Medicine and Morality in Egypt

Gender and Sexuality in the Nineteenth and Early Twentieth Centuries

Sherry Sayed Gadelrab

• Publisher: I.B. Tauris
• Year: 2016
• ISBN:
  9780857737724
• Edition: 1
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

In Middle Eastern and Islamic societies, the politics of sexual knowledge is a delicate and often controversial subject. Sherry Sayed Gadelrab focuses on nineteenth and early-twentieth century Egypt, claiming that during this period there was a perceptible shift in the medical discourse surrounding conceptualisations of sex differences and the construction of sexuality. Medical authorities began to promote theories that suggested men's innate 'active' sexuality as opposed to women's more 'passive' characteristics, interpreting the differences in female and male bodies to correspond to this hierarchy. Through examining the interconnection of medical, legal, religious and moral discourses on sexual behaviour, Gadelrab highlights the association between sex, sexuality and the creation and recreation of the concept of gender at this crucial moment in the development of Egyptian society. By analysing the debates at the time surrounding science, medicine, morality, modernity and sexuality, she paints a nuanced picture of the Egyptian understanding and manipulation of the concepts of sex and gender.

CHAPTER 1

DISCOURSES ON SEX DIFFERENCES IN MEDIEVAL SCHOLARLY ISLAMIC THOUGHT¹

Questions such as: How are men and women distinct from each other? How do men and women contribute to generation?, and how can one have a male or a female child?, were questions that received special attention from philosophers, physicians, theologians and religious scholars in medieval Islam. The main purpose of this chapter is to explore the scientific understandings of sex differences in medieval Islamic intellectual discourses. Medieval thinkers’ interpretations of sex differences were, as this chapter argues, complex and divergent, reflecting and contributing to the social and cultural constructs of gender.

In his influential book Making Sex: Body and Gender from the Greeks to Freud, Thomas Laqueur was among the earliest scholars to examine the historiography of the biological theories of sex differences and their relationship to the social and cultural construction of gender. He argues that Greco–Roman medical and natural philosophical authorities offered their successors what could be termed as the “one-sex model” for interpreting sex differences. The one-sex model continued to dominate medical thinking about sex differences until the Enlightenment.² In the one-sex model, according to Laqueur, male and female anatomy and physiology are supposed to be functioning on a hierarchical continuum, in which the female body was a similar but lesser version of the male body.³ The one-sex model is founded on the humoral theory, which pre-supposes that the human body comprises four humors with different characteristics: cold, hot, moist and dry. Men generally have a warm temperament, and women's is cold. Laqueur employed the Galenic anatomical teachings that suggested that women have the same sexual organs as men but that their organs are trapped inside their bodies because of their lower natural heat.⁴ Thomas Laqueur argues that, despite Aristotle's insistence on the contrast between male and female bodies, Aristotle considered the main difference between the sexes as that of degree. He believed that the main difference between the sexes is that women's temperament is too cold so that they lag far behind men and cannot produce seed. The biological boundaries between the sexes, according to this physiological system, were seen as flexible allowing room for the difference of the humoral composition of individual men and women. In the Enlightenment, Laqueur argues, the one-sex model was replaced by a two-sex model, in which the male and female bodies were viewed as incommensurable opposites, with rigid and biologically inescapable boundaries between the sexes.⁵

Laqueur's study had a powerful impact on the history of gender. Historians of sexuality, gender and women examined the various social and cultural consequences of the shift in the understanding of biological differences of sex differences from pre-modern to Enlightenment Europe.⁶ Dror Ze'evi's study of sexual knowledge in the Ottoman Empire (1600–1900) is the only study, to the author's awareness, that addressed the question of sex differences in Islamic culture. Based on his analysis of a number of Ottoman Turkish medical treatises, Ze'evi suggests that a one-sex model, in which women's sexual organs are perceived as a flawed version of male genitalia, dominated thinking about sex differences in Ottoman medical literature. The dominance of the one-sex model in Ottoman medical discourse was attributed, according to Ze'evi, to the harmony between the medical view of women as imperfect males, and orthodox Islamic teachings about women's position in Muslim society.⁷

Not all scholars, however, accepted Laqueur's argument. Despite the immense importance of Laqueur's work, his approach to the history of the rich and complicated ancient and medieval biological theories of sex differences was criticized by many scholars. Helen King and Lesley Dean Jones argue that, based on their analysis of the Hippocratic corpus, the ancient Greek medical tradition depicted the female body as distinct from the male's, and that these scientific ideas were used to justify the inferiority of women in society.⁸ Joan Cadden's study of medieval notions of sex differences in medieval Latin medical, natural philosophical and physiognomic texts also emphasizes the plurality and complexity of medieval interpretations of sex differences. These, according to Cadden, contributed to constructing the view of women as physically and mentally inferior to men.⁹

By analyzing the interpretations of sex differences in a selected number of medieval Arabic medical, natural, philosophical and other texts, this book will be the first to test the application of Laqueur's hypothesis on medieval Muslim scientific discourses on sex differences. The analysis of these texts reveals the diversity of opinions and lack of consensus on a single authoritative model for interpreting sex differences in medieval Muslim scholarship. Medieval discussions of sex differences, implicitly or explicitly, emphasized the inferiority of the female body. Nonetheless, the plurality and complexity of ideas about sex differences and the acceptance of the flexibility of barriers between the sexes made it difficult to assume that the biological knowledge about sex differences formed an ideological foundation for a system of gender hierarchy.

The wide spectrum of viewpoints on sex differences can be interpreted as part of a wider intellectual debate during the medieval period. Medieval Islam (ninth–fourteenth century) was a period of intellectual dynamism, which witnessed the rise of different schools of thought: legal-religious orthodox, philosophical, theological schools. Early twentieth-century historiography depicted the relationships between these schools of thought as antagonistic, emphasizing the hostility of religious scholars to Greek sciences. Recent scholarship on medieval Muslim thought, however, asserts that the relationships between different medieval schools of thought was more complex.¹⁰ The topical boundaries between medieval schools of thought were often flexible, allowing the exchange of ideas from Greek or religious sources among different scholars with diverse intellectual backgrounds. Bassim Musallam's study of the means of birth control in medieval Islam demonstrates how religious scholars’ justification of the practice of coitus interrputus was based on Greco–Islamic medical knowledge of conception.¹¹

Such complexity of relationships and interactions between learned medical, philosophical and orthodox religious discourses on sex differences is particularly manifested in medieval discourses on sex differences. Inheriting a wide range of Greco–Roman natural philosophical and medical ideas on sex differences, medieval natural philosophers, learned physicians and religious scholars adopted, negotiated and refuted scientific and biological ideas on the subject in various contexts, ranging from medical literature to Qur'anic commentaries. In the process, they produced multifarious views of male and female bodily differences. Although medicine was included under the umbrella of natural philosophy, medical and natural philosophical authors still recognized medicine and natural philosophy as distinct intellectual disciplines each with its own authorities and sources to draw from. Religious scholars employed Greek biological knowledge of sex differences alongside sources such as the Qur'an and the Sunnah (traditions and sayings attributed to Prophet Muhammad). The relationship between religious and biological discourses was, in contrast to Ze'evi's assumption, not always smooth. Different aspects of the medical discourse on sex differences and sexuality, such as the possibility of hermaphrodites, represented a challenge for religious scholars’ commitment to a binary model of sex differences.

To achieve its goals, this book will, first, begin by examining the origins of biological knowledge about sex differences in medieval Islam derived mainly from the writings of Greco–Roman medical and natural philosophical authorities. Using primary sources as well as secondary literature, the book will provide an overview of the discourses on sex differences in Greek medical and natural philosophical thought. The goal of this overview is to demonstrate the diverse and conflicting Greco–Roman medical and natural philosophical theories of sex differences, inherited by scholars and physicians in medieval Islam. Secondly, it will proceed to examine how medieval scholars interpreted the differences between male and female bodies through the analysis of selected medical, natural philosophical, religious and other types of texts in medieval Islam. The scrutiny of learned interpretations of male and female characteristics and bodily differences asserts, as this book argues, that there was no single coherent theory of sex differences with a well-defined relationship to the medieval gender system. Instead, there were rather wide-ranging notions about sex and gender. By demonstrating how certain scholars integrated and accommodated various ideas about sex differences in diverse ways, the book aims to untangle the complex interactions and relationships between medieval medical, natural philosophical and religious discourses on similarities and differences between males and females.

Sex Differences in Greek and Roman Medical Thought

The massive translation movement that took place in the ninth and tenth centuries made available a large number of ancient medicine and natural philosophy texts in Arabic to scholars in medieval Islam. However, it was Greco–Roman medical and natural philosophical theories which became the main sources for the biological knowledge of sex differences in medieval Muslim thought. The emphasis in this book will be on a select number of texts including the Hippocratic treatises on gynaecology, embryology and obstetrics, Aristotle's On Generation of animals as well as Galen's on the Usefulness of the parts of the body. Although ancient texts were written in specific contexts, they will be examined in this book, just as they appeared to scholars of medieval Islam, as authoritative and revered sources, that belong to a past great civilization.

The impact of the selected texts on different aspects of medieval Muslim thought, including but not limited to medicine and natural philosophy, is the main criteria for choosing them. For medieval scholars, Galen and Aristotle were considered important and acknowledged to be leading authors in their respective fields. In medieval thought, natural philosophy and medicine were two clearly defined intellectual disciplines each with its leading authorities. Aristotle was reknowned for his writings on natural philosophy, and Galen for his writings on medicine. Subsequently, the different and controversial opinions of these authorities of antiquity on the subject of sex differences, as demonstrated later on in this book, had a great impact on medieval Muslim scholarship.

Although introduced to medieval Muslim scholarship through Galenic commentaries, the Hippocratic treatises eventually became widespread among medieval physicians because of their practical form and their accessibility for medieval practising physicians. The Hippocratic treatises on gynaecology and obstetrics were commonly referred to by Muslim clinicians when discussing female diseases. Written in a practical manner, the Hippocratic corpus represents a rich and accessible mine of information on the diagnosis and treatment of diseases for practising physicians. Hippocratic opinions were widely disseminated and cited frequently in practical health manuals for the use of practising physicians.¹²

To be able to understand Greek and Roman medical notions of sex differences, it is important to interpret the theory of “humoral balance”, which belies Greek medical thinking. The theory presupposes that the world is composed of four elements: fire, air, water and earth. Each of the four elements is linked with one of the four principal body humors and each of the humors assumes certain qualities of the elements. For example, yellow bile is connected with fire and is therefore hot and dry; blood is associated with air and is hot and moist; phlegm is associated with water and is moist and cold; while earth is the element of black bile, which is cold and dry. The humors govern a person's temperament, complexion and physical appearance. Every human was believed to have his own innate complexion, which identified his characteristics and behaviour. The complexion of a human being varied according to different factors such as age, sex or geographical location. Young people were generally regarded as hotter than elderly people. Generally, women were expected to have a cold temperament while that of men was warm. People who lived in hot and dry climates were believed to have hotter temperaments than those who lived in cold-weather climates.

In the light of the theory of humors, Greek and Roman physicians and philosophers, particularly the most influential such as Hippocrates, Aristotle and Galen, presented their view of sexual difference by focusing on the differences in fluid balance in the whole body, rather than the anatomy of specific bodily organs.

The Hippocratic Corpus

The Hippocratic corpus is a collection of medical treatises composed by different generations of authors, yet all attributed to the famous Hippocrates of Cos. It includes a number of treatises on gynaecology, embryology and obstetrics, which greatly impacted on medieval Islamic medical literature.

In the Hippocratic corpus, it is possible to distinguish two main models for understanding sex differences. On the one hand, the authors of Hippocratic treatises on obstetrics and gynaecology treated the female body as significantly different from that of the male, focusing on the role of the womb and menstruation as definitive features of the female body. On the other hand, the Hippocratic theory of conception suggests that both men and women contribute equally to reproduction.

The Hippocratic authors associated women's general and reproductive health with organs and functions that they believed to have no equivalent in the male body. The Hippocratics blamed the womb for many of women's health problems. They described the womb as an independent entity inside the female body. They believed that when the womb was not fixed in place by pregnancy or moistened by sexual intercourse, the womb, which craves moisture, would move towards more moist body organs, such as the liver, heart or brain. It was this movement of the womb that was said to cause many health conditions, particularly hysteria, if it came to rest beside the brain.¹³ The regularity of menstruation was considered essential for maintaining women's general health. The womb would act as a receptacle for excess blood before discharging it from the body through the vagina (the latter defined as a passage to the womb and differentiated from the urethra). Thus, therapies or a medical regimen, including bleeding, were prescribed for women who did not menstruate regularly.

The Hippocratic theory of conception also asserts the similarity between the reproductive functions of both the male and female. According to the theory, a child is formed from a mixture of the two seeds contributed by both the mother and the father.¹⁴ The seed is a representative of the various parts of the body, as every part of each parent's body provides an aspect in itself; a theory known as “pangenesis”.¹⁵ The Hippocratic author supports his view with the argument that the intensity of sexual pleasure is felt throughout the body. The Hippocratic treatise does not differentiate between male and female seeds on an hierarchical basis. The seeds of either the male or female could be weak or strong.¹⁶ The Hippocratic theory of conception, thus, provides a conventional explanation for the resemblance of children to both parents. A child is expected to resemble more the parent whose contribution is greatest.¹⁷

Finally, the Hippocratic theories of sex determination suggest a sliding scale rather than a total polarization of the sex differences, accepting the possibility that someone might be more masculine or feminine than others in his or her own sex. The Hippocratics suggested different theories for having a male or a female child, including the strength and weakness of seed. The sex...

Table of contents

• Front Cover
• Title Page
• Copyright
• Dedication
• Contents
• List of Illustrations
• Transliteration
• Introduction Conceptualizing the History of Sexual Knowledge in Nineteenth and Early Twentieth-Century Egypt
• 1. Discourses on Sex Differences in Medieval Scholarly Islamic Thought
• 2. Professional Medical Discourse on Sex Differences and Sexuality in Egypt, 1827’1928
• 3. Science, Medicine and Debates on the Woman Question
• 4. Nahal: Anglo-American Relations and Ibn Saud outside Saudi Arabia, 1943
• 5. Sexual Fears: Public Discourses on Prostitutes and Prostitution in Egypt, 1828–1928
• Conclusion
• Notes
• Bibliography