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Social History of Medicine Vol. 23, No. 1 pp. 38–55 Understanding Emasculation: Western Medical Perspectives on Chinese Eunuchs Melissa S. Dale* Keywords: eunuch; emasculation; urology; eugenics; China In the late 1800s, western physicians and medical observers in China became fascinated by the Chinese practice of emasculating young boys and men for service as palace eunuchs. At that time, little was known about the emasculation procedure, in part due to Chinese knife experts ( daozijiang) guarding the hereditary secrets of their profession.1 As western hospitals and dispensaries in the Qing capital of Peking (Beijing) increasingly became sites of interaction between western physicians and Chinese eunuchs ( taijian) in the late nineteenth and early twentieth centuries, eunuchs became a serious subject of medical inquiry. As a result of their treatment of and research on eunuchs, western physicians in Peking became important conduits of information on eunuchs between China and the west. Today, these writings by western physicians and foreign observers are the only known historical accounts of the emasculation procedure during the Qing dynasty (1644 –1911). This paper explores late nineteenth- and early twentieth-century understandings of emasculation and how western language writings on Chinese eunuchs shaped Chinese– western interactions and mutual perceptions. Over the course of some 50 years, from the late 1870s through the early 1930s, these western language writings would shift in content and focus. More than just records of medical voyeurism and Orientalist views on Chinese culture, these writings would provide insight and data valuable for *Assistant Director for Strategic Planning, Institute of East Asian Studies, University of California, Berkeley, 2223 Fulton Street, 6th Floor, Berkeley, CA 94720-2318, USA. Email: [email protected] or [email protected] 1 I have chosen to translate the term daozijiang as ‘knife expert’ rather than use the traditional English translation of ‘knifer’. Since ‘knife expert’ still does not adequately express the true meaning of the term, ‘one who works with knives’, I have opted to use daozijiang throughout. & The Author 2010. Published by Oxford University Press on behalf of the Society for the Social History of Medicine. All rights reserved. doi:10.1093/shm/hkp139 Advance Access published 17 February 2010 Downloaded from http://shm.oxfordjournals.org/ at University of Colorado on March 31, 2015 Summary. In the late nineteenth and early twentieth centuries, western physicians and medical observers became fascinated by the Chinese practice of emasculating young boys and men to serve as palace eunuchs. As a result of interaction and encounters between western physicians and Chinese eunuch patients at western hospitals and dispensaries in Peking, emasculation became a serious subject of medical inquiry that also shed light on Chinese-western mutual perceptions. The writings of these western physicians are the only known historical accounts of the emasculation procedure from the Qing dynasty (1644–1911) extant today. More than just voyeuristic commentaries on another Orientalist stereotype of ‘exotic’ China, these accounts presented readers with what their authors perceived to be textual evidence of the efficacy and/or superiority of western medicine and even offered insight and medical data of importance for topics being debated in the West, such as the use of castration to resolve sexual and psychological deviancy. Western Medical Perspectives on Chinese Eunuchs 39 2 Wu and Gu 1991, pp. 254– 5. In 1900, the government revoked these licences and assigned the Department of Punishment to perform emasculations. See Du 1996, p. 23. 4 Jin and Shen 1992, p. 106; Tang 1993, p. 38. 5 Dale 2000, p. 32. 6 Eunuchs were screened for ‘appearance, conversation, intelligence and cleverness, and strength’. See Ma et al. 1982, p. 178. 7 Elderly eunuchs supervised by officials from the Department of Ceremonial and Accounts verified that applicants had already been emasculated. See Li Hongzhang et al. 1909, juan 1216, Imperial Household Department, Eunuchs, Eunuch Selection, SZ 18. 8 Jin and Shen 1992, p. 105. 9 Perront’s introduction in Dan 1995, p. 12. 3 Downloaded from http://shm.oxfordjournals.org/ at University of Colorado on March 31, 2015 the debate over eugenics, specifically the use of castration as a treatment for sexual and psychological deviancy. Before one can understand the emasculation procedure, one must first examine how eunuch candidates found themselves under the knife. Since the process of becoming a eunuch in China during the Qing dynasty involved the complete removal of all of the male external genitalia, I have chosen to use ‘emasculation’ rather than the term ‘castration’ (excision of the testes) to refer to the procedure.2 Here, Chinese sources complement western accounts, providing necessary background information. The majority of Qing dynasty emasculates began the physical transformation required to become a eunuch at one of the ‘sheds’ ( changzi) located near the palace (Forbidden City) gates. The palace relied on daozijiang licensed by the government to perform the emasculation procedure and to supply the imperial court with enough eunuchs to meet its demand.3 Four times a year, the imperial court required daozijiang to supply the palace with at least 40 emasculates (160 per year). Summer was a favourite season for emasculations as it offered post-operative advantages—the new eunuch needed to remain unclothed below the waist during the healing process and mosquito and fly populations were lower during these months.4 Accepting applicants only after the emasculation had been performed, the imperial court effectively distanced itself from the genital mutilation of Chinese males and child trafficking.5 The use of a daozijiang also proved beneficial for the young men and boys who underwent emasculation at a daozijiang’s shed. Aside from their obvious experience in performing the procedure, daozijiang also screened eunuch candidates, selecting those most suited for service in the imperial court, thereby increasing a candidate’s likelihood of acceptance into the palace system.6 It is important to note that emasculation did not ensure employment in the palace; it was merely an application prerequisite.7 In exchange for a payment of six taels, the daozijiang would emasculate and provide recovery care for eunuch candidates. Chinese accounts note that the daozijiang would also expect to receive offerings of food and alcohol in exchange for his services. The use of a sliding scale for payment indicates that the financial situation of a candidate’s family was taken into consideration when accounts were paid.8 Daozijiang also obtained candidates through the sale of boys facilitated by their parents and/or kidnappers. Parents could sell their seven- and eight-year-old sons for a sum of money that would feed the family for a couple of months.9 A boy sold to a daozijiang would become his ‘adopted son’ and was 40 Melissa S. Dale often required to turn over his salary to him.10 While the majority of emasculations were classified as ‘voluntary’ during the Qing, with many parents providing consent for their young sons and others being sold to daozijiang, the use of the term ‘voluntary’ is problematic. Orientalist Stereotypes of ‘Exotic’ China 10 Ma et al. 1982, p. 179. Lorcin 1999, p. 660. 12 Rogaski 2004, p. 167. 13 Morache 1869, p. 134. 14 Morache 1869, p. 135. 11 Downloaded from http://shm.oxfordjournals.org/ at University of Colorado on March 31, 2015 Western language accounts of the Chinese emasculation procedure first appeared in print in the late 1860s and 1870s. Authors of these works were western physicians and foreign observers attached to the foreign legations and customs offices in Peking. In these early studies, one finds a combination of social commentary and medical voyeurism. As will be seen, these writings transmitted the authors’ Orientalist perceptions about the barbarity of emasculation and the backwardness of the Chinese to their western audiences. The earliest known western language account of the Chinese emasculation procedure was written by Dr Georges Morache, a physician in the French army and member of the French legation in Peking. Morache’s writings on eunuchs appear in his 1869 work, Pékin et Ses Habitants: Étude d’Hygiene (Peking and Its Inhabitants: A Study of Hygiene). Morache’s work, like that of other French physicians stationed in foreign lands, assessed the ‘geography, climate, and conditions of hygiene in the prevailing area’.11 At first glance, one might consider eunuchs an unlikely subject for discussion in a book on hygiene. Yet, as Ruth Rogaski has noted about Tianjin in the 1900s, ‘personal hygiene and public health administration had become markers of civilization and modernity in the context of high imperialism’.12 For Morache in 1869, the hygiene of Peking was intertwined with the city’s poverty and cultural practices commonly viewed by western observers as backward. Eunuchs are mentioned in Morache’s chapter on poverty in Peking, situated among discussions on beggars, infanticide, prostitution and syphilis. Here, alongside Morache’s Orientalist stereotypes about ‘exotic’ and ‘backward’ China, one finds the first western language description of the emasculation procedure. According to Morache, on the given day, the eunuch ‘patient’ would be plunged into a very cold bath to numb the senses just prior to having his genitalia wrapped in a silk-like packet and excised with one cut of the knife after which a handful of styptic powder was immediately applied to the wound to stop the bleeding.13 One can infer from Morache’s study of the city that the French presence is necessary in China if only to clean up Peking’s environmental and cultural filth. Morache concludes his chapter on poverty by noting: ‘Beggars, infanticide, abandoned children, prostitution, such is the canvas of misery in the city of Peking.’14 Eight years later, George Carter Stent wrote what would become the best known source on the Chinese practice of emasculation. Stent, who was not a medical doctor and appears to have had no medical training, was in China officially first as a British Western Medical Perspectives on Chinese Eunuchs 41 Legation guard and later as a member of the Chinese Imperial Maritime Customs (CIMC).15 Prior to the publication of his 1877 report, ‘Chinese Eunuchs’ in the Journal of the Royal Asiatic Society, Stent had made a name for himself writing about Chinese culture and language.16 To Stent, eunuchs were a fascinating subject of study, yet also a ‘vile blot’ that plagued ‘less fortunate’ non-Christian countries among which China was most certainly one. In his introduction, Stent writes: Here, Stent indirectly makes a case for the presence of the British in China, if nothing more than for evangelization purposes. Stent’s article contains the most detailed description to date of the emasculation procedure. Due to space restrictions it will only be summarised here. At the time of the procedure, the ‘candidate or victim’ was positioned on a kang [Chinese raised bed] in a ‘reclining position’. He would then be held still by three men, one securing his waist and the other spreading and holding down his legs. With knife in hand, the daozijiang would then ask the ‘candidate’ if he would regret it. If the candidate gave any indication that he might, the operation did not take place. If he was willing, he would then become a eunuch ‘with one sweep of the knife’. According to Stent: The operation is performed in this manner:—white ligatures or bandages are bound tightly round the lower part of the belly and the upper part of the thighs, to prevent too much hemorrhage. The parts about to be operated on are then bathed three times with hot pepper-water, the intended eunuch being in the reclining position as previously described. When the parts have been sufficiently bathed, the whole,—both testes and penis—are cut off as closely as possible with a small curved knife, something in the shape of a sickle. The emasculation being effected, a pewter needle or spigot is carefully thrust into the main orifice at the root of the penis; the wound is then covered with paper saturated in cold water and is carefully bound up. After the wound is dressed the patient is made to walk about the room supported by two of the ‘knifers’, for two or three hours, when he is allowed to lie down.18 After the procedure, the patient was not allowed to drink anything for three days. Stent describes how this could be a period of great ‘agony’ for the eunuch, due to both thirst and pain due to the inability to urinate. At the end of the three days, the bandages would be removed, the spigot pulled out, and the eunuch would ideally finally release a ‘copious flow of urine which spurts out like a fountain’. Eunuchs who were able to urinate were 15 ‘The Takao Club—George Carter Stent’ 2008. Stent 1877. 17 Stent 1877, p. 143. 18 Stent 1877, pp. 170 –1. 16 Downloaded from http://shm.oxfordjournals.org/ at University of Colorado on March 31, 2015 This serves to shew at least one beneficial result of the spread of Christianity; for while we are free from the baneful practice, it is a vile blot on less fortunate countries; too palpably shewing in what a low estimation the women of these countries must be held, when their husbands or masters conceive it necessary to resort to such horrible mutilation of one sex to keep the other pure.17 42 Melissa S. Dale Medical Reporting on Emasculation In the 1890s, western physicians living and working in Peking became fascinated by Chinese eunuchs not merely as symbols of Chinese exoticism or backwardness but as patients presenting opportunities for interesting case studies. As western hospitals and dispensaries were established in and around the capital, eunuch patients sought out western physicians to treat the many urological problems associated with emasculation. While it remains unclear if Morache or Stent actually witnessed the emasculations described in their writings noted above, accounts from the 1890s were based upon western physicians’ interaction with eunuch patients and/or informants. These encounters and the writings that resulted from them would influence Chinese–western mutual perceptions about each other’s societies and western medicine. As will be seen, social commentary now took a backseat to medical research and writings designed to present evidence of the efficacy and superiority of western medicine. In 1896, J. J. Matignon, a French medical doctor and attaché with the French Legation in China, published his work, Superstition, Crime et Misère en Chine.24 At first glance, Matignon’s title suggests that like Morache, he contextualizes eunuchs among other Orientalist symbols of Chinese backwardness. An examination of the book reveals 19 Ibid. Stent 1877, p. 171. 21 Stent 1877, p. 183. 22 Ibid. 23 See Jamieson 1877, p. 123; Powell et al. 1877, p. 301. See also Gordon 1884, p. 225. 24 Matignon 1900, p. 253. The paper was first published in 1896 in Le Bulletin de la Société d’Anthropologie de Paris, tome VII (4e série). 20 Downloaded from http://shm.oxfordjournals.org/ at University of Colorado on March 31, 2015 considered free of danger and congratulated. Those ‘unfortunate wretch[s]’ who could not, were ‘doomed to a death of agony’. Eunuchs were considered cured in about 100 days.19 Stent notes that death resulting from the procedure was quite rare and occurred in about ‘two out of a hundred cases’, usually due to the inability to urinate after the procedure.20 The amputated genitalia, known as the ‘precious’ ( bao), were preserved in a ‘pint measure’ for future use by the new eunuch in promotion ceremonies and at burial. Like Morache, Stent’s study provided him with the means to transmit his views on emasculation, a cultural practice symbolic of the backwardness of Chinese society, to western audiences. It is interesting to note that Stent chooses to translate daozijiang as ‘knifer’ which carries a pejorative tone; for example, ‘slasher’, that is not reflected in the Chinese. For Stent, the Chinese practice of emasculation is clearly intertwined with polygamy, another Orientalist stereotype of ‘exotic’ China. Stent writes, ‘From everything we can learn regarding eunuchs, but one conclusion can be drawn as to their origin, and that is, polygamy; were it not for that eunuchs would be as rare as unicorns.’21 Stent then cautions that ‘If the Mormons, who are polygamists, are left to themselves, will they not hereafter introduce eunuchs?’22 While Stent’s social commentary appears to have had little historical longevity, his account of the emasculation procedure quickly became disseminated throughout the western medical community, appearing in condensed form in many medical journals in the United States and Europe.23 Western Medical Perspectives on Chinese Eunuchs 43 25 Matignon 1900, p. 257. Matignon does not mention any specifics about this pre-operative procedure. Matignon 1900, p. 258. 27 See L. J. 1898, p. 399. 28 The excerpt of Korsakow’s writings on eunuchs, published in the German publication Deutsche Medicinische Wochenschrift, makes it difficult to ascertain if the author intentionally focuses only on the emasculation procedure or if that was the editor’s choice. 29 Anon. 1898, p. 339. 26 Downloaded from http://shm.oxfordjournals.org/ at University of Colorado on March 31, 2015 however that the title is misleading. Matignon’s ‘Les Eunuques Du Palais Impérial de Pékin’ (‘Eunuchs in the Imperial Palace in Peking’) is actually a reprint of his 1896 article published in Le Bulletin de la Société d’Anthropologie de Paris. For Matignon, eunuchs are not solely a Chinese phenomenon; he notes that they were also present in societies such as ancient Rome. As will be seen, Matignon views eunuchs as patients presenting interesting cases that can be cured by western urological techniques and treatments. Matignon’s 1896 account provided additional medical details to western understandings of Chinese emasculation. In particular, Matignon’s description noted a pre-operative procedure that caused the patient’s testicles to atrophy slightly and the application of an anaesthetic that reduced the pain by 90 per cent.25 Just prior to the excision, the daozijiang would grab the genitalia with his left hand and compress and twist the organs in order to reduce the blood flow. At this point, the patient would be asked, ‘Are you willing?’ An affirmative response would result in the excision of the genitalia followed by the insertion of a ‘nail-shaped’ wooden or tin plug into the urethra. Contrary to Stent’s account, in which pepper water was used as an anaesthetic, Matignon described its use as a post-operative rinsing agent.26 By including information on the effectiveness of the anaesthetic and the voluntary nature of the procedure, Matignon transformed the description of the emasculation from purely voyeuristic details of genital mutilation to a medical procedure performed on a willing male. While Matignon’s account adds detail to our understanding of emasculation, as will be seen, his focus is really on the use of western medical techniques to treat sick eunuchs. In the late 1800s, the Chinese emasculation procedure also captured the attention of Dr W. Korsakow, a physician at the Russian embassy in Beijing. Korsakow’s 1898 account was also frequently used as the basis of western medical articles on Chinese eunuchs.27 While Korsakow’s textual description of the procedure differs little from that of Stent except for the surgical tools used by the daozijiang and the application of the anaesthetic, such details would have been of value to western physicians interested in learning how to actually perform the procedure.28 Korsakow noted that the anaesthetic was a ‘secret medication known only to the surgeon’ and that the excision of the genitalia was performed with either a pair of ‘sturdy scissors’ or a sickle-shaped knife. Korsakow then pointed out that the plug inserted into the urethra was made of wood or lead. Like Matignon, the application of hot pepper water followed the excision as a rinsing agent. The wound was then dressed with a piece of paper soaked in water. Korsakow noted the practice of keeping the patient ambulatory immediately following the procedure as a Chinese practice used in cases of trauma to aid the circulation of bodily fluids.29 Korsakow attributed post-emasculation complications to ‘carelessness and a well-known Chinese uncleanliness’, a comment that reveals that Orientalist stereotypes 44 Melissa S. Dale 30 I have revised Tsai’s translation here from ‘self-castration’ to ‘self-emasculation’ (see Tsai 1996, p. 22). Two late Qing eunuchs recalled that only a small percentage of eunuchs became emasculated in this manner. See Ma et al. 1982, p. 177. 31 At the end of the Ming dynasty (1368 – 1644), there were 100,000 emasculated males in the population. The Qing dynasty employed far fewer eunuchs, approximately 3,000 during the early Qing to 800– 900 during the late Qing. For Ming dynasty eunuchs, see Tsai 1996. The interference of eunuchs in government is one of the reasons often cited for the downfall of the Ming dynasty. For information on the prohibition of self-emasculation during the Qing, see Tang 1993, p. 37. 32 Tiedemann 2008. 33 Coltman 1894, p. 28. 34 Ibid. 35 Coltman 1894, pp. 28 –9; Coltman 1893, p. 329. 36 Coltman 1894, p. 29. 37 Ibid. Downloaded from http://shm.oxfordjournals.org/ at University of Colorado on March 31, 2015 of China as filthy continued to influence western medical perceptions of Chinese society and medicine. Interaction between western physicians and Chinese eunuchs soon led to the realisation that not all emasculations were performed by professionals. Eunuch candidates who were unwilling or unable to pay to have the procedure performed by a daozijiang could choose the riskier and more painful method of self-emasculation ( zigong).30 During the early years of the Qing dynasty, due to the imperial court’s decision to employ fewer eunuchs, non-professional emasculations were prohibited.31 These prohibitions did not prevent the practice, as will be seen below. In the early 1890s, Dr Robert Coltman, Jr, a medical missionary doctor assigned to the American Presbyterian Mission in Peking wrote two articles on ‘self-made eunuchs’.32 Initially, Coltman thought that the practice was a rarity. However, after treating several in his practice in Peking, he came to the conclusion that many of the eunuchs serving in the palace had not been emasculated by a professional.33 Coltman’s writings, unlike earlier accounts of the emasculation procedure which appear at times voyeuristic and even emotionally sterile, presented western readers with the human side of emasculation: its motivations, its violence, and its scars. In The China Medical Missionary Journal, Coltman writes, ‘I never for a moment supposed the mutilation extended beyond the removal of the testicles, nor did I suppose that any but children were thus treated.’34 Coltman makes it clear that he feels nothing but ‘disgust and contempt’ for self-emasculates, especially those who emasculated themselves as adults to spite their fathers or to gain employment as palace eunuchs.35 Two of Coltman’s patients mentioned in his writings had emasculated themselves (one with a razor, the other with a butcher knife) in order to deprive their fathers of heirs. He is also not impressed with his eunuch patients’ generosity. After treating one wealthy eunuch, Coltman commented that he was rewarded ‘with a present of four miserable oranges’.36 Coltman concludes his article by posing the following question to his readers: ‘Yet knowing all the pain and odium that is sure to be theirs, to say nothing of the risk of their life, many ablebodied men voluntarily submit to the operation by others, and not a few perform it upon themselves. Do such specimens of humanity deserve any sympathy?’37 Self-emasculation was undoubtedly a much riskier procedure than that performed by a daozijiang. Oral histories of eunuchs compiled during the early 1980s provide a record of Western Medical Perspectives on Chinese Eunuchs 45 eunuch voices on the topic. Ma Deqing, a eunuch during the reign of the Guangxu emperor (1875–1908), recalled the day his father emasculated him: The year I turned nine, perhaps it was Guangxu 31 (1905), my father called me in, held me down in the shop, and emasculated me with his own hands. . . . Please remember at this time, there weren’t any anaesthetics, injections, or things to stop the bleeding. . . . To forcibly hold down a child who is kicking and screaming and cut off his reproductive organs. . . . That child is in so much pain!38 One eunuch I had the opportunity to see at the French hospital in Peking was only able to urinate in a very fine stream or in drops; the opening of his urethra was not wider than the head of a pin. The surgery had been performed on him only a year prior. After a bougie treatment had resulted in a minor widening he withdrew from further treatment after the fifteenth session.41 Coltman wrote that nearly all eunuchs in the city suffered from ‘obliteration of the urethral orifice . . . [which] leads to the accumulation of phosphatic and uric-acid deposits in the track of what is left of the urethra and at the neck of the bladder’.42 The western medical practice of catheterisation through the use of a bougie (an instrument for dilating 38 Ma et al. 1982, p. 176. Jamieson 1877, p. 123. 40 For information on this hospital, see Fabre 1937, p. 279. 41 Anon. 1898, p. 339. 42 Coltman 1893, p. 329. 39 Downloaded from http://shm.oxfordjournals.org/ at University of Colorado on March 31, 2015 In cases of self-emasculation, haemorrhage was the most immediate concern. If the eunuch could survive this, he often faced urological complications such as ‘obliteration of the urethral orifice’—a problem that could prove deadly. It remains unclear how many Chinese boys and men died while undergoing non-professional emasculations. While interactions between western physicians and Chinese eunuchs provided insight into Chinese emasculations, these encounters also presented western physicians with opportunities to treat sick eunuchs. Western surgical techniques offered alternatives to traditional Chinese medicine and were particularly helpful to eunuchs suffering from urological ailments. According to R. A. Jamieson, consulting physician to the CIMC, ‘as a rule, Chinese practitioners are timid and tardy in their use of the knife. . . . Surgical operations among the Chinese are for the most part limited to the opening of abscesses, the performance of acupuncture, and the application of the moxa’.39 Western surgical treatments, especially in the area of urology, offered relief to eunuchs suffering from painful and often life-threatening ailments such as stones and trouble urinating. It also provided western physicians with evidence to support their claims of the superiority of western medical techniques since at the time many of these ailments could not be treated successfully by Chinese medicine. According to Matignon, who treated eunuchs at the diplomatic quarter’s Nantang hospital, as soon as the wound from the emasculation had healed, the difficulty of urination would begin.40 Korsakow noted the problems that eunuchs suffered due to the closing of the urethra: 46 Melissa S. Dale the urethra) enabled western physicians to treat and often cure eunuchs suffering from problems in passing urine.43 Matignon also wrote that eunuchs suffered from magnesium ammonium phosphate (MAP) urinary stones which he attributed to ‘the fermentation and stagnation of urine’.44 Inability to empty their bladders was a serious problem for eunuchs. According to Coltman’s eunuch patients, ‘many of their kind die[d] annually from suppression of urine’.45 Frederick M. Hartsock, an Assistant Surgeon in the US Army, attached to the American legation, also noticed the prevalence of bladder stones in eunuchs. He writes: Some eunuchs also suffered from urinary incontinence caused by the imprecision of the daozijiang. These eunuchs found it necessary to wear a large handkerchief wrapped around their loins.47 Incontinence contributed to the stigmatisation of eunuchs who were ridiculed for smelling of urine.48 News of the efficacy of western medicine in treating eunuch ailments even prompted the invitation of western physicians to enter the palace to treat eunuch favourites of the imperial court. In 1902, Dr Pritchard was invited into the palace to perform ‘an important surgical operation on one of the favorite eunuchs’.49 The ability to save a eunuch favourite of the imperial court provided welcome opportunities to western physicians desiring to win the favour of the imperial court. In sum, western medical writings about eunuchs presented western audiences in China and abroad with what their authors perceived to be textual evidence of the efficacy and/or superiority of western medicine. Emasculation and the Debate over Eugenics The audience for western language articles on Chinese eunuchs reached well beyond the medical community in China. These articles were of great interest to American physicians and politicians involved in the debate over eugenics. An examination of western language medical journals from the late 1800s through the 1930s, reveals that some physicians at the time were calling for and had utilized castration as a form of sterilisation for criminals, the insane and the mentally disabled.50 Physicians debated the use of ‘castration’ as a form of punishment, ‘a method of treatment for ‘sexual perverts’’, and a ‘curative treatment’ for 43 Coltman 1894, p. 29. Matignon 1900, pp. 262 –3. 45 Coltman 1894, p. 29. 46 Hartsock 1904, p. 262. 47 Jin and Shen 1992, p. 147. 48 Matignon 1900, p. 260. 49 Headland in Grant (ed.) 1902, p. 117. See also Headland 1900. 50 Anon. 1905, p. 1202. Studies from the late 1800s through the 1930s did not differentiate between ‘castration’ and ‘emasculation’. For consistency in this article, I have chosen to use ‘castration’ to refer to western medical practices during this period and ‘emasculation’ for references to the Chinese procedure. 44 Downloaded from http://shm.oxfordjournals.org/ at University of Colorado on March 31, 2015 Stone in the bladder is a common disease in China and is ascribed to the extreme hardness of the water. Practitioners among the natives operate frequently for this affection. It is especially prone to develop in eunuchs on account of the contraction of the urethra after the operation of castration.46 Western Medical Perspectives on Chinese Eunuchs 47 Recently, a 20- to 22-year-old man came to the hospital for consultation. The mysterious air with which he approached to inquire of me in private, made me realize that I was dealing with a eunuch. He had undergone the operation 10 or 12 months prior, but at the level of the urethra was a small raised scar, as large as a one franc piece and of approximately one cm high. In his view, and especially in the eyes of the inspector of the ‘precious’, the fleshy bud reminded him too much of the absent penis and at a recent review he had received a severe reprimand. He begged me to rid him of this vestige of his virility, as useless as it was dangerous for his career.53 While Matignon never actually performed surgery on this eunuch as the eunuch suddenly left when Matignon asked to photograph him prior to the operation, this example does reveal the uncertainty at the palace regarding the question of eunuch libido post-emasculation. While most western physicians assumed that castration eradicated sexual desire, not all were convinced. In Europe, some castrati were known to have maintained their libido post-castration.54 However, in the case of the castrati, the removal of only the testes left the castrati with the organs necessary to function sexually, even if with some deficiencies. During the eugenics debate in the late 1890s in the United States, doctors such as Dr Edmund Andrews, Professor of Clinical Surgery at Northwestern University, noted that the age at the time of castration affected the eunuch’s libido. In his 1898 article on ‘castration’ as a form of treating ‘sundry criminals’, Andrews concludes that age at the time of the procedure determined its effectiveness in negating sexual desire and notes: ‘The fact appears to be that men castrated in adult life often retain a troublesome amount of sexual desire, and that even if it is done in childhood there is by no means a total absence of it, though it is much lessened.’55 51 Bliss and Binder (eds) 1908, p. 154. See Anon. 1905, p. 1202; Potts 1898; Marshall 1865, pp. 81 –4. For information on regeneration, see Jay 1993, p. 466. For information on duishi, see Dale 2000, p. 107. 53 Matignon 1900, p. 260, fn. 1. 54 Jenkins 1998, p. 1879. 55 Andrews 1898, p. 176. 52 Downloaded from http://shm.oxfordjournals.org/ at University of Colorado on March 31, 2015 the ‘insane’ and ‘feeble- minded’.51 As a result, studies on Chinese eunuchs became important resources on the long-term effects of ‘castration’ on the body. Initially, the Chinese believed that the complete excision of the male genitalia would leave the eunuch totally devoid of both sexual function and desire. The Qing imperial court, however, was unsure if emasculation eradicated the libido in all eunuchs. Biannual examinations of eunuchs to check for ‘regenerated’ genitalia, the transfer of young eunuchs out of the women’s quarters once they grew older, and the prohibition of duishi (eunuch–maidservant) relationships suggest that the Qing imperial court questioned the effectiveness of emasculation in eradicating the libido.52 Eunuchs with remnants or eunuchs whose scars were not flat aroused suspicion and faced discrimination. As a result, some eunuchs sought out western surgeons to remove remnant genitalia or raised scarring at the site of the wound. Matignon recounts the story of a young eunuch who sought such treatment: 48 Melissa S. Dale 56 Anon. 1905, p. 1202. Bliss and Binder (eds) 1908, pp. 154 –5. 58 Gordon 1884, p. 225. 59 Matignon 1900, p. 269. 60 Morache 1869, p. 135. 61 F. Wagenseil’s study, some 20 years after the fall of the Qing and eight years after the abolition of the eunuch system, would have provided eunuchs with welcome income. See Wagenseil 1933. 57 Downloaded from http://shm.oxfordjournals.org/ at University of Colorado on March 31, 2015 For the remainder of US publications on ‘castration’ during the early 1900s, the focus remained on ‘castration’ as a method of sterilisation. An examination of these articles reveals an interest in ‘castration’ to prevent procreation among ‘idiots and imbeciles in public institutions’. In a Journal of the American Medical Association article from 1905, the governor of Pennsylvania is noted as having vetoed such a bill on the grounds that ‘the nature of the intended operation is not sufficiently described’ and that such a practice would inflict ‘pain and suffering on helpless creatures’.56 In the entry on ‘castration’ in the 1908 New Encyclopedia of Social Reform, the author argues that while ‘advances in modern surgery make this [castration] a comparatively safe and painless operation’, he doubted that the procedure would be ‘permitted by modern communities’. The author quotes an address to the Association of Medical Officers of Institutions for the FeebleMinded, which promoted the ‘salutary results’ of removing the procreative organs from ‘feeble-minded’ boys and girls before adolescence.57 While viewed as safe by some, concerns in the USA about the psychological effects of ‘castration’ on the body troubled others. The hormonal imbalance caused by emasculation was reported to affect the psychological behaviour of eunuchs. In the late 1800s and early 1900s, physicians differed greatly in their views on the psychological effect of emasculation. Sir Charles Gordon, a medical officer to the CIMC, wrote, ‘Eunuchs are described as being hysterical, easily moved to violent anger, easily appeased, readily amused or depressed, timid, honest, and charitable’.58 The hormonal imbalance caused by emasculation was even reported to cause some eunuchs to suffer from hot flashes and mood swings. The violence associated with genital mutilation itself was also seen as contributing to depression, hatred toward their fathers, and sexual frustration.59 Such undesirable behaviours and symptoms would have led many doctors to question whether castration as a treatment for mental and sexual deviants involved too many unwanted side-effects. The desire to understand the morphological changes associated with emasculation also fuelled research on eunuchs. As early as the late 1890s, western physicians were already aware that age at the time of emasculation, namely before or after puberty, determined the amount of physical change. Morache even notes that those operated on at a very young age tended to be obese while those emasculated as adults were difficult to distinguish from other Chinese.60 In the 1930s, these morphological changes would become the subject of a medical study in Peking. This study would mark a shift from research obtained sporadically during eunuch visits to western physicians to more detailed and organised studies, from doctor/patient forms of interaction to that of researcher/subject.61 In the early 1930s, Professor Ferdinand Wagenseil, MD, conducted a study at the German Hospital in Beijing on the anthropological and morphological effects of Western Medical Perspectives on Chinese Eunuchs 49 Visual Representations of Emasculation Wagenseil’s study is particularly important due to its publication of photographs of the morphological effects of emasculation on Chinese men. In fact, it is one of only three known studies from the late nineteenth and early twentieth centuries that provide visual representations of eunuch bodies. Prior to his 1930s study, the only extant medical photograph of a eunuch’s genital region appeared in Matignon’s 1896 study. The absence of medical photography on the emasculated body is striking when one considers the audience for early medical photography in China, and the western desire for postcards depicting Chinese exoticisms such as punishments or pictures of the bound 62 Wagenseil 1933, p. 464. Ibid. 64 Breast enlargement. 65 Morrissey (ed.) 1990, p. 249. See also Andrews 1898, p. 176. 66 Wagenseil notes the extreme wrinkling of eunuchs. See Wagenseil 1933, p. 464. 67 Melicow and Stanford 1974; Jenkins 1998. 63 Downloaded from http://shm.oxfordjournals.org/ at University of Colorado on March 31, 2015 emasculation. Wagenseil was a German anthropologist and professor at the universities of Bonn and Giesseu. During his tenure at the German Tung-Chi University in Shanghai (1922 –31), Wagenseil was employed at the Institute for Anatomy, working on various topics among which was the study of Chinese eunuchs. Funded by the Cultural Department of the German Foreign Department of State, Wagenseil compared the bodies of 31 Chinese eunuchs ranging in age from 45 to 75 with groups of ‘normal’ Chinese men. Measuring and photographing eunuchs in categories ranging from body type to height to length of extremities, facial and skull structure, skin and eye colour and hair, Wagenseil produced the most comprehensive analysis to date on the effects of emasculation on Chinese men. Among his eunuch research subjects, Wagenseil found that eunuchs exhibited shorter torsos and a tendency towards broader hips and stomachs.62 Some eunuchs were also found to suffer from bowed or crossed legs. Wagenseil’s measurements of eunuchs’ skulls and noses also revealed greater length and narrowness than that in non-emasculated Chinese men.63 Wagenseil’s study, when combined with current research with its focus on endocrinology, provides additional insight into the effects of emasculation upon the body. Current research shows that emasculation after puberty produced far fewer physical effects than those exhibited in pre-pubescent eunuchs. Those emasculated as adults typically only experienced a lightening of the beard and an increase in fatty tissue such as gynaecomastia.64 Pre-pubescent emasculates often exhibited above-average height and longer hands and fingers, a result of delayed closure of the bone growth plates and absent testosterone.65 Lacking the opposing activity of testosterone on oestrogen, eunuchs exhibited an absence of facial and body hair as well as an increase of fatty tissue and fat distribution patterns more typical of females. Wagenseil notes that eunuchs were often described as looking like old women, perhaps due to the pronounced wrinkling they exhibited, especially on the face.66 Emasculation also prevented the eunuch’s voice from deepening naturally during puberty. As a result, in China as in Europe with the castrati, eunuchs were prized as singers.67 50 Melissa S. Dale 68 For the western desire for postcards, see Heinrich 2008, pp. 73– 111. Matignon 1900, p. 259, fig. 42, ‘A Palace Eunuch’. 70 Matignon 1900, p. 260, fn. 1. 71 ‘Ocular evidence’, as quoted in Heinrich 2008, p. 40. 69 Downloaded from http://shm.oxfordjournals.org/ at University of Colorado on March 31, 2015 foot.68 During the late nineteenth and early twentieth centuries, at a time when western physicians were increasingly documenting Chinese pathogens and cultural practices such as foot-binding, first through the medium of paint and drawings and then photography, only textual descriptions were published on the emasculation procedure. In 1894, the first rendering of the wound produced by emasculation was printed in Coltman’s article in The China Medical Missionary Journal. Even then, it is important to note that the image was totally removed from any association with the body. The journal only published a drawing reflecting the circular shaped scar common among eunuchs in their genital region. In Matignon’s 1896 article, one finds the first visual representations of the Chinese body post-emasculation and the surgical tools used during the procedure (Figure 1).69 In this only known photograph of a eunuch with his genital region exposed, one is presented with the image of a young Chinese boy naked from the waist down. With his robe parted and his pants down, the young eunuch appears to flash the photographer, lending a voyeuristic quality to the print. Recounting an earlier attempt to photograph one of his eunuch patients, Matignon writes: ‘I made the mistake of asking him if I could photograph him before the operation, but, rather than refuse me, he told me he had something urgent to take care of, promising me to return the following day and never stepped foot into the hospital again’.70 As this photograph reveals, Matignon does appear at some point to have obtained the photograph of a eunuch exhibiting his genital area that he so desired. By the time of Wagenseil’s study in 1930, many eunuchs were willing to be photographed by a western physician (Figure 2). There is, however, one major difference. Wagenseil’s photographs exhibit eunuchs like other anthropological subjects in the 1930s, from the waist up, facing front in the first photographs and to the side in the next. Wagenseil, unlike earlier western physicians, was not treating these eunuchs as patients. Eunuchs were simply research subjects to be studied, measured and documented, all of which was reflected in their photographs. The rarity of visual representations, artistic renderings and/or photographs, of the eunuch body ultimately made it difficult for western physicians and observers writing on the subject to present their readers with ‘ocular evidence’ of the ‘medical and spiritual superiority’ of western medicine. The treatment of Chinese eunuchs’ urological ailments, while successful, did not present the same kind of ‘ocular evidence’ as did surgeries on tumours performed by British and American Protestant missionary doctors in the mid-1800s.71 There were simply no ‘before’ and ‘after’ renderings to be exhibited in hospital lobbies or on foreign fundraising campaign stops. As a result, the Chinese public most likely knew little of the success that western physicians had in treating Chinese eunuchs. If western physicians wrote about eunuchs to further their careers or gain fame, they certainly did not obtain the same exposure as other western surgeons in China like Peter Parker. As for the absence of eunuch photographs in postcard series or photographic albums depicting other Orientalist stereotypes of China’s ‘suffering Western Medical Perspectives on Chinese Eunuchs 51 humanity’, such as Chinese corporal punishments or the bound foot, it can perhaps be attributed to the modesty of eunuchs and the graphic nature of the photograph’s content.72 While images of bound feet and a eunuch’s genital region both involved physical mutilation, the sexual nature of the content of the eunuch photograph may have made it off-limits for publication among the general public in the west. This absence may have actually benefited the advocates of castration in the eugenics debate. Lacking images of the effects of genital mutilation on the body, those decrying the barbarity of the practice would have had only textual evidence to support their case. 72 ‘Suffering humanity’, as quoted in Brook, Bourgon and Blue 2008, pp. 152 –202. Downloaded from http://shm.oxfordjournals.org/ at University of Colorado on March 31, 2015 Fig. 1 Un eunuque du Palais imperial de Pékin. Source: Matignon J.-J. 1900 , Superstition, Crime et Misère en Chine, Paris: Masson and Cie, p. 259. 52 Melissa S. Dale Conclusion Chinese eunuchs continued to be a topic of interest for medical researchers even into the 1960s, when Wu Chieh Ping and Gu Fang-Liu conducted their study on the effects of emasculation on the prostate.73 At the time of their study, there were still 26 eunuchs living in Beijing. With the death of the last Qing-dynasty eunuch in 1989, the interaction between Chinese eunuchs and western physicians would come to an end. While no living eunuchs remain in China, eunuchs in other cultures continue to influence studies on the effects of ‘castration’ upon the male body.74 The writings of western physicians and foreign observers on Chinese eunuchs provide the foundation for our understanding about Chinese emasculation. Beyond descriptions of the medical procedure, these writings provide important insight into Chinese–western mutual perceptions during the late nineteenth and early twentieth centuries. A combination of voyeurism and social commentary, early writings on eunuchs provided writers with a medium to comment on the filth of the Chinese city and its ‘backward’ and ‘exotic practices’. For these writers, eunuchs were a symbol of the backwardness of Chinese culture, a fascinating topic that revealed the barbarity of the Chinese in its willingness to mutilate ‘one sex to keep the other pure’.75 In the late 1890s, as western physicians began to interact with eunuchs as patients, the recording of interesting case studies took precedence over social commentary. Published in western language medical journals, these articles served western medical communities in China and abroad. Within 73 Wu and Gu 1991, p. 251. Wilson and Roehrborn 1999, pp. 4324 – 31. 75 Stent 1877, p. 143. 74 Downloaded from http://shm.oxfordjournals.org/ at University of Colorado on March 31, 2015 Fig. 2 Photos of Eunuchs from Wagenseil’s Study. Source: Wagenseil F. 1933, ‘Beiträge zur Kenntis der Kastrationsfolgen und des Eunuchoidismus beim Mann’, in Zeitschrift für Morphologie und Anthropologie, Band XXXII, Heft 3. http://www.schweizerbart.de Western Medical Perspectives on Chinese Eunuchs 53 Acknowledgements My thanks are due to Mark Mir and Jan Vaeth (both of the Ricci Institute at the University of San Francisco Center for the Pacific Rim), Marta Hanson (Johns Hopkins University), and my father Robert Dale, urologist, for commenting on earlier versions of this paper. Special thanks to Drew Bourn of Stanford University’s Lane Medical Library for helping me locate archival medical articles. Thanks also to Social History of Medicine’s anonymous reviewer for encouraging me to further develop my line of analysis. Bibliography Primary sources Andrews E. 1898, ‘The Oriental Eunuchs’, Journal of the American Medical Association, 30, 173– 7. 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