath or ghunj (excited sexual noises) as well as sexually explicit talk is not just allowed but recommended (Qurʾān 2:187). There is no restriction on sexual positions (Qurʾān 2:233), and men are supposed to ascertain that their partner is satisfied. (Tijānī, 1992, pp. 113–114)

            This sense that sexual satisfaction is as important for women as it is for men is articulated (somewhat obscurely it seems to me) not just in the Qur’an, but also in the hadith and the various writings of the jurists. And, while the act of coitus brings about a state of impurity (which must lead to cleansing), many texts, the Qur’an, the hadith, and numerous jurists’ writings, speak to the importance of a woman’s right to pleasure.  

           This apparent equal right to pleasure for women is also reflected in the creation story of man and woman in the Qur’an. In their entry on “Women and Islam” in The Oxford Encyclopedia of the Islamic World, Soraya Altorki, Zayn Kassam, Valerie J. Hoffman, and Valentine M. Moghadam remark on this “equality” in the creation of Adam and Eve: "The creation of the female is attributed, along with that of the male, to a single soul (4:1) from which the other is created as its mate" (4:1). Another verse declares: “Allah created you from dust, then from a little fluid, then He made you pairs” (35: 11). Thus, the Qur’an grants both sexes equality from the perspective of origin and spiritual status.

        This is further evident in the Qur’an in “The Cow” (2.222-224), when the subject of sexual positions is addressed:

                     When they have cleansed themselves, then come unto them as God has commanded                            you.’ Truly, God loves those who repent, and He loves those who cleanse themselves.                          Your women are a tillage for you; so come unto your tillage as you wish, and forward                          for your souls; and fear God, and know that you shall meet Him. Give thou good tidings                      to the believers.

While men are clearly the governing or acting body, and women the more passive ground to be “tilled,” it is clear that both souls are “forwarded” in this encounter. Thus, the spiritual and sexual status are inextricably linked. In this sense, as scholars note, Islam “regards sexuality as a natural part of human relations which must be regulated within the spiritual, ethical and social framework of the religion” (Ruth Roded, “Islamic Views on Sexuality” 159). 

The Pleasure of Her Sex: Medieval Women’s Right to Pleasure, Part 1

The Pleasure of Her Sex: Medieval Women’s Right to Pleasure

One need only to open the New York Times and see the current debate about Flibanserin, the (one) drug designed to address female sexual “dysfunction,” or Hypoactive Sexual Desire Disorder, to get a small taste of the minefield that is part of the debate over women’s sexual pleasure and reproductive rights (by the way there are over thirty drugs for male sexual dysfunction). From “Insurance Won’t Pay for Women to Have Pleasurable Sex” (one CNN headline reads, June 29, 2016) it’s a short search to the multitude of other conversations about women’s sexuality, popular and scientific: are women’s orgasms better than men’s? Is female orgasm necessary?, to name just a few related to sexual pleasure. 

In addition, it’s not surprising that women’s sexual and reproductive rights are a global issue, negotiated in political, economic, social, and religious terrains.  To wit, the 1995 United Nations Fourth World Conference on Women and Girls Platform for Action in Beijing articulated the right of women to have “safe and satisfying” sex lives. The 2014 International Conference on Population and Development, which purports (going back to the first meeting in Cairo in 1994) that “fulfilling the rights of women and girls is central to development,” and argues for “prioritizing the rights of young people -- in terms of education, sexual and reproductive health” (http://www.unfpa.org/icpd#sthash.GRPRen0D.dpuf). That’s all well and good in principle. But when the rubber hits the road in terms of practice, it seems that’s another story. Take the practice of Female Genital Mutilation. According to the United Nations Population Fund (United Nations Fund for Population Activities), over 200 million girls and women have been subjected to FGM. The majority of these women live in Sub-Saharan Africa, but this practice occurs in “Asia and Latin America and amongst migrant populations in Europe, North America, Australia and New Zealand” (http://www.unfpa.org/resources/female-genital-mutilation-fgm-frequently-asked-questions#sthash.IHWaPxrR.dpuf). According to “Equality Now,” more the 513,000 women in the US have had, or at risk for, FGM (http://www.equalitynow.org/sites/default/files/EN_FAQ_FGM_in_US.pdf). This is not a path to “safe and satisfying sex.” And this doesn’t include the number of sex re-assignment surgeries that lead to loss of genital sensation. Clearly, some women don’t have the same right to pleasure as others.

And if we look at the number of women who suffer from Post Coital Dysphoria, we see that, even when women seem to have a right to pleasure, they don’t feel we deserve it somehow. In one study, 49 percent of female university students experience PCD. A 2011 study in the International Journal of Sexual Health reported that “a third of women said they felt depressed even after satisfactory sex” (The Independent, Tuesday, 6 October 2015). While FGM and PCD don’t particularly compare in terms of relative pain and suffering, we can see cultures worldwide are a long way from providing education and a culture that promotes women (and men) embracing their own right to pleasure.

The topic of women’s right to pleasure was at least as vexed (and varied) in the Middle Ages, and no less global.  In this inquiry, I look briefly at different, but interacting, perspectives: Christian, Jewish, Muslim, and Indian. A comparative inquiry of this type has (at least) two stories. One tells of a complicated past that might belie our modern day imagination about how female sexual desire was constructed, controlled, and represented. The other draws us to our present day narratives about female sexual desire. Such a narrative might help us to peel back our own various notions about female sexual desire, and what is behind the various ways we attempt to manage, liberate, and adjudicate it, locally and globally. Cross-cultural inquiry, as Sahar Amer notes, “reveals the historical and ideological power structures that construct discursive representations of sexualities” (“Cross-Dressing and Female Same-Sex Marriage in Medieval French and Arabic Literatures” 81). While Amer focuses on the relationship between medieval Islamicate and French representations of female same-sex marriage, the general principle applies to the relationship between the medieval Muslim, Christian, Jewish, and Hindu women’s right to pleasure—that in exploring the multiple ways in which a women’s right to pleasure is defined, managed, represented, and prescribed, we gain a deeper understanding of the power structures at play, as well as modes of resistance to those ideologies.

“Sex Bomb”: Our Distant Past, Our Modern Day

The healing arts, religion, and magic have long been intertwined. We can see the legacy of herbal or “folk” medicine and the fascination that accompanies it in the media (not to mention in our email inboxes) and in the plethora of popular homeopathic remedies, herbals, and dietary supplements.  Further, different cultural contexts reveal a dynamic dialogue between the ideologies behind “traditional” uses of herbs and regulated, FDA-approved drugs—a discourse which has long occupied the annals of medicine (and religion!) in one form or another. This is particularly true when the remedies at hand involve managing the sexual body.  These negotiations of the sexual body extend into social, national, and international interests in addition to playing out in public policy and practices—and these present day negotiations can help shed a light on medieval negotiations of the sexual body; likewise, the medieval might also help us to reexamine our present day assumptions about our relationship to that body.

I provide two modern examples here that I hope will help be a touchstone to a deeper conversation about our anxieties around the sexual body—in particular to bodies that are “Other”; I also hope to show ongoing connections between our Western notions, practices, and anxieties, around the sexual body to those in the East--and our relationship to those notions. Though quite dated in the age of the Internet, the two examples I offer (and there are more where these came from—see a 2009 piece in “The Telegraph” on the alleged dropping of aphrodisiac gum on Gaza by Israel) are nonetheless useful when linking medieval and modern negotiations (and discourse) of the sexual body and its management through medicinal (and magical) remedies.

To wit, in the March 2005 Harvard Women’s Health Watch, one reader asks if natural herbal preparations in fact enlarge breasts, as advertised. The response from the editors to the question, not surprisingly, reminds readers that “natural” (non-prescription) breast enhancement products are not FDA approved. They describe the types of ingredients usually found in these products, including “phytoestrogens (plant-derived chemicals such as soy, flaxseed, red clover, alfalfa, and fennel), alleged aphrodisiacs (such as damiana or oat straw), and herbs traditionally used for women’s menstrual and reproductive complaints (including blessed thistle, motherwort, black cohosh, chaste-tree berry, and saw palmetto).”  The bottom line for the Harvard Women’s Health Watch doctor is that if they work at all, they don’t work safely, and that “we’ll probably never know the truth” because of lack of “rigorous evaluation” (March 2005).  We see yet another example of this dialogue—on the military level— in New Scientist, which reported that newly declassified documents originating from the US Air Force Wright Laboratory in Dayton, Ohio, suggested developing “non-lethal chemical weapons that would disrupt discipline and morale among enemy troops.” Specifically, the proposal suggested the development of an aphrodisiac chemical weapon which “would make enemy soldiers sexually irresistible to each other…and would cause ‘distasteful but completely non-lethal’ blow to morale” (2005).  (This latter piece of news made its way into an episode of “30 Rock.”)

What these examples demonstrate is a web of power negotiations in which multiple cultural factions are at play. The Harvard Women’s Health Watch newsletter puts in high relief regulations and medicinal formation in negotiation—and often at odds—with unregulated practitioners and unregulated substances (not to mention a discourse around female breasts, sexuality, and the male gaze that falls outside the purview of this post). The example of the “non-lethal” chemical weapons designed to manage an enemy’s sexual desires, which speaks interestingly to our own culture’s homophobia, suggests ways in which certain institutions such as the government seek to disrupt its enemies through manipulating sexual desire and exploiting the social codes around that desire.  I recount these articles not because I believe them inherently “medieval” (though you can read it how you wish). Rather, I want to illustrate both the cultural flexibility of medicinal and “magical” remedies and their ongoing significance as artifacts that reflect elements of a cultural practice and negotiation of religious ideology, national and individual identity, and social economy.

Defining Pneuma

History of Medicine and Sexuality: Sources and Transmission

This following is an excerpt from my essay on “Medieval Conceptions of Pneuma and its Relationship to Sexuality and Sex Difference: From Arabic to European Philosophy and Practice,” in Lebenskraft and Radical Reality 1700-1900: The Soul-Body-Mind Question in German Thought and Literature. John A. McCarthy, Heather Sullivan, Stephanie Hilger, and Nicholas Saul, eds. Amsterdam & New York: Rodopi Publishers, forthcoming.

Defining Pneuma

The idea and definition of pneuma, most often translated into English as “vital heat” or “life-bearing spirit,” or even “vital power,” was described by Aristotle in a number of his works.[1] In De generatione animalium, Aristotle explains the central role of innate pneuma to the “perception, mental activity, and physiological vigour” of all living creatures.[2] The text also connects pneuma to conception as well as how the “faculties of the soul are transmitted to offspring.”[3] The notion of innate pneuma is embedded in a system that connects the non-human, the “astral” (or aether) element of the stars, with the human, as it is drawn into the body through respiration and is the source of vital heat. According to Aristotle, “pneuma is already present in semen and is an analogue of the astral element, which is responsible for the fertility and life-generating power of semen.”[4] Aristotle thus draws a close connection between these two elements, the role respiration plays in feeding the “internal fire” of living creatures, and the special role that sperma plays as a unique foam-like substance which provides the “form” in the act of conception.[5]

The role and purpose of pneuma reflects as well the humoral principles established by Hippocrates, Aristotle, and later in greater detail by Galen. Humoral theory informed the explanatory principles for medical practice for the Greeks and Romans, and then later the Muslims, and then Christian Europeans through at least the sixteenth century and in a more limited way into the nineteenth century. Humoral theory is a worldview based on the relationship between the macrocosm and the microcosm and the interaction between the four primary principles in the body. In brief, the theory held that the body contained four basic substances –humors—which, when in balance, made for a healthy individual. These bodily humors are black bile, yellow bile, phlegm, and blood, and they were thought to be directly related to the four earthly elements, earth, fire, water, and air (respectively). Each individual had his or her own temperament (Melancholic, Choleric, Phlegmatic, or Sanguine) depending on his or her basic humoral makeup; this temperament might shift as the balance of one’s humors shifted, but essentially one was thought to be fundamentally one kind of temperament or another.

Just as the humors dictated a person’s temperament, all ailments and diseases were believed to be caused by an imbalance of humors in the body. These imbalances would be addressed through diet, exercise, and medicinal remedies designed to bring the body’s humors into balance. This might include purging (blood, excrement, phlegm, etc.), fumigation, applying heat or cold, and the use of herbs and other substances thought to be associated with counteracting or restoring the deficit humor. Treatments would also be determined based on macrocosmic elements that were associated with the humors and the elements, including seasons and astronomical and astrological influence.[6]

Each humor is also associated with a particular organ and, in a tripartite pneumatic frame, certain organs were paired with one of the three pneumas. The theory held that food is digested and transmitted (from the stomach) to the liver, where it is transformed into blood with the natural pneuma (spiritus naturalis, natural spirit). It is then imbued with the vital pneuma (pneuma zotikon, vital spirit) as it passes to heart; the vital spirit is imbued with the air from the lungs, drawn in through the air inhaled from breathing (also known as aether or astral air as described above). The psychic pneuma (pneuma psychikon, animal spirit) is formed as the vital pneuma moves to the base of the brain, and then the arterial blood moves through the brain’s vessels in a kind of distillation process. The pneuma then moves outward in arteries and veins to all the organs.[7] In this schema, the natural pneuma is associated with yellow bile, fire, and the liver (or sometimes the gallbladder); the vital pneuma is associated with blood, air, and the heart; the psychic pneuma is associated with phlegm, water, and the brain. Further, pneuma has associated with it rational, spirited, and appetitive “principles in the brain, the heart, and the liver respectively” as the function of pneuma changes and is elaborated depending on where it is located in the body.[8] It should be noted, however, that there is some variation amongst theorists in these associations and pairings, as the different organs are sometimes connected with different humoral qualities—and note, too, that the humor associated with black bile has no specific (tripartite) pneuma associated with it.

Not surprisingly, the theory of humors was central to medieval medical practices and understandings of sex differentiation, conception, and sexual desire, and the theory supported each culture’s view of women as the inferior sex by ascribing to the female (or feminine) the weaker or inferior temperaments. The physiology of the body was thought to consist of a combination of hot, cold, dry, and wet, and these elements were in turn associated with male or female characteristics. It was hypothesized that humans, as well as animals, consisted of the elements of fire and water (fire, hot and dry, and water, cold and wet). Males were considered hotter and more perfect. Women were considered to be essentially colder than men, and those temperaments that were associated with colder elements were considered more feminine in nature. Likewise, the theory of conception generally, and the relationship of pneuma to humoral theory more specifically, hierarchized the role of the male both socially, in terms of gender roles, and biologically, in terms of their role in conception, particularly in the formation of sperm. The association of some elements with more masculine or hierarchized characteristics naturally extended to the nonhuman macrocosmic elements of earth, water, air, and fire, as well as the celestial bodies and seasons.

The relationship between pneuma—in the broadest sense of the term—and air in the functioning of the body, the relationship between pneuma and the soul, and the relationship between pneuma and conception are examples of ways in which the philosophical, physiological, medical, and even spiritual systems were shaped by a male discourse that viewed women and feminine characteristics as weak, imperfect, irrational, passive, inferior, etc. As seen above, the air (or aether, the cosmos) sets in motion pneuma throughout the body (along with digestion). Air, variously described as aer, aither, pneuma, phusa, and anemos, brings with it a gendered quality, and one that emerges in the role of pneuma in sexual desire, sex differentiation, conception, as well as in relation to the soul.[9] Most clearly this gendered connection can be seen through a binary system famously attributed to Aristotle, that delineates (among other binaries) the two fundamental principles of active and passive; these principles apply to pneuma and its relationship to the soul and bodily function.[10]

In this schema, the passive is a “quality-less substance or matter”, and the active is identified as “the cause, god, reason, fate, soul, or pneuma”, where pneuma is the “active principle” that “pervades everything” and holds everything together.[11] Pneuma was also considered to be connected to the macrocosmic: “just as our soul, being air (aer), holds us together, so does pneuma or air (aer) enclose the whole world.”[12] For example, the (clearly masculine) power of the wind, or air is, as Geoffrey Lloyd points out, “worked out especially in connection with sex […] the winds were reputed to be able to impregnate mares.”[13] This (metaphorical) image that connects the power of air/wind with conception is found in texts from Plato, Homer, and then later Aristotle, and Galen. The various meanings of pneuma also include “breeze and breath/respiration but stretch to spirit, inspiration, and eventually to […] Holy Spirit” all of which are associated with masculine characteristics.[14] The ancient writers such as Hippocrates, Aristotle, and later theorists, saw these elements both in terms of sex differentiation as well as in relation to the soul. This combination of elements also accounted for the composition of the soul: “Soul, psuche […] is a blend of fire and water,” though the blending is different in the case of males and females.[15] Further, Aristotle viewed the soul and the body as interconnected, where the soul is the activity of the body.[16] Numerous philosophers would find divine presence in pneuma, which they saw as sharing both the cosmic, divine, and psychic principles.[17] Thus the role of pneuma in bodily function, reproduction, and the soul was intimately tied to concepts of active and passive, form and matter, male and female.

Similarly, the process of distillation noted above in relation to pneuma in the body had an analogy in the production of sperma; this theory privileged the role of male sperm.[18] There were, of course, debates over the centuries, first amongst Greeks and Romans, then later in the Muslim, Jewish, and Christian worlds, about the nature of sperm and the role of female versus male seed in conception. But the general consensus saw sperm as “man’s purest blood” and the “residue of the last coction” which, as it makes its way from the brain towards the sexual organs through veins and arteries, finally “undergoes one final metamorphosis” in which the purified “moist sperm accompanied by pneuma is ejaculated.”[19] This view connected with later discussions in the Middle Ages, first by Arabic, Jewish, early Christian, and then later Christian European thinkers, philosophers, and scholars.


[1] Bos and Ferwerda, p.2. note 4;  Friedrich Solmsen, “The Vital Heat: The Inborn Pneuma and the Aether,” The Journal of Hellenic Studies, 77. 1 (1957), 119-123 (p.119).
[2] Bos and Ferwerda, p.2.
[3] Solmsen, p.119.
[4] Bos and Ferwerda, p.1.
[5] Bos and Ferweda p.9-10. This theory of sperm was established in earlier works by Plato Diogenes, and Empedocles (Slomsen, pp.119-120).
[6] Jacquart & Thomasset, pp.48-86. See also Peter E. Pormann and Emilie Savage-Smith, Medieval Islamic Medicine (Edinburgh: Edinburgh University Press, 2007), pp.41-79.
[7] Jacquart & Thomasset, pp.48-49; Jacalyn Duffin, History of Medicine: A Scandalously Short Introduction (Toronto: University of Toronto Press, 2000), pp.43-45; Geoffrey Lloyd, “Pneuma Between Body and Soul,” Journal of the Royal Anthropological Institute, 13.1 (2007), 135-146 (p.143); C. E. Quin, “The Soul and the Pneuma in the Function of the Nervous System after Galen,” Journal of the Royal Society of Medicine, 87 (July 1984), 393-395 (p.393).
[8] Lloyd, pp.142-143.
[9] Lloyd, p.136; Lloyd does an excellent job articulating the history, subtle variations, and uses of this term as well as the other, related, terms referred to in this paper: aer, aither, pneuma, phusa, and anemos.
[10] Lloyd also includes a discussion of the Stoics and pneuma, and how those theories connect to later Galenic and the Arabic texts (p.142).
[11] Lloyd p.142.
[12] As quoted in Lloyd, p.145, n. 9
[13] Llyod, p.136.
[14] Lloyd, p.137.
[15] Lloyd, p.140.
[16] Lloyd, pp.140-141.
[17] Solmsen, p.122; the Stoics, Aristotle, Diocles, etc. shared this notion. In addition, we see this connection in Virgil’s Aeneid VI, where Virgil connects aether, or pneuma as “the home or essence of the soul” and “employs freely one or the other of our concepts as a symbol of man’s divine origin” (Solmsen, p.123).
[18] Jacquart and Thomasset, p.49.
[19] As quoted in Jacquart and Thomasset, p.60. This quotation is a translation of a late fourth century Christian philosopher and Galenist, Nemesius, bishop of Emesa, from (what is now) Syria. Interestingly, Nemesius is noted by Philip van der Eijk as an early practitioner and theorist of addressing the problem of the relationship between mind and body through associating different parts of the brain with different functions, and by exploring “the structure of the human body, the position and function of its constituent parts, and the relation between the body and the soul (or the mind) in complex activities such as sense perception, voluntary movement, imagination, memory, thought, desire, and the emotions. The presupposition of the work is that the human soul-body composite is as good as it possibly can be: the body and its parts serve as an ‘instrument’ (the Greek word is organon) for the mind and its functions.” Philip van der Eijk, “Nemesius of Emsea and Brain Mapping,” The Lancet, 372.9637 (9 August 2008), pp.440–441 (p.440).