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In this Curiosities of Medical History feature, we look at the unusual practice of exposing the body to cold temperatures for therapeutic purposes: therapeutic hypothermia.

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She lives in London. Brought to you by Curioan Aeon partner. Edited by Sam Haselby. In the popular imagination, the history of sex is a straightforward one. For centuries, the people of the Christian West lived in a state of sexual repression, straitjacketed by an overwhelming fear of sin, combined with a complete lack of knowledge about their own bodies.

The salacious middle ages

Those who fell short of the high moral standards that church, state and society demanded of them faced ostracism and punishment. In reality, the history of human sexuality is far more interesting and wild. Many prevailing presumptions about the sex lives of our medieval ancestors are rooted in the erroneous belief that they lived in an unsophisticated age of religious fanaticism and medical ignorance.

While Christian ideals indeed influenced medieval attitudes to sex, they were rather more complex than contemporary prejudices suggest. Christian beliefs interacted with medieval medical theories to help shape some surprising and sophisticated ideas about sex, and a wide variety of different sexual practices, long before the sexual revolution. The case of the French cleric Arnaud de Verniolle illustrates the sophistication of medieval sexuality. One day in the early 14th century, when Arnaud was a student, he had sex with a prostitute.

Several years later, he confessed this lapse to the Inquisition, explaining that:.

Many medieval men found themselves with undesirable symptoms after a brothel visit, and attributed their plight to their sexual behaviour. Among the various medical miracles attributed to St Thomas Becket, for example, was the cure of Odo de Beaumont, who became leprous immediately after a lateth-century visit to a prostitute.

Much has been made of the medieval tendency to interpret disease as a product of sexual sin. Too much. In fact, the medieval tendency to see disease as sexual sin was not solely based on moral judgments — there were also strong medical elements. C oncerns about the sexual transmission of disease via prostitutes were often addressed in an entirely rational manner. Moreover, the concerns of the people of Southwark were rooted in medical theory. When the penis of the healthy man came into contact with this vapour, the heat of his body would ensure that it was absorbed through his open pores.

Sores would soon appear on his genitals, before spreading around his body. Fortunately for Arnaud, and many others, it was often possible to treat sexually transmitted leprosy.

Curiosities of medical history: the controversy of using cold as a treatment

The 14th-century English physician John of Gaddesden suggested several protective measures that a man should take after having sexual relations with a woman he believed to be leprous. He should cleanse his penis as soon as possible, either with his own urine or with vinegar and water. Then he should undergo intensive bleeding by a phlebotomist, followed by a three-month course of purgation, ointments and medication. He treated this unfortunate individual by cutting away the dead flesh with a blade, then applying quicklime.

If such prophylactic measures failed, then the patient might need one of the many remedies for swollen, itchy or pustulent genitals found in medical treatises and recipe collections. Such a man should use a poultice to reduce the swelling.

A cold case

Such preparations were undoubtedly unpleasant, but the surgical remedies recommended by the 14th-century English surgeon John of Arderne were downright brutal. Arderne treated this unfortunate individual by cutting away the dead flesh with a blade, then applying quicklime — a process that must have been extremely painful, but apparently produced a cure. However, neither author explicitly identifies their remedies as cures for diseases transmitted by sexual contact. The man with the swollen yard might well have been viewed by his contemporaries as a victim not of infection, but of overindulgence.

M edieval physicians saw too much sex as a real medical concern. Conventional wisdom held that several noblemen died of sexual excess. Today, his symptoms would suggest venereal disease, but his contemporaries would probably have seen parallels with the case of Ralph, count of Vermandois. This 12th-century French nobleman had recently married his third wife when he fell seriously ill. During his convalescence, he was advised by his physician that he must abstain from intercourse, but disregarded this warning. The humours system derived from the idea that health was based on an equilibrium of the humours, and illness the product of imbalance.

Humours were balanced, and good health maintained, through the expulsion of various bodily fluids, including semen. Regular sexual intercourse was thus part of a healthy life for most men, but moderation was key. Too much sex would leave the body depleted; in the most serious cases it could have fatal consequences, as Count Ralph found to his cost.

On the other hand, medieval medical authority held that too little sex presented a medical problem: celibacy was potentially detrimental to health, particularly for young men. Long-term celibacy meant the retention of excess semen, which would affect the heart, which in turn could damage other parts of the body. The celibate might experience symptoms including headaches, anxiety, weight loss and, in the most serious cases, death.

Although celibacy was highly valued as a spiritual virtue in medieval society, in medical terms the celibate was as much at risk as the debauchee. Conventional opinion attributed his death to the resulting celibacy, making him the most famous victim of death by celibacy.

According to the 12th-century Norman poet Ambroise, abstinence claimed many victims:. For most crusaders, sexual abstinence was at most a temporary inconvenience, to be endured only until they returned home and were reunited with their wives. Becket lived for many years after this and ultimately died a martyr at the hands of an assassinbut other bishops were less fortunate. An unnamed 12th-century archdeacon of Louvain, having struggled to remain celibate for a long time, was promoted against his will to the bishopric of the same city.

For a month, he abstained from all sexual activity, but soon his genitals swelled up and he became seriously ill. Within days, he was dead. Non-saintly celibates who faced the challenge of celibacy tended to favour the obvious cure.

Others, hoping never to face this predicament, adopted behaviours informed by medical theory believed to protect the health of a celibate man by promoting alternative forms of excretion. Humours-based medical theory held that all bodily fluids were processed forms of blood, and that their common origins rendered them interchangeable. Weeping for example, the lachrymose prayers favoured by pious individuals could also serve as an alternative to sexual intercourse, with the blood that would have been converted into semen instead producing tears.

Exercise and bathing, both of which produced sweat, were also useful for those who wished to practise long-term abstinence. As well as taking measures to encourage the excretion of superfluities, a celibate man needed to be careful about what he put into his body. Diet thus directly related to sexual health. The problem was threefold. Firstly, the proximity of the genitals to the stomach meant that the former would be warmed by the food or wine contained in the latter, providing the heat that defined the male body, and was necessary for the production of semen.

Secondly, semen was thought to be the product of completely digested food, with nourishing foods such as meat and eggs especially conducive to its production. Finally, certain windy foodstuffs including beans produced an excess of flatulence, which in turn produced an erection. Taken together, these factors made overindulgence at the table a real problem for priests.

Numerous medieval writers told tales of monks who ate too well, and consequently experienced a violent desire for sex, along with almost continuous emissions of semen. On the other hand, knowledge is power, and religious men could use fasting as a practical strategy to protect themselves from the health risks posed by clerical celibacy.

Salted fish, vegetables in vinegar, and cold water were thought to be particularly suitable foods for monks. In addition, some medical writers recommended anaphrodisiacs for men who wished to avoid sexual intercourse. The 11th-century physician Constantine the African recommended rue, a strong and bitter tea made from an evergreen shrub.

Two centuries later, Peter of Spain the only practising physician ever to become pope was also recommending rue; alternatively, one could drink juice of water-lilies for 40 days. A lthough the most famous cases of death by celibacy relate to male clerics, women were, in their own way, equally vulnerable to this medical problem. According to contemporary medical theory, both sexes produced seed that was necessary for conception — and just like semen, the female seed needed to be expelled from the body during regular sexual intercourse.

In a woman who was not sexually active, the seed would be retained within her body; as it built up, it would cause suffocation of the womb.

The symptoms of this condition included fainting and shortness of breath, and in the most serious cases it could be fatal. If this was not possible, there were a range of useful remedies, including restricted diets and vinegar suppositories. Some physicians, however, recommended a rather startling alternative: masturbation. Unsurprisingly, the medieval Church took a rather dim view of this practice: most medieval penitentials handbooks for confessors identified masturbation as a sin, and imposed heavy penances for it — typically around 30 days of fasting, but sometimes as much as two years.

On the other hand, masturbation was usually placed towards the bottom of the hierarchy of sexual sins, and confessors were permitted to make some allowance for those including unmarried youths who lacked another outlet for their desires.

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