A HISTORY OF THE MALE AND FEMALE GENITALIA

A HISTORY OF THE MALE AND FEMALE GENITALIA

"Turn outward the woman's, turn inward, so to speak, and fold double the man's, and you will find the same in both in every respect." -- Galen, 2nd century A. D.

Physicians throughout time have analyzed, compared, and puzzled over the male and female reproductive organs. In 1620, the Scottish medical student John Moir aptly summed up the problems of this elusive subject: "A consideration of the genital members is very difficult, and everything should not be revealed particularly with youths, because sin makes the subject of generation diabolical and full of shame, and a discussion might excite impure acts." Christianity, at least, had to overcome its special shame over this part of the body in order to inquire further into its structure.

Were men and women different? Were they different in degree or in kind? From antiquity through the Renaissance, most physicians portrayed the female and male reproductive organs as counterparts of each other and wrote of homologous anatomical structures. Female genital organs were often explained as "lesser" male organs due to differences in size, complexion and orientation. Words such as testes applied to both male and female reproductive parts, since it was believed that both produce substance by similar means that contributed to generation. What that substance was became a matter of heated debate. In the fourth century B. C., Aristotle wrote that man contributed the form of humanity through his semen, while woman contributed only brute matter -- a substance less pure and less sanctified than semen itself. Hippocrates and Galen preferred to describe human conception as occurring from two "seeds," though they differed slightly on the relative importance of each contribution. In this model, both men and women produced semen.

The Aristotelian model of the body emphasized sexual difference, though it harbored the potential for a Platonic universe in which all creatures might become male. Galen, as a physician, could not envision such a world. Instead he sought to understand the nature of the difference of the sexes through their commonality. His elaborate though experiment yielded the following: "[T]he 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." Look at the two images from Vesalius. How does they contain traces of Galen's idea?

Debates about these different models of the body continued throughout the Middle Ages. We might even say that they intensified as Aristotle and Galen became key authorities in philosophy and medicine respectively, and moral questions of sexuality became of increasing interest in medieval society. In the early eleventh century, we can see the Islamic medical philosopher Avicenna reintroducing Aristotle's ideas of sexual difference. In the Canon of Medicine, he wrote: "According to the teaching of philosophy, the process of generation may be compared with the processes which take place in the manufacture of cheese. Thus the male 'sperm' is equivalent to the clotting agent of milk, and the female 'sperm' is equivalent to that of milk. The starting point of the clotting is in the rennet; so the starting-point of the clot 'man ' is in the male semen." He even cited a saying of the Prophet to support this idea: "We made the life-germ a clot." By contrast, Master Nicolaus of Salerno appears a fairly orthodox Galenist in the late twelfth century, when he writes of the testes: "In men they are large, in women small. In both sexes they germinate sperm." Compare these two medieval images of male and female anatomy from Islam and Europe. What information is each trying to convey?

Galen's neat idea of the uterus as an interior scrotum notwithstanding, most medieval medical practitioners believed the uterus to be a distinctly female organ that caused a host of specifically female diseases. "The uterus is called also matrix because it is the mother of all," wrote John Moir in 1620. It was a cold and dry organ. Less attractively, some proposed that the uterus was a "sewer" -- a site of noxious poisons that caused diseases such as the "suffocation of the mother," a condition in which the womb wandered throughout the body and which the Greeks described as hysteria. No equivalent male organ could be found that affected the body so dramatically.

The uterus was also the site of a great deal of reproductive speculation. For centuries, its structure was thought to reveal the mysteries of the number and sex of its offspring. "It is hollow and villous within, smooth outside, divided into seven cells, and has two openings," wrote Master Nicolaus, reflecting the standard view that the womb had as many divisions as the days of the week and could yield a maximum of seven children at a time. Mondino de' Liuzzi affirmed this idea in 1316. Others divided the womb simply into two parts, arguing that males were born on the right side and females on the left. "Woman was endowed with two wombs," wrote Moses Maimonides in the late twelfth century, arguing that they corresponded to the number of breasts. Many insisted on a central cell in which hermaphrodites were born. Finally, anatomists argued for the presence of uterine horns, an error that arose from dissecting animals. Look at the medieval images of the uterus on the right. Can you see the uterine horns? What other peculiarities do you observe? Look at the sixteenth-century diagram of the uterus on the left. What features of the medieval uterus do you still see?

By contrast, the male reproductive organs were described in far less detail, undoubtedly because there was little considered to be peculiar about them. "The origin of the penis is situated upon the pubic bone in that it can resist it's active force on coition," wrote Leonardo da Vinci at the end of the fifteenth century. "If this bone did not exist, the penis in meeting resistance would turn backwards and would often enter more into the body of the operator that into that of the operated." Medical practitioners devoted far more attention to male reproductive fluids than to male reproductive anatomy. In the Galenic model, both men and women were believed to have "seminal vessels" that carried sperm to its point of exit; at the end of the fifteenth century, Jacopo Berengario da Carpi affirmed that these vessels must be longer in the male because male semen was "thicker." How male sperm was generated was a source of some speculation. Did it come directly from the brain via the spinal cord? Was it concocted from purified blood? "The semen is a superfluous nourishment of the body, a material pure and separate from the principle members necessary for generation," wrote Alessandro Benedetti in 1497. " It is believed on the authority of Galen that it is drawn from the brain."

Benedetti also noted one fact of male anatomy that continued to suggest the connections between the sexes. "When [the testicles] are cut off the masculine form and behavior is almost completely changed and becomes feminine, for men lose their strength, boldness, habits, and beard." In 1653, William Harvey also concurred, citing ancient authority: "Rufus says that eunuchs, as I believe, are women." Males could become more female, though it rarely happened by nature alone but through surgical intervention. Accounts of lactating monks and fathers who breastfed their daughters after the death of the mother suggested that other circumstances might render the male body female. More easily, the female body might become male at puberty, much in the way that Galen had suggested: the inside simply dropped out. While the uterus was predominantly female and a strong, life-giving semen predominantly male, neither sex could claim absolute autonomy.

Several key developments altered the traditional images of the reproductive organs. Vesalius and his followers began to give more physical specificity to the human uterus. Initially, Vesalius in 1543 prominently displayed the uterine horns -- he described them as "two blunt angles .. which resembe the immature honrs on the foreheads of calves" -- but he began to wonder why they, like the cells of the uterus were so difficult to see. In the 1570s, Laurent Joubert stoutly contradicted the idea of the womb "being divided in two in the manner of animals" or having "booths separated one from another."

New anatomical features of the female genitalia emerged. In 1559, the anatomist Realdo Colombo claimed to have discovered the clitoris, which cast some doubt on Galen's claims about the nature of an interior penis, not to mention the idea that women took no pleasure in conception. By the end of the century, Gabrielle Fallopia had identified the Fallopian tubes, though no one was yet sure what there function was. Look at the Renaissance illustration to the right. How can we see some of the changes in female anatomy depicted here?

In the seventeenth century, the vocabulary for the male and female bodies grew much more specific to each sex. Terms such as "ovaries" are a product of an era of increased dissection and ultimately the introduction of the microscope as a tool of investigation. In 1672, for example, the Dutch anatomist Renier de Graaf published On the Generative Organs of Women, in which he mistakenly identified the Graafian follicles, by which we now remember him, as "eggs." Like his predecessor William Harvey, de Graaf placed great emphasis on woman's contribution to reproduction.

By contrast, the Dutch microscopist Antoni van Leeuwenhoek argued by the end of the 1670s that "a human being originates not from an egg but from an animalcule that is found in the male semen." The sins of Adam and Eve had yet to be resolved. In the meantime, the formation of the offspring of this union remained the ultimate mystery of all -- a human seed, both male and female, immaterial and material, that both sexes claimed for their own. Look at Leonardo's famous image of the human fetus to the right. Its uterus resembles nothing more than an acorn cracked open, a birth of nature rather than of mankind.