Castration as medical treatment1:

治療行為としての去勢（紺谷）
the Miracles of St. Artemios and Paul of Aegina

KONTANI, Yuki

Keywords
Constantinople, castration, hagiography, physician, intestinal hernia

Introduction
Illness and injury have been common problems throughout
history. From ancient times, sick people, wishing for a cure, relied on
physicians and/or gods, such as the god of medicine Asclepius. They
received treatments and some of them might have even had surgical
operations. Moreover, in the cult of Asclepius, patients were ‘remedied’
through divine dreams during incubation or temple sleep2. After the
rise of Christianity, this role was partly succeeded by church; some sick
people flocked in church expecting their cure. The narrative of healing
miracles through dreams appeared in that context.
As for castration, it is a well-known fact that castrated men or
eunuchs were present in the Byzantine Empire, especially as servants
in the imperial court. However, as legal sources briefly referred to,
castration was needed not only to create servants or hurt someone,
but also to treat disease3. As a result, examining the phenomenon of
castration as medical treatment might be valuable for understanding
medical practice and considering the variety of eunuchs in the Byzantine
society.
An important source concerning castration for medical reasons is
a hagiographical text, especially the Miracles of St. Artemios, because
the martyr St. Artemios specialized in cure of some disorders of male
genitals4. It was supposedly written in the last decade of the reign of
Constans II (r. 641-668) by a Constantinopolitan author and the most
of narratives in the Miracles (41/45) dealt with miracle healings of
hernias and genital diseases5. G. Sidéris emphasises the importance of
these narratives, considering that they suggests that men from various
classes were frequently castrated by doctors on account of some illness
in Constantinople6.

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 However, there are two questions concerning descriptions in
the Miracles. The first one is about the details of the ‘castration’. What
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symptoms caused the operation? How did the saint or doctors operate
the genital diseases? Furthermore, another question arises as to what
extent the operations in the Miracles of St. Artemios reflected actual
medical treatments. Previous scholars, who examine the hagiographer’s
identity or the relation between medical knowledge and religion, are not
interested in the details of operations in the Miracles. On the one hand,
when scholars discuss the hagiographer’s identity, they note that the
author of the Miracles is familiar with the medical terminology and with
the contemporary doctors and hospitals in the capital. However, this
fact is not helpful for their examination, because medical knowledge and
its vocabulary were rather fashionable among the literary intellectuals
of Byzantium 7. On the other hand, those who examine the relation
between medical knowledge and religion emphasise the polemical aspect
against physicians in the Miracles, whilst they also notice that the
miracle collection has the information on the practice of the surgery8.
They then consider the descriptions about the methods of physicians
not as actual medical treatments but as a kind of polemical rhetoric,
by which compilers of miracle stories were keen to attract support
and to emphasise the credibility of divine healing in competition with
traditional medicine. In addition, even scholars who are interested in
castration, like Sidéris, do not discuss the details of the description
in the Miracles of St. Artemios9. As a result, though these studies are
valuable, there has been little modern discussion about how medical
sources referred to castrations or removals of testicles and how these
sources treated symptoms in hagiographical sources. This situation
might be partly due to the fact that the operations are narrated as
‘miracles’, namely, ambiguous and extraordinary stories.
Despite this, the article of A. P. Alwis is remarkable, because
she exceptionally uses a medical text of the seventh-century physician,
Paul of Aegina and indicates that Paul’s descriptions had something
in common with some symptoms in the Miracles of St. Artemios10. Her
method is stimulating in regard to consider that the miracle stories
reflect the real world, even if these stories seem to be extraordinary.
However, she does not take into account sufficiently the surgical
operations in the Miracles, because her primary interest is not to

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examine operative methods for diseases, but to make tentative
diagnoses for some of sufferers in order to investigate the masculinity of

治療行為としての去勢（紺谷）
the ordinary Byzantine men.
Therefore, this paper will examine the surgical methods in the
Miracles of St. Artemios and compare the ambiguous descriptions of
operations in this text with surgical operations described by Paul of
Aegina in order to elucidate in detail the nature of castration as medical
treatment. In the end, I will indicate that these two kinds of sources
mutually demonstrate that the knowledge and practice of operations for
genital diseases spread to Byzantine society.

I. The descriptions in the Miracles of St. Artemios: physician and saint

Miracle collection is a literary genre flourished between the fifth
and the seventh centuries and consists of short narratives relating a
saint’s miracles11. Each of the stories collected in the Miracles of St.
Artemios has a standard structure12. At the beginning, the narrator
introduces a protagonist of various ages from various social classes
suffering from a certain particular disorder, like a tumour or a hernia
(κήλη/καταβαρής). Most sufferers were men with the exception of an
example concerning a female hernia patient, Mir. 24. Moreover, when
a small child became ill, his mother often appeared as a protagonist.
Although sufferers occasionally consulted a physician, they became
more ill when they did so. Then, left with no other choice, they visit the
Church of St. John Prodromos in Constantinople, where the relics of
St. Artemios are kept13. While awaiting a miraculous cure, St. Artemios
appears to them in a dream. The saint talks with the sufferers and
sometimes healed them personally by touching their bodies. The stories
end on a happy note: when the sufferers wake up, they find themselves
healthy and glorify God. In these narratives, the narrator of the
Miracles refers to operations, when physicians attempted wrongfully
to treat their patients and when St. Artemios cured diseases. Table 1
lists these narratives referring to methods of physician and/or personal
treatment of St. Artemios.

1. Negative descriptions of surgeons

Recent scholars have demonstrated that medicine and religion
were not exclusive of each other in that period, indicating a benign

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 attitude to medicine in Christian treatises, priests with medical
abilities, and Christian hospitals14. However, a hostile attitude against
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medicine could be a traditional pose from the Roman and Hellenistic

world 15. The author of the Miracles of St. Artemios often criticized
physicians as ineffective in order to emphasise the saint’s achievements
although he actually accepted that sufferers relied on physicians first16.
Concerning castration, some sufferers were told to have an
operation by their friends or doctors before they turned to the saint17. In
Mir. 25 and Mir. 44, two persons, both named George, were advised to
have their testicles amputated. Yet both of them protested that many
operations were unsuccessful and many patients had ended up dying
in the course of the operation. The mortality caused by castration was
also emphasised in the Justinian’s Novels saying that three of ninety
who have been castrated have hardly survived18. Exceptionally, Mir.
21 said that Stephen, who suffered a rupture of his testicles, actually
underwent surgery in the hospital of Sampson after many treatments
had been performed19. After three days’ treatment with cold cauteries20,
the surgeon performed the surgery (τομή) and the cauterization (καῦσις).
Thus, although he feared he would die, his life was restored. However,
it was not the surgery but the saint’s miracle that cured his disease
completely, because after the surgery the same condition recurred and
he reverted to his former state.
On the other hand, the descriptions of operations were inserted
in the epilogues of some miracle stories, in which incisions on the ailing
body part and use of a scalpel (ξίφος) suggested a surgical operation by
a physician. Nonetheless, the operations were always looked down upon
in comparison with the miracle cures. Mir. 25 connected the medical
treatment of hernia with the doctors’ scalpels and blunt retractors
(τυφλάγκιστρα) and judged that their treatment was useless. Moreover,
in Mir. 26, the narrator criticized a doctor who was about to operate on
swollen testicles with scalpel. He spoke to Hippocrates and criticized
his knowledge or surgical operation, because the operation might kill
the patient, whilst God could make him well. In addition, the epilogue
of Mir. 27 referred to the operation of swollen testicles by simple or
double incisions (ἁπολοτομία/διπλοτομία), and Mir. 28 suggested that
an intestinal hernia was operated by an oblique incision (λοξῆς γέγονεν
διαιρέσεως χρεία).

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2. Operations by St. Artemios
In spite of the criticism against medicine, the author of the

治療行為としての去勢（紺谷）
Miracles narrates that St. Artemios occasionally appeared in sufferers’
dreams in the guise of a physician21. When the saint healed sufferers
with his own hands, he merely touched or pushed the ailing part in most
cases except for Mir. 28, in which the saint grabbed the child suffering
from intestinal hernia by his right foot and dangled him upside down22.
Other stories describe how sufferers awoke and cried out in pain because
the saint squeezed their testicles forcefully or trod on their stomach or
testicles23.
St. Artemios, like a surgeon, operated upon diseased testicles24.
However, the descriptions are so vague that it is difficult to understand
the saint’s actions precisely. For example, miracle operations in a
dream were occasionally accompanied by blood (αἷμα) and pus (πύον) in
actuality. When St. Artemios pricked the sufferers’ testicles with the
point of a scalpel, Mir. 13 narrates that the skin of his testicles was
ruptured and covered with blood and pus while blood and pus oozed out
from the hole made by the saint in Mir. 22.
In addition, Stephen in Mir. 41 saw St. Artemios holding a
golden lancet (σμίλη), with which the saint traced a perfect circle over
all the ailing parts of testicle. Nonetheless, this operation has a clear
implication of being a Christian miracle, because the circle signifies
the religious symbol, the omnipotent Holy Trinity25. Mir. 44 indicates
the miracle treatment of hernia amputating a testicle by a cord. After
refusing an operation, the sick man George sees St. Artemios with a
medical instrument and a cord (σφήκωμα); he understands that the
man was a person who performs hernia operations. Then, the saint
binds the ligament of George’s left testicle and orders the sufferer to
pull one end of the cord. As he, obeying the saint’s order, pulls one
end and the saint pulls the other end, George seems to amputate his
testicle. In comparison with these miracles, the treatment of Mir. 25 is
more metaphorical, for the saint appears as a butcher in the dream of
another George who refused surgery. The butcher incised the sufferer’s
lower abdomen with a knife (μάχαιρα), took out all his intestines, and
rearranged them.

The Miracles of St. Artemios referred to some operations on

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 genitals (actual or imaginary). However, we are unable to judge with
certainty from the ambiguous miracle descriptions whether the saint or
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physician removed the patients’ testicles, namely performed ‘castrations’

as medical treatment. Furthermore, even in the cases of Mir. 25 and
Mir. 44, which suggested testicular amputation, the descriptions of
surgical operations were suggestions that were never followed and
might simply be a means of criticising medicine.

II. Therapeutic methods in medical sources: Paul of Aegina

Concerning the surgical operations for genital diseases (especially,
testicular amputation), there are not many examples before the
seventh century. The first-century Aulus Cornelius Celsus mentioned
symptoms of hernia and their surgical treatment, although his influence
on medicine in late antiquity have supposedly been negligible26. He
explained concerning cirsocele that ‘but if a varix has developed between
the inner tunic and the testicle itself and its cord, there is but one
method of treatment, to excise the testicle entirely’27. Furthermore,
Leonides, who was a Greek physician in the second and the third
century, said that testicles should be cut out in the operation of
cirsocele28. On the other hand, the six-century physician Aetios of Amida
advised doctors to avoid any operation because of its risk, although he
did not explain the detail of the surgical method29.
In the seventh century, Paul of Aegina (c.625-c.690), a physician
who likely practiced in Alexandria, wrote Epitome of medicine 30.
Although this is an encyclopaedia of medicine containing extracts from
the earlier medical writers, it is remarkable that his Epitome is more
than mere repertory of the past, especially in a description of surgery.
As H. Hunger indicates Paul’s ‘Praxisorientierheit’, scholars suggest
that Paul’s Book VI contains detailed descriptions concerning surgical
methods based on his experience in Alexandria31. Therefore, Paul of
Aegina provides enough information about surgical methods for hernias
or other genital diseases, although we are not able to affirm whether his
knowledge was common in the empire, especially in Constantinople32.

1. Paul’s surgical methods for genital diseases

Paul arranged surgical methods for various genital disorders from
VI.61 (on the parts about the testicles) to VI.69 (on hermaphrodites).

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 At first, it might be necessary to note Paul’s description of
castration. He distinguished castration from treatments for testicular

治療行為としての去勢（紺谷）
disorders 33 ; however, it was placed just after hernia operations.
According to him, the operation of castration had an object opposite
to the original goal of medicine, which was to restore preternatural
states to natural. There were two methods of castration: compression
of testicles by fingers and excision of testicles by scalpel. He said that
subjects of castration were children and a purpose of the operation was
to repress sexual desire.
In addition to this, he mentioned four kinds of diseases that could
become the subject of removal of testicle: (i) hydrocele (the accumulation
of inert fluid in the scrotum)34, (ii) sarcocele (a fleshy tumour formed in
any part around scrotum)35, (iii) cirsocele and pneumatocele (a varicose
state of testicular vessels)36, and (iv) enterocele (intestine hernia)37. The
symptoms of these diseases were a swelling of the genitals (scrotum or
testicles), which was sometimes accompanied with pain in the case of
sarcocele. For the first three of these diseases, Paul’s operations did not
always involve the removal of testicles; he noted the necessity of making
a mere incision with a scalpel down to the ailing part and dissecting
out a tumour (ii) or discharging the fluid (i) or blood (iii). However, if
patients were in a worse condition, such as their one or both testicles
were directly diseased, Paul instructed the amputation of their ailing
testicle(s). He also applied the same treatment to every patient who had
intestinal hernia:

…then we take a large-sized needle containing a doubled thread of

ten pieces, and we pass it through the middle at the extremity of the
peritoneum close to the incision; and cutting the double we make four
pieces of them, and laying them over one another in the form of the
Greek letter X, we bind the peritoneum securely, and again twisting
round the pieces we secure it so that none of the nutrient vessels may
have a free passage to it lest any inflammation be occasioned, and
we apply another ligature farther out, less than two fingers’ breadth
distant from the former. After making these ligatures we leave about
the size of a finger of the peritoneum, and cut off the whole all round,
removing at the same time the testicle, then making an incision at
the lower part of the scrotum to favour the discharge, we introduce

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 an oblong pledget, and apply embrocations of oil and bandages as for
hydrocele38.
史苑（第七七巻第二号）

2. Comparison with the Miracles of St. Artemios

The symptoms and surgical methods in Epitome of Medicine
corresponds to the swelling on the sufferer’s testicles and the incision
with a scalpel narrated in the Miracles of St. Artemios. Besides basic
information, these two texts are also united in a point of cause of hernia;
Paul explained that an intestinal hernia － the sinking of intestine
into the scrotum － was caused by the rupture or stretching of the
peritoneum as a result of certain violent movements, such as a blow, a
leap, loud crying and so on. The protagonists of the Miracles also had
hernia from these causes, for example, Stephen, deacon of the Hagia
Sophia and a ποιητής of the Blue Faction. He said himself that his
testicles were ruptured either from shouting acclamations or from lifting
a heavy weight39.
Moreover, Paul’s explanation could fill out the hagiographical text
and help us to understand the miracle surgeries of St. Artemios. The
first point is the description of blood and pus, which oozed out from the
diseased part of the sufferer’s body as a result of St. Artemios’ ‘miracle
operation’ by touching the testicle with the point of a scalpel. Concerning
the operations of hydrocele, Paul said that after the operations (a mere
incision or a removal of testicle(s)), an incision was again made with a
sharp-pointed scalpel for discharging coagulated blood and pus40. This
means that the saint’s incision in a dream was only the last step of a
surgical operation for genital diseases. Although it is uncertain whether
the narrator omitted intentionally the main part of the operation, there
is a possibility that he knew this process and used the description
of ‘blood and pus’ to suggest the end of the saint’s operation and the
patient’s cure.
The second point is a code which St. Artemios bound the ligament
of the hernia patient’s testicle in Mir. 44. Although it seems to be mere
miracle, Paul’s description suggests that the saint’s action might be
based on medical practice, a ligature; he instructed that surgeons should
enclose vessels in a ligature when they removed testicles. It is true that,
strictly speaking, a hapax βαστακτῆρα (ligament) did not mean vessels
and that making a ligature might be an ordinary measure whenever

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physicians incised vessels. However, there is another similarity: the
reference to ‘seven days’. In the chapter on intestinal hernia, Paul said:

治療行為としての去勢（紺谷）
These after the operation (the removal of the testicles) straightway
bathed their patients in a long wooden trough containing hot water,
until the seventh day, repeating this as often as five times during
the period of a day and a night, more especially with children; and it
succeeded wonderfully, for they remained free from inflammation, and
the ligatures fell out speedily along with the parts41.

Interestingly, Mir. 44 narrated that after making a ligature George

said to the saint in the guise of physician: ‘Oh me, you will tie me up
with a surgeon’s thread and for seven days it is not possible to undo
the suture, as I hear, and what I avoided out of fear, I have come back
to’42. The fact that at the end of his dream he seemed to have amputated
his testicle probably meant that this operation by St. Artemios was
that of intestinal hernia and the removal of testicles and the falling
out of ligature occurred at the same time in a miracle dream, omitting
the main part of the operation43. Nevertheless, Alwis suggested that
the operation in Mir. 44 was not for hernia but for cirsocele44, for Paul
explained the ligature for evacuating blood collected in the cirsoid
tumour in detail in VI.64. However, his description of ligature was
common in the other operations and his explanation of cirsocele did
not provide any information related to Mir. 44 such as seven days or
testicular amputation. Accordingly, it is suitable to consider that George
had an operation for intestinal hernia in his dream.
There could be no doubt that surgical methods in Paul’s Epitome
of medicine and the descriptions of the Miracles of St. Artemios have
some common points. However, it might be wrong to consider that the
author of the Miracles quoted Paul’s theories from his writings, for he
could have other sources of knowledge: medical writings and medical
practices in the capital. In particular, Mir. 28 implies that the narrator
read the works of some surgeons, which told him that the symptom
of the sufferer was intestinal hernia45, even though it gives us no hint
about the surgeons and the content of their operations and, compared
with the miraculous cure, it ends with the same irony to medical
operations. In addition, more importantly, he referred to the therapeutic

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 methods not instructed by Paul, such as the three-days cold cauteries
before surgery in the hospital of Sampson46. As a result, it suggests
史苑（第七七巻第二号）

another possibility that the methods of testicular amputation were

derived from the medical knowledge and custom which had already been
accepted in the Constantinople rather than from the writings of Paul
of Aegina. To be sure, it is an inconclusive question, because we could
not know how doctors treated genital diseases before Paul. However,
considering the fact that a castration for medical treatment were more
or less mentioned in the sixth century, it might not be unlikely that the
surgical method for genital diseases had been already known or even
performed by physicians in Constantinople when Paul completed his
Epitome in Alexandria.

Conclusion
These examinations indicate that the narratives of the Miracles of
St. Artemios are based on contemporary medical knowledge represented
by Paul of Aegina in many points. This means that the operations in the
Miracles were not mere fantasies in a dream. Conversely, the case of
Mir. 44 in particular suggested that the surgical methods of intestinal
hernia which were explained in Paul’ Epitome of medicine were reflected
in the descriptions of the saint’s operation. Setting aside a question
about the sources of medical knowledge, this perhaps means that these
methods were narrated in the Miracles, because Paul’s instruction on
intestinal hernia operation, namely the removal of testicles was not
theoretical, but practical ones even in the capital. Therefore, the advice
for sufferers in Mir. 25 and Mir. 44 that they should have their testicles
amputated might be a realistic one, not mere polemical rhetoric against
physicians. The surgical method for intestinal hernia might have been
common in seventh-century Constantinople. Finally, turning our eyes
to the problem of the Miracles’ audience, Nesbitt indicates that the
appearance at the end of certain miracles of what can be described as
short sermonettes means that the Miracles of St. Artemios were read to
the patients at St. John’s and were read aloud at the Saturday vigil47.
If we accept his opinion, it is supposed that the author wrote these
miracle stories on the assumption that the audience had also known the
operative procedure of genital diseases and the castration as medical
treatment.

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 Consequently, operation in the case of genital diseases or the
removal of testicle(s) were actually considered as an option of medical

治療行為としての去勢（紺谷）
treatment. It might be a hasty conclusion that the castration as medical
treatment was carried out frequently because Paul suggests that this
was the last resort for physicians48. However, we could suppose that, as
the narrator of the Miracles of St. Artemios suggests, patients of genital
diseases were of various ages and classes and some of the patients were
treated by castration running the risk of death.

Bibliography
Primary sources
Aetius of Amida (Aet.):
Da Monte, Giovanni Battista (latin trans.), Aetii Amideni medici
clarissimi de re medica, vol. 3, Basel, 1535.
Celsus, On medicine (Celsus, De med.):
Darenberg, C.(ed.), A Cornelii Celsi De medicina libri octo, Bibliotheca
scriptorvm Graecorvm et Romanorvm Tevbneriana, Leipzig, 1891.
Spencer, W. G.(trans.), De Medicina/Celsus, vol. 3, The Loeb classical
library 336, London/Cambridge MA, 1938, rep. 1953.
Miracles of Sr. Artemios (Mir.):
Papadopoulos-Kerameus, A., (ed.), Διήγησις τῶν θαυμάτων τοῦ ἁγίου καὶ
ἐνδόξου μεγαλομάρτυρος καὶ θαυματουργοῦ Ἀρτεμίου, in Varia Graeca Sacra,
St. Petersburg, 1909, pp. 1-75.
Crisafulli, V. S. and J. W. Nesbitt (trans. and comm.), The Miracles of
St. Artemios, Leiden/New York/Köln, 1996.
Novels (Nov.):
Schöll, R. and W. Kroll (eds.), Novellae, Corpus Iuris Civilis III, 6th ed.,
Berlin, 1954.
Paul of Aegina, Epitome of medicine (Paul.):
Heiberg, J. L. (ed.), Paulus Aegineta, Libri V-VII, Corpus Medicorum
Graecorum IX-2, Leipzig/Berlin, 1924.
Adams, F. (trans. and comm.), The seven books of Paulus Aegineta, vol.
2, London, 1846.
Modern Works
Alwis, A. P., ‘Men in pain: masculinity, medicine and the Miracles of St.
Artemios’, Byzantine and Modern Greek Studies 36-1, 2012, pp. 1-29.
Bliquez, L., ‘Two lists of Greek surgical instruments and the state of

－ １１
－ 238 －
－
 surgery in Byzantine times’, DOP 38, 1984, pp. 187-204.
Constantinou, S., ‘Healing dreams in early Byzantine miracle
史苑（第七七巻第二号）

collections’, in S. M. Oberhelman (ed.), Dreams, healing, and medicine

in Greece: from antiquity to the present, Farnham, 2013, pp. 189-197.
Csepregi, I., ‘Who is behind incubation stories? the hagiographers
of Byzantine dream-healing miracles’, in S. M. Oberhelman (ed.),
Dreams, healing, and medicine in Greece: from antiquity to the present,
Farnham, 2013, pp. 161-187.
Duffy, J., ‘Byzantine medicine in the sixth and seventh centuries:
aspects of teaching and practice’, DOP 38, 1984, pp. 21-27.
Efthymiades. S., ‘A day and ten months in the life of a lonely bachelor:
the other Byzantium in Miracula S. Artemii 18 and 22’, DOP 58, 2004,
pp. 1-26.
Grass, J. M. and N. A. Watkin, ‘From mutilation to medication: the
history of orchidectomy’, British journal of urology 80, 1997, pp. 373-
378.
Gurunluoglu, R. and A. Gurunluogu, ‘Paul of Aegina: landmark in
surgical progress’, World journal of surgery 27, 2003, pp. 18-25.
Haldon, J., ‘The miracles of Artemios and contemporary attitudes:
context and significance’, in V. S. Crisafulli and J. W. Nesbitt (trans.
and comm.), The Miracles of St. Artemios, Leiden/New York/Köln,
1996, pp. 44-46
Hunger, H., Die hochsprachliche profane Literatur der Byzantiner, 2
vols., Munich, 1978.
Magner, L. N., A history of medicine, 2nd ed., New York, 2011.
Marx-Wolf, H. and K. Upson-Saia, ‘The state of the question: religion,
medicine, disability, and health in Late Antiquity’, Journal of Late
Antiquity 8-2, 2015, pp. 257-272.
Nesbitt, J. W., ‘Introduction’, in V. S. Crisafulli and J.W. Nesbitt (trans.
and comm.), The Miracles of St. Artemios, Leiden/New York/Köln,
1996, pp. 1-30.
Nutton, V., Ancient medicine, London/New York, 2004.
Sidéris, G., Eunuques et pouvoir à Byzance IVe-VIIe siècle, these de
doctrat de l’ université Paris I Pantéon-Sorbonne, Paris, 2001.
――, ‘Une société de ville capitale: les eunuques dans la Constantinople
byzantine (IVe-XIIe siècle)’, in Société des historiens médiévistes de
l'enseignement supérieur public (ed.), Les villes capitales au Moyen

－ １２
－ 237 －
－
 Âge: XXXVIe congrès de la SHMES (Istanbul, 1er-6 juin 2005), Paris,
2006, pp. 243-269.

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Tougher, S., The eunuchs in Byzantine history and society, New York,
2008.

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 Notes
1 This phrase is used by Tougher. S. Tougher, The eunuchs in Byzantine
史苑（第七七巻第二号）

history and society, New York, 2008, pp. 26-28. In modern medicine,
‘castration’ might be distinguished from orchidectomy (the surgical
removal of a testicle), and be meant the removal of both testicle or
removal of the penis. J. M. Grass and N. A. Watkin, ‘From mutilation
to medication: the history of orchidectomy’, British journal of urology
80, 1997, p. 373. This paper treats orchidectomy as something like
castration.
2 L. N. Magner, A history of medicine, 2nd ed., New York, 2011, pp. 103-106.
3 Legal sources treated the castration caused by sick as exception.
Canon 1 of the first council of Nicaea (325) concerning the suspension
of self-mutilated or self-castrated clergy stipulated that if anyone have
been amputated by physicians because they were in sick, or if he has
been cut off by barbarians, he could remain among the clergy. In imperial
legislations, Nov. 142. 2, in which the emperor Justinian I (r. 527-
565) prohibited castration inside the empire, permitted exceptionally
castration on account of some illness (διὰ πάθος): εἰ μέντοι διὰ πάθος συμβῇ
δοῦλον εὐνουχισθῆναι, κἀκεῖνον κελεύομεν τῆς ἐλευθερίας τυγχάνειν˙ οἱ γὰρ
ἐξ ἀρχῆς ὄντες ἐλεύθεροι πάθει ὡς εἰκὸς τοιούτῳ περιπίπτοντες ἑαυτῶν ἔχουσιν
ἐξουσίαν, ἣν ἂν θέλωσι θεραπείαν ἑαυτοῖς προςάγειν.
4 Artemios was a dux of Egypt in 360. After his debatable death under the
emperor Julian (r. 361-363), he was known to be a martyr. J. W. Nesbitt,
‘Introduction’, in V. S. Crisafulli and J.W. Nesbitt (trans. and comm.),
The Miracles of St. Artemios, Leiden/New York/Köln, 1996, pp. 1-4; Mir.
17, 24.
5 Nesbitt, op. cit., pp. 7-9; S. Efthymiades, ‘A day and ten months in the life
of a lonely bachelor: the other Byzantium in Miracula S. Artemii 18 and
22’, DOP 58, 2004, p. 1.
6 G. Sidéris, Eunuques et pouvoir à Byzance IVe-VIIe siècle, these de doctrat
de l’ université Paris I Pantéon-Sorbonne, Paris, 2001, pp. 18-19; Idem,
‘Une société de ville capitale: les eunuques dans la Constantinople
byzantine (IVe-XIIe siècle)’, in Société des historiens médiévistes de
l'enseignement supérieur public (ed.), Les villes capitales au Moyen Âge:
XXXVIe congrès de la SHMES (Istanbul, 1er-6 juin 2005), Paris, 2006,
pp. 245-246.
7 For the author of the Miracles, scholars accept that he might be an adherent
of the cult and a member of the all-night vigil society. Nesbitt, op. cit.,
pp. 26-27; Efthymiades, op. cit., pp. 1-26; I. Csepregi, ‘Who is behind

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 incubation stories? the hagiographers of Byzantine dream-healing
miracles’, in S. M. Oberhelman (ed.), Dreams, healing, and medicine in

治療行為としての去勢（紺谷）
Greece: from antiquity to the present, Farnham, 2013, pp. 184-185.
8 J. Duffy, ‘Byzantine medicine in the sixth and seventh centuries:
aspects of teaching and practice’, DOP 38, 1984, pp. 24-25; J. Haldon,
‘The miracles of Artemios and contemporary attitudes: context and
significance’, in V. S. Crisafulli and J. W. Nesbitt (trans. and comm.), The
Miracles of St. Artemios, Leiden/New York/Köln, 1996, pp. 44-46.
9 Sidéris, Eunuques et pouvoir, pp. 18-19; Idem, ‘Une société de ville capitale’,
pp. 245-246; Tougher, op. cit., pp. 26-28.
10 A. P. Alwis, ‘Men in pain: masculinity, medicine and the Miracles of St.
Artemios’, Byzantine and Modern Greek Studies 36-1, 2012, pp. 8-11.
11 S. Constantinou, ‘Healing dreams in early Byzantine miracle collections’,
in S. M. Oberhelman (ed.), Dreams, healing, and medicine in Greece: from
antiquity to the present, Farnham, 2013, p. 190.
12 Ibid., p. 191.
13 Nesbitt, op. cit., pp. 8-19.
14 V. Nutton, Ancient medicine, London/New York, 2004, pp. 292-309;
H. Marx-Wolf and K. Upson-Saia, ‘The state of the question: religion,
medicine, disability, and health in Late Antiquity’, Journal of Late
Antiquity 8-2, 2015, pp. 257-272.
15 Duffy, op. cit., p. 24; Haldon, op. cit., pp. 44-45.
16 Duffy, op. cit., pp. 24-25. Mir. 3, 4, 20, 23.
17 Regarding penile disease, some doctors proposed cutting ailing part of a
protagonist of Mir. 20, who had seven sores on the tip of penis.
18 Nov. 142. pr. In some miracles, surgical operation by St. Artemios in a
dream also reminded the sufferers of their death, as the sufferers or their
family asked the saint, without noticing his identity, whether he killed
the patient. Mir. 25, 28, 42.
19 Mir. 21.
20 ‘cold cautery’ refers to the application of various caustic substances.
Crisafulli and Nesbitt, op. cit., pp. 257-258.
21 Mir. 2, 6, 40, 42, 44.
22 Mir. 5, 9, 12, 29, 32, 36, 37, 39, 40.
23 Mir. 1, 2, 6, 7, 17, 35.
24 Mir. 3, 13, 22, 25, 41, 42, 44.
25 The circularity of O symbolises ‘the alpha and the omega’. When the saint
traced the figure for a third time, he uttered the words concerning the
Holy Trinity. Crisafulli and Nesbitt, op. cit., p. 288.

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 26 Celsus, De med. VII.18-24.
27 Celsus, De med. VII.22.5. Ubi vero inter imam tunicam et ipsum
史苑（第七七巻第二号）

testiculum nervumque eius ramex est ortus, una curatio est, quae totum
testiculum abscidit.
28 Paul. VI.64.2. ὁ δὲ Λεωνίδης φησίν, ὡς, ἐὰν μέν τινα τῶν τρεφόντων τὸν δίδυμον
ἀγγείων ἀποκιρσωθείη, οὕτω δεῖ πράττειν, εἰ δὲ πάντα, σὺν αὐτοῖς καὶ τὸν δίδυμον
χρὴ λαμβάνειν, ἵνα μὴ τῶν τρεφόντων ἐστερημένος ἀγγείων ἀπομαρανθείη.
‘Leonides says, that when a few of the vessels which nourish the testicles
are in a varicose state this operation should be performed, but that when
all are affected, the testicle should be cut out along with them, lest being
deprived of its nutrient vessels it should decay’.
29 Aet. XIV. 21-23.
30 L. Bliquez, ‘Two lists of Greek surgical instruments and the state of
surgery in Byzantine times’, DOP 38, 1984, p. 187; R. Gurunluoglu, R.
and A. Gurunluogu, ‘Paul of Aegina: landmark in surgical progress’,
World journal of surgery 27, 2003, p. 18.
31 H. Hunger, Die hochsprachliche profane Literatur der Byzantiner, vol. 2,
Munich, 1978, pp. 302-303; Nutton, op. cit., pp. 295-296.
32 However, J. Haldon supposes that doctors in the capital had been
familiar with medical theories of the contemporary medical writers, such
as Paul of Aegina. Haldon, op. cit., p. 45.
33 Paul. VI.68.
34 Paul. VI.62.
35 Paul. VI.63.
36 Paul. VI.64.
37 Paul. VI.65.
38 Paul. VI.65.3. εἶτα λαβόντες βελόνην εὐμεγέθη λίνον ἔχουσαν διπλοῦν
δεκάπλοκον πρὸς τὸ πέρας τοῦ περιτοναίου τὸ πρὸς τῇ διαιρέσει κατὰ μέσον
διείρομεν, κόψαντες δὲ τὴν διπλόην τέσσαρας ἀρχὰς ποιήσομεν καὶ ταύτας κατὰ
χιασμὸν ἀντεμπλέξαντες ἐξ ἀμφοτέρων τὸν περιτόναιον ἰσχυρῶς ἀποσφίγξομεν
καὶ πάλιν τὰς ἀρχὰς περιειλήσαντες ἐπισφίγξαντες τε γενναίως, ὡς μηδὲν τῶν
τρεφόντων ἀγγείων ἔτι χορηγεῖν δύνασθαι, ἵνα μὴ ἐντεῦθεν φλεγμονὴ γένηται,
καὶ δεύτερον ἐξωτέρω δεσμὸν ἐμβαλοῦμεν ἧττον ἢ δύο δακτύλους ἀπέχοντα τοῦ
προτέρου. μετὰ δὲ τούτους τοὺς δεσμοὺς ὅσον δακτύλου μέγεθος ἐάσαντες τοῦ
περιτοναίου ὅλον αὐτὸν κατὰ κύκλον ἀποτέμωμεν, συναφαιροῦντες δηλαδὴ καὶ
τὸν δίδυμον, καὶ πάλιν τὴν καθ’ ὑπόρρυσιν τοῦ ὀσχέου παρασχόντες διαίρεσιν τόν
τε λημνίσκον διεισβαλόντες τάς τε ἐλαιοβραχεῖς ἐμβροχὰς καὶ τοὺς ἐπιδέσμους
ὡς ἐπὶ τῶν ὑδροκηλικῶν ἐπιβαλόντες ἅπαντα τὰ λοιπά, καθάπερ ἐκεῖσε λέλεκται,
διαπραξόμεθα.

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39 Mir. 21. Ἐξηγήσατο καὶ Στέφανος, διάκονος τῆς ἁγιωτάτης Μεγάλης Ἐκκλησίας
καὶ ποιητὴς μέρους Βενέτου, τοιοῦτόν τι. ‘Κατὰ τῶν διδύμων μου’, φησίν, ‘σπάσμα

治療行為としての去勢（紺谷）
μοι γέγονεν, εἴτε ἀπὸ κραυγῆς, εἴτε ἀπὸ βάρους, εἰπεῖν οὐκ ἐπίσταμαι’. A rupture
caused by lifting a heavy weight was also referred to in Mir. 7 and Mir.
40. Alwis, op. cit., p. 10.
40 Paul. VI.62.3. εἰ δὲ ὁ δίδυμος σῆψιν ἢ ἑτέραν τινὰ κάκωσιν ἔχων εὑρεθείη,
δεῖ τὰ ἀγγεῖα τὰ σὺν τῷ κρεμαστῆρι βρόχῳ διαλαβόντας αὐτὸν τὸν κρεμαστῆρα
διατέμνοντας ἐξελεῖν τὸν διδυμον. ... μετὰ δὲ ταῦτα καθέντες πυρῆνα μήλης διὰ τῆς
διαιρέσεως κάτω πρὸς τὸ πέρας τοῦ ὀσχέου δι’ αὐτοῦ τε τὸν ὄσχεον κυρτώσαντες
ἐπάκμῳ σμιλίῳ τὴν καθ’ ὑπόρρυσιν παράσχωνεν τομήν. ἵνα καὶ οἱ θρόμβοι τοῦ
αἵματος καὶ τὸ πῦον δι’ αὐτῆς ἐκκρίνοιντο. This measure might be applied
after other operations. Celsus, De med. VII.19; Paul. VI.65.3.
41 Paul. VI.65.4. οὗτοι δὲ αὐτοὶ μετὰ τὴν χειρουργίαν ἔλουον εὐθὺς τοὺς κάμνοντας
ἐν πυέλῳ μακρᾷ ξυλίνῃ θερμὸν ὕδωρ ἐχούσῃ μέχρι τῆς ἑβδόμης ἡμέρας ἕως
πεντάκις τοῦ νυκθημέρου τοῦτο πράττοντες, καὶ μάλιστα ἐπὶ τῶν παιδίων, καὶ
θαυμασίως ἐξέβαινεν ἀφλεγμάντων τε μενόντων αὐτῶν καὶ τῶν βρόχων ἅμα τοῖς
σώμασιν ταχέως ἀποπιπτόντων·
42 Mir. 44. λέγει αὐτῷ ὁ ἀσθενῶν· ‘Οὐαί μοι, ἀπολινῶσαί με ἔχεις καὶ ἐπὶ ἑπτὰ ἡμέρας
οὐκ ἔνι λῦσαι τὴν ἀπολίνωσιν, ὡς μανθάνω, καὶ ὃ ἔφυγον δειλιῶν, εἰς αὐτὸ πάλιν’.
43 Mir. 44. ὁ φαινόμενος ἰατρός· ‘Σῦρον μόνον’. καὶ ὡς ἔσυρεν ὁ νοσῶν τὴν μίαν
ἀρχήν, κρατῶν ὁ ἅγιος Ἀρτέμιος τὴν μίαν ἀρχὴν ἔσυρεν καὶ ἔδοξεν ἀποτεμεῖν τὸν
δίδυμον αὐτοῦ, καὶ ἐκ τοῦ πόνου διυπνίσθη ἀγωνιῶν· ‘The one who appeared
as the physician said: “Just pull the cord”. And the patient pulled one
end, St. Artemios held onto the other end and pulled and he seemed to
amputate his testicle and he woke up in agony from the pain’.
44 Alwis, op. cit., pp. 10-11.
45 Mir. 28. καὶ μὴν τοῦτο τὸ εἶδος οἱ κηλογράφοι χειρουργοὶ ἐντεροκήλην ὀνομάζειν
εἰώθασιν· ὅπερ καὶ πλεῖον τῶν ἑτέρων διδυμικῶν νοσημάτων. ‘And to be sure
those surgeons who write about hernias are accustomed to call this kind
an “intestinal hernia”, which indeed is more severe than other testicular
disorders’.
46 Mir. 21.
47 Nesbitt, op. cit., pp. 25-27.
48 Cf. Sidéris, ‘Une société de ville’, pp. 245-246.
（東京大学大学院人文社会系研究科博士課程）

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 史苑（第七七巻第二号）

Table 1. Narratives in the Miracles of St. Artemios that refer to the methods of physicians and/or personal treatment by St. Artemios
Symptom/disease Method of physician Treatment by St. Artemios’ methods
1 Testicular disease Squeezing the testicles
2 Foot pain/three hernias In the guise of a physician/squeezing the testicles
3 Boil on testicles Ineffective An incision with a scalpel
4 Testicular disease Ineffective
5 Hernia Touching the testicles
6 Testicular disease In the guise of a physician/squeezing the testicles
7 Hernia (intestinal rupture) Treading on the stomach
9 Hernia Touching pulse
12 Hernia Touching the testicles
13 Testicular disease Pricking the testicles
14 Testicular disease Treading on the testicles
20 Seven sores on the tip of the penis Ineffective/contemplating surgery Advised to apply white vinegar and salt
21 Rupture in testicles Surgery
In the guise of a friend of the patient/touching the skin of the

－
22 Dropsy in chest/hernia Consultation with a physician/bandage
testicle with a scalpel
23 Hernia Ineffective Conversation with the patient

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In the guise of a butcher/piercing the patient’s lower abdomen
25 Testicular disorder An advice of testicular amputation
with a knife and arranging the intestines

231 －
－
27 Swollen testicles In the guise of a sailing master/putting three nomismata on the stomach
Grabbing the patient’s right foot, and dangling and shaking the
28 Intestinal hernia
patient upside down
29 Hernia Pushing a testicle into the intestines
32 Intestinal and genital injury Consultation with a physician Touching the navel and lower abdomen
32’ Swelling of two genitals Touching the testicles
35 Hernia Planting the hand on the patient’s testicles
36 Hernia A physician demanding 12 nomismata Placing the hand on the patient’s testicles
37 Hernia Touching the testicles
39 Many severe diseases Touching the intestines and belly
Intestinal troubles/swollen left In the guise of a physician/pushing the testicle gingerly and
40
testicle making the sign of the cross
41 Pain in and swelling of the left Holding a medical lancet made of gold/tracing a perfect circle
testicle over the testicle
42 Swelling of the left testicle In the guise of a physician/inserting an instrument near the testicle
44 Pain in and swelling of the An advice of testicular amputation In the guise of a physician who performed hernia operations/binding
right testicle the ligament of the left testicle with a cord and pulling each end
論文要旨

治療行為としての去勢（紺谷）
治療行為としての去勢
―『聖アルテミオスの奇蹟譚』とアエギナのパウロス

紺谷由紀

ビザンツ帝国における去勢行為の目的として、皇帝の宮廷で奉仕する宮
廷宦官の供給や政敵の排除、犯罪者に対する処罰などが広く知られている。
しかしその一方で、言及は多くないものの、去勢が男性生殖器の疾患を治療
する目的で行われていたことが史料から示唆される。この病気治療のための
去勢について検討することは、外科手術のような当時の医学的状況に加え、
ビザンツ社会における去勢の多様性を理解するうえで重要であると思われ
る。
7 世紀半ば頃に成立したと考えられる『聖アルテミオスの奇蹟譚』
（以下『奇
蹟譚』 ）は、聖アルテミオスの遺物が納められたコンスタンティノープルの
洗礼者ヨハネ教会を主たる舞台として、聖人の遺物、あるいは患者たちの夢
の中で聖人が引き起こしたという治癒の奇蹟にまつわる物語を収録したもの
である。その大部分が生殖器の疾患、特にヘルニアの治癒に関わるものであ
るため、 『奇蹟譚』は治療のための去勢を考察する上での貴重な史料である。
しかしその一方で、奇蹟という性質上、治療の叙述は曖昧かつ非現実的な表
現が多いことから、 『奇蹟譚』における手術の描写と当時の帝国における実
際の医療行為との関連性について十分な検討はなされてこなかった。
そこで本稿は、 『奇蹟譚』と同時期の人物と考えられている医師アエギナ
のパウロスの 『医学要覧』を用い、
彼の説明する生殖器疾患の症状や手術法を、
『奇蹟譚』内で語られる医師や聖アルテミオスによる治療と比較することで、
曖昧な奇蹟の物語の背後に隠された 7 世紀ビザンツ社会における治療行為と
しての去勢の詳細を明らかにすることを試みる。
アエギナのパウロスは、陰嚢水腫、精巣腫瘍、陰嚢静脈瘤として現在知ら
れる疾患について、その症状が深刻な場合には精巣の摘除を提案し、さらに
腸ヘルニアに至っては、あらゆる場合において精巣摘除によって治療されう
ると述べる。また、これらの疾患に関するパウロスの説明と、 『奇蹟譚』の
登場人物たちの症状や聖アルテミオスが彼らに施した治癒の描写との間には
様々な類似点が存在することから、 『奇蹟譚』が対象とする病は腸ヘルニア
を含む陰嚢に関するものであり、 『奇蹟譚』で語られた精巣の摘除も単なる

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 誇張ではなく、現実的な治療法の一つとして想定されていたと考えられる。
『奇蹟譚』の著者がいかにかかる医学的知識を獲得したのかという点に関し
史苑（第七七巻第二号）

ては断定できないものの、両史料の類似性は、『奇蹟譚』の記述が完全な創
作ではないことを意味すると同時に、アエギナのパウロスの『医学要覧』に
記された手術法が単なる理論上のものではなく、当時のコンスタンティノー
プルでも知られ、医師たちにより実行されていた可能性を示唆するものであ
るといえるだろう。頻繁に行われていたとは言い難いが、『奇蹟譚』は、精
巣摘除としての去勢が治療行為として当時の人々に知られており、様々な年
齢、社会的地位の患者たちが時に死の危険を冒して手術を受けたことを示し
ているのである。

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