FRANZ ROSENTHAL
The catalogue of
Arabic manuscripts in the General Library in 
fourth a
quotation from it from Ibn al-Matran's
Bustan al-atibba' with Ibn al-Matran's comments (see
below, n. 20).[4]
As it turned out,
the Teheran manuscripts (T) contain only the first half of the work. All
three of them do not have the section concerned with the treatment of the
disease which, as indicated by the transmitted titles (above, n. 2), was an
integral part of it. That section can, therefore, not be a secondary addition in the
If
the text available to us at this time is an excerpt, it might very well be a representative
one that omits nothing essential. The authorship of ar-Razi,
about
which I originally expressed doubts,[6] seems beyond
dispute. Lingering suspicions can all satisfactorily be disposed of. The
quotation in Ibn al-Matran provides strong
supporting evidence, even if by itself it proves no more than that the text, in
some undetermined form, was believed in the twelfth century to be a work by ar-Razi, and already al-Biruni
knew of works of doubtful attribution.[7]
While ar-Razi likes to refer the reader to other
works of his, as a careful scholar he is usually specific in his references and
indicates the exact titles.[8]
In the treatise on ubnah, his references are vague,[9] but
this may be because he did. not feel
it would be necessary for the reader to have recourse to other specific works as they did not contribute
much to the debate. The introductory statement on motivation and quality has
its analogues in other works of ar-Razi.[10] Quoting cases from his own practice (even
if it is only one as in the present work)
was ar-Razi's customary procedure. Forgers could have successfully reproduced these devices, to be
sure, but that is unlikely. A rather
uncommon scientific spirit, such as that of ar-Razi,
is unmistakably at work throughout; if the author appears to be brief
and a bit jumpy in his presentation, this
may be due to his uncertainty and hesitation as to what to say about the
puzzling subject. In sum, there is no decisive evidence to cast suspicion on ar-Razi's
authorship, but everything tends to confirm it. However, we must repeat
that the original work may have been fuller than the text preserved in R and T.
The title found in R,
speaking of a "hidden illness," goes back to ar-Razi's
own reference to a work so-titled by
an unnamed predecessor. "Hidden" is meant to imply that it is an illness which the afflicted person keeps
secret because he is ashamed of it. Love is sometimes called a hidden disease
which one tries to conceal.[11]
The "hidden illness" allegedly caused by hashish may refer to ubnah,[12] which in another passage is stated expressly to be
one of the evil consequences of
hashish consumption.[13]
Elsewhere, ubnah is referred to as the
"incurable ('udal) illness."[14] The scribe of R, or an earlier copyist, may' have
picked the title in order to avoid the straightforward but crude word. This
would be in line with the note of prudery struck at the end of the treatise
where ar-Razi apologizes for having discussed such an
unpleasant subject. Coming from a
physician, it may seem a somewhat unexpected statement, and those who know the ribaldry and coarseness of the
innumerable jokes and anecdotes in
Arabic belles lettres that have the ma'bun as
their object may be surprised by it.
However, they need not be. The attitude expressed by ar-Razi
reflects Muslim middle class
sentiment much more accurately than the entertaining literature, and while ar-Razi's
statement is particularly to the point, it is not unique.[15]
Ar-Razi's claim that his is
the first detailed work to deal with the subject is hard to refute. No earlier
medical monographs, and none from later medieval times, are known at present. In
fact, we find little serious discussion either before or after him.[16] The ninth-century
'Isa b. Massah invokes the
authority of Aristotle and devotes the thirty-first of his own Problems to a paraphrase of Physical Problems, IV, 26, ascribed to the
Greek philosopher.[17]
Ar-Razi's illustrious, much older Christian
contemporary, Qusta b. Luqa,
did not evade the subject in his remarkable "Book on the reasons why
people differ in their character traits, their ways of life, their desires, and
their preferences."[18] Qusta admits to having knowledge of only
two brief passages from the works of the
Ancients dealing with it, one from the sixth book of Aristotle's Physical Problems, and the other from his work on Physiognomy.[19] The
contention that passive intercourse serves for some individuals as a stimulus
for active intercourse goes back to
the Physical Problems, but Qusta also reports that the great Hunayn b. Ishaq
called his attention to it. He himself hesitantly proffers the
suggestion that the cause may be sought in the smallness and dysfunction of the
penis as stimulating itching and motion.
All this is indeed less, and less
scientific, than what ar-Razi had to say. As in all his medical
monographs, he structured his discussion to deal in strict sequence with
cause and symptoms and the recommendable treatments and medicaments. He
considers the illness to be basically a genetic one. This would imply that
it cannot be "cured." However, ar-Razi uses
the unambiguous
root for "healing" (b-r-’) twice, and apparently refuses to give up hope
for a complete cure under favorable circumstances; mostly he speaks of 'ilaj which vacillates in meaning between treatment and
the cure effected by it. A certain amount of physical treatment at an early
stage promises some relief, as do
certain drugs and the observance of certain dietary rules. He considers the psychological aspect of the disease and
recommends avoidance of any sort of self-indulgence. In particular, he warns
against the kind of entertainment,
common at the time both in public places and at private parties, which would arouse sexual emotions. A
most potent palliative he finds (true to his intellectual outlook) in the
occupation with science and metaphysics.
In his commentary on the passage
referring to the bearded Kurdish lady,[20] Ibn al-Matran largely agrees with ar-Razi on the genetic origin of the disease. He is slightly
more detailed with respect to the physical characteristics of masculinity and
femininity. However, he feels compelled to account for the existence of various
degrees in the loss of sexual identity. He suggests as a likely cause the
different amount of hotness in the temperament of the afflicted
individual. In both males and females, the symptoms he mentions include
disinterest in intercourse with the other sex. His starting point leads him to paying
slightly greater attention to female masculinity, which, he says, may even go
so far that masculine women "kill with their own hands." It may be due to his
interest in the factor of hotness that he concludes that race (fins) and geographical location (lnaknn) play a
significant role. "If a Slavic woman (saqlabiyah) were affected similarly as the Kurdish
woman mentioned by ar-Razi, she would under
no circumstances have grown a beard."
A predominantly genetic cause of ubnah is strongly denied by Ibn Sina, whose brief discussion of the subject is patently
dependent on the Physical Problems, with, however, considerable distortion and
change.[21] He believes that it is the
result of habituation in an individual possessing weak sexual potency to begin
with and a strong desire created by the imagination (shahwah wahmiyah). He rejects as
absurd a physiological explanation proposed by an unnamed scholar concerning
an abnormality of the sensing nerve leading into the penis. The persons
affected by ubnah may be physically better endowed than ordinary males. They
are people of a vile psychological (suqut an-nafs) and bad physical
disposition who have accustomed themselves to non-virtuous ways (rada'at al-`adah) and feminine behavior. "Any other theory is wrong. He who wishes to
treat them is the most stupid of men. Their
disease is one of the imagination, not a physical one. Things that break the desire, such as worries, hunger, vigils,
detention, and beatings, constitute
useful treatment." Ibn Sina
does not mention ar-Razi's treatise. It would be surprising if he had not known it. Could
it be that he meant ar-Razi by his vigorous
denunciation of those foolish physicians who think that there might be a cure?[22]
The omission of the second half of ar-Razi's treatise concerned with the treatment of ubnah in T might possibly be due to the influence of Ibn Sina and his school. The
compiler of T might have considered this part as superfluous and outdated, and
therefore omitted it. We have no way of knowing whether this was so. If
this was his motivation, he did not serve scholarship well. It was unavoidable
for ar-Razi to come up with highly speculative, not
to say fanciful or even silly, ideas. As a whole, however, his monograph on a
problem or set of problems long debated and as yet unsolved would seem to be
quit remarkable for its time as a work of serious scholarship groping in the
dark.
TRANSLATION
Muhammad b. Zakariya' ar-Razi says:[23]
As we have stated in the beginning of
more than one of our books, (scholars) later in time must investigate what early
(scholars) have neglected and[24], postponed[25]
or scattered[26] (in different
places) or expressed obscurely. The will thus mention what they had
neglected, bring together what they had kept separate, comment upon what they
had expressed summarily, and explain what they had kept obscure.
Something
the early (scholars)[27] have neglected is
the discussion of ubnah, and its cause and treatment. Till now, I have not found
this discussed exhaustively
by anyone. Indeed, I have not found it mentioned by nearly anyone of them except for one man who wrote a
book on this subject which he entitled
"The Hidden Illness," but he indicated in it[28]
neither specific[29] cause or satisfactory reason nor medication[30]
or useful[31]
treatment.
Now, I am going to speak about it succinctly and
to the extent I consider sufficient, if God wills. Thus, we say: We must seize and
exploit here a premise that has been previously established in another book
(of ours). [32] That is, femininity or masculinity occurs only
in accordance with the prevalence of one of the two sperms over the other in
quantity and[33] quality, until one of them becomes the one that transforms (muhil) and
the other the one that is transformed (mustahil).
I say: [34]The
obvious proof for that is the fact that the female mule is better than the male
mule, because the horseness is prevalent, and the assness inferior, in it. This is the case when the ass is the
male. Conversely, if the horse is the male, as they do in some places (where they mate
stallions with she-asses in order to produce hinnies), the male mule is
better than the female mule.
He says in another treatise:[35] If the question is asked why mules are sterile, the
answer should not be: because "male mules do not reproduce on account of
the scarcity, thinness, and coldness of the sperm, and the females since their
uteri are not open"; or because, "as Empedocles has stated, this
results from the smallness, low location, narrowness, and crookedness of their
uteri and because they are placed opposite to the position of the stomach and
the sperm cannot get to them directly and reach the place where it is
needed," and he assumed that "he had seen during the dissection of
mules uteri of such a shape, and it may be that the sterility of women results from a similar cause.”[36] For we say that, if these are indeed the reasons for
the sterility of mules, he has not provided the basic reason. That is, one must
know why the sperm of mule: becomes colder and thinner, and why their uteri are
placed in such a position. It should rather be said that the most likely and
convincing (explanation) concerning this subject is that the sperm of this
animal has undergone a transformation (istahala) and has greatly deviated from
the nature of reproductive sperm because it is generated from two sperms
different in species that have mixed although they are very different. This has
the effect that it is outside the accidental temper ('
Now, I say: This proof does not at all achieve
the objective sought, because the fact that what is generated is unlike both
does not require it to be non-reproductive; it rather requires it to be able to
reproduce another species. If it is correct, as stated (by some), that the
sperm of the sim‘ (Lycaon pictus), which is a cross between wolf and hyena, is able
to reproduce, then the proof is entirely invalid. If it is not correct-and it
is obvious that this is the truth-, the proof needs completion, because the
statement mentioned leaves it incomplete. The most likely assumption is that,
if sperms of two species combine in
the uterus, the formative power of the sperm of the male finds it hard to act
upon the sperm of the female because it can indeed influence it, or be
influenced by it, only with difficulty. The same applies to the
formative sperm of the female. Thus, both powers are weakened or
ineffective in the male and female of the species that originates from the two
species, because they find it difficult and troublesome to act and be acted
upon. Similarly, if the stomach of a person is able to digest only soft foods,
and he then combines soft and coarse food, the digestive power of his stomach
is weakened, because it suffers on account of having to digest that coarse
food. If the power of formation in the sperm of the female mule is weakened
or ineffective, no animal can be generated from it.
If[37] the
sperm of the man is the one that transforms, the newborn child will be male, and if the sperm of the woman is the one
that is prevalent, the newborn child
will be female. We have explained the correctness of this proposition in
another book (of ours).[38]
The Ancients have also much discussed it.[39] If the
matter is as we have described it, it may happen [40] in some cases that the sperm of the man is very forceful and strong in transforming the
sperm of the female. Accordingly, it
is necessary that the child born from such a sperm will be very strongly masculine-I mean, the properties
of masculinity in him will be strongly and obviously masculine, such as limbs
hard, dry, and large, much hair, a strong pulse and breath, prominent (zuhur) joints,
thick bones and similar properties
peculiar to persons of a hot and dry temper, such as courage, quickness of speech and anger, and the
like.[41] If it happens in some cases also that it is the sperm of the female that
possesses very great force and prevalence,
then the newborn child will have the properties that are peculiar to females, which are the extreme opposites of what
we have mentioned. Mostly it happens that one of the two sperms undergoes
transformations between these
(extremes). Then, the newborn child, whether male or female, is not masculine
in the extreme and not feminine in the extreme.
If the matter with regard to this subject
as is we have described it,[42] it is possible that in some cases it
happens that a male child's masculinity or a female child's femininity is
extremely weak. We therefore find masculine women, as we find feminine men. Among masculine women, it may
go[43] so far that they have little menses or none at all,[44] and
occasionally, they will grow beards. I
have seen beards and[45]
faint moustaches[46] on
certain females.[47] Once I
saw a Kurdish woman with a luxurious beard who had been brought to al-Mu'tadid as a
curiosity.[48] This is
not the only thing that may occur. Rather, when
the two sperms are equivalent and the one has little superiority over the other, hermaphrodites (khinath) will occur', and a child may even be born with both penis and vulva. We have learned[49]
stories in this connection containing
things that are marvelous,[50]
hideous, and noteworthy'[51] in connection with this chapter. We have omitted to mention them because we consider them absurd.[52] For
instance, a certain surgeon is reported to have found a uterus in some male animals, and many[53] people
tell of a woman who gave birth to children
and then afterwards, a male organ appeared on her (body).[54] This
story and others like it have come to us from many directions. For the
purpose we have before us, we do not need (to
ascertain) the correctness of this (particular)
story. Rather, we can be satisfied with what has been mentioned before,[55]
namely, that not every male is masculine in the extreme and not every
female is feminine in the extreme and that there exist masculine women and feminine men.
For, after the ideas which we have just mentioned have
been perceived, the cause
of ubnah
is easy to understand. That is, when
it happens by chance that the male newborn child
is feminine because of the weak degree of prevalence of the sperm of the male over the sperm of the female, even if it is
prevalent in general, the consequence
is that the male organ, the testicles, and the sperm ducts and vessels do not fully tend outward and do
not hang down low[56] and are not big
and strong, but the contrary is the case. I mean, they tend upward, are mostly
also small, withdraw inward into the cavity of the belly, and are drawn toward the hypogastric and[57] pubic regions
because of their weak masculinity, since the organs of reproduction in the
female are placed inside the belly and conditioned to tend in that direction, while in
males, they are outside the belly and are by
nature disposed to tend in that direction. Such disposition has the
effect that the tickling and the motion that results from the sperm
stirring it up by its quantity and quality are in the region of the rectum behind[58] and not in the direction of the hypogastric[59] and pubic regions, because the sperm vessels and testicles tend by
nature in that direction. Therefore, someone affected by ubnah
is rarely found to have large[60] testicles that hang down, but the contrary is
the case. Mostly he will have small and wrinkled testicles, drawn toward above
and entering the groin (urbiyatan). The hanging down of the testicles
and the thickness and width of the skin of the testicles are an unfailing[61]
indication of the absence of unbar. It is also[62]
mostly accompanied by bigness of the penis, as is ubnah by its
smallness.
If it happens by chance that the male newborn child is
feminine and those parts of the body are placed in that manner, he is affected[63]
by something like the motion of tickling in the region of the rectum when the
sperm is plentiful and sharp, just as masculine persons have that in the pubic
region when the sperm is plentiful and[64]
sharp. If someone whose natural disposition is such is aided by his passion
because of delicateness[65]
or some chance happenings that happen to him, so that something that[66]
touches and moves that place of his gets near it, he finds,[67]
on account of it, a pleasure similar to that found by someone who[68]
scratches his ear or nose by putting a finger into it and moving it around and
scratching it,[69]
because that removes the prickling humor (khilt) and scatters it and
also resolves these(?)[70]
which quiets[71]
the stirring and tickling. And if he aids the pleasure and is inclined to it,[72]
this sensation (‘arid) gains in strength, and the limit of it is
reached, corresponding to the strength of the tickling and stirring of the
sperm in that man and corresponding to his degree of effeminacy (khanath) and
his love of femininity and[73]
his inclination to pleasure. This is the active cause of this disease.[74]
We
have described this disease[75]
as briefly and succinctly as we are able to do.[76]
Now, we shall mention what we consider useful and satisfactory with respect to
its treatment. Thus, we say:
If
the ubnah is prolonged, the person affected by it cannot be cured, in particular, if he is obviously
feminine and effeminate (ta'nith-takhnith) loves very
much to be like a woman. If it is in its beginning stages and person
affected by it is not obviously effeminate and not strongly incline pleasure but rather ashamed (of it) and would like
to be free from it, possible for him
to be treated.
The best
treatment consists of frequently massaging penis and testicles drawing them
downward. Maids and slaves[77]
with nice faces and much practice
(mufritat) in
this matter should be put in charge of the patient, in order to rub and massage that place and apply themselves
to it and kiss it and fondle it. This should be done as much as possible. At other times, his treatment should consist of the application to the pubic
region, penis, and testicles of oil to
which borax, euphorbia, and musk are added. At times, some asafetida maybe added to the oil. The penis is massaged with
it, and drops of it are put into the urethra. When this treatment is
applied, he should sit in hot water, and the penis
and testicles are massaged while he is in the bath tub .[78]
Once each week, fluid pitch is employed. For it[79]
is the strongest treatment, which draws the blood and the hot vapor into this direction. If
erection approaches (?)[80]
while the testicles hang down, the penis extends and grows big, and de! increases, it is a sign of the effectiveness of the
treatment. He must apply entire treatment faithfully. Nothing whatever should
be omitted. When feels well (fi awqat al-ittisa'
lahu), the
patient must not give up any part of the first
being, as we have described, the maids, then the application various) oils, and then the fluid pitch. In
addition, we should undertake treatment
(tadbir) of the
lower back. For as there is need for the blood and the spirit to be drawn to this region (the genitals),
thus the region of lower spine and the rectum must be cooled. This is to
be done by his lying his back on the ground that is
sprinkled (with water) or by his placing on lower back rags likewise wetted with ice water. He should guard against lying down on the back upon something hot. He should
wear a wide belt along period.[81]
He should receive an enema of rose oil into which vinegar has been boiled
till the vinegar (with the rose oil) can be poured, and also with rose water with a little vinegar. In
general, if he is able to have his lower
back always cold and the pubic
and hypogastric regions always hot, he should do it, for it is the most appropriate thing
to do.
It is clear that
there is nothing more harmful for someone affected by this disease than
having passive intercourse, as there is nothing more useful for him than
practicing active intercourse or attempting to practice such intercourse as
much as possible.
This then is the
sum and substance of the treatment of ubnah according to the
straightforward norm and method.
I am going to
mention also (other) ways of treating it. One of them consists of giving the
patient many times an enema of strong intoxicating liquor (ash-sharab al-muskir). More than one person has been cured by
one or two enemas. Other things that lighten (?)[82]and weaken this
are lying on the back upon
the ground[83] and wearing as a belt a large sheet of
black lead,[84] also, receiving an enema of the boiled seed of the
chaste-tree[85]
and lying on the back upon its leaves.
This is advice (isharah) for someone who
confided his secret to me. I decided that he would benefit from it, and he did so
greatly. When that man ate and repaired to his bed, this disease bothered him. So one day I advised
him to cut off a piece of ice to serve as a
suppository and carry it (in his anus). He slept in this manner satisfied and was able to dispense with what he had
been forced to do most days. He was
almost close to being cured, and he would have been if he had exercised strong
control over himself.
The treatments mentioned by me are right
for young men and affluent people (mutraf). In connection with others, your aim in
treating them should be
to make them lose weight and diminish the blood. Thus they should be ordered to
fast, to give up drinking wine, to use vinegar for seasoning, to keep the lower back as cold as possible, and (to take)
drugs known as effective for diminishing the sperm, especially those
that are cold, such as the drug derived from
the roots of waterlilies, roses, camphor, and tabasheer, as this is a drug that diminishes and jells the sperm. We have mentioned its composition
in more than one place in our books.
They should also stick to foods such as qaris,[86] masus,[87]
hulam (?),,[88]
hisrimiyah[89]
with gourds and lentils,[90]
drink constantly oxymel, do much sweating in the
bath, place the feet in cold water, keep away
from parties where there are amusement, winedrinking,
and singing, and occupy themselves with pious devotions and the true
kinds of knowledge that take hold of the hearts and engage the souls strongly,
such as geometry and logic, and more than
that, with that divine knowledge (metaphysics).
For the concern with it and the immersion in it weaken all desires.
Having reached
this place, I would like to mention the prescription for the compound that
diminishes the sperm, so that the person who studies this essay (maqalah) has no need to
search for it in my other books[91] and in the books of the Ancients. This is one of
the prescriptions:
Take ten dirhams of the dried roots of waterlilies,
five dirhams of ground red roses, two and a
half dirhams of white sandalwood, and five danags of camphor. These are ten drafts.
Another
prescription which is useful when the roots of waterlilies
cannot be found: Ten dirhams
of ground roses, five dirhams of white tabasheer, two and ,a half
dirhams of white sandalwood, and five danaqs of camphor. These are ten drafts.
Another
prescription for those who dislike camphor: Take five dirhams
of ground
roses, ten dirhams of fleawort seed that is not
crushed, three dirhams each of lettuce seed, endive
seed, and origanum (?)[92]seed, and two and
a half dirhams of dry coriander, (each) draft three dirhams of the whole, with half an
ounce of vinegar.
Another prescription, good for those of a cold and wet nature
and for those who are advanced in age: Take
ten dirhams of chaste-tree seed, five dirham of river mint[93] dried,
and two and a half dirhams of dried rue leaves,
(each) draft three dirhams
of it, with an ounce of vinegar. Those who are sensitive to vinegar should drink it with cold water or rose
water.
I have discussed this matter
sufficiently. We apologize for having discussed it. We have been forced to do so
because our predecessors did in no way discuss it sufficiently.
To the Giver of the intellect be praise
without end as He deserves and merits. His
prayers and blessings be upon His Prophet, Muhammad, and his family.
Bulletin of the History of Medicine, 52 (1978) pp.
45-60