Kathryn Ringrose

University of California, San Diego, USA

Perceivi ng Byzantine Eunuchs Through Modern Medicine

Byzantine eunuchs were perceived by their contemporaries as culturally,

psychologically, and physically distinctive. While eunuchs clearly were not

women, their infertility and distinctive physical appearance distanced

them from the gender construct Byzantine society assigned to adult

males. Byzantine observers routinely described eunuchs using pejorative

terminology, comparing them, unfavorably, to testiculated men. In my

earlier book, The Perfect Servant: Eunuchs and the Social construction of

Gender in Byzantium, I assumed that most of the pejorative comments

about the physiology and personality of eunuchs were part of a

generalized set of negative attitudes about both eunuchs and women.

More recently I have been prompted to question this assumption and I

have begun to explore current medical literature that deals with the

results of castration or with conditions that are analogous to castration.

This literature focuses on androgens and the effects of androgen therapy

and androgen deprivation on the human body and mind, on dental

research that discusses the changes in the anatomy and appearance of

the face in the absence of certain androgens, and on psychological and

neuroscientific research that explores the changes in the human brain

that take place at puberty.

It is risky to reach historical conclusions based on contemporary

evidence, but in dealing with the topic of Byzantine eunuchs we have two

problems: (1) Our primary sources are few, scattered, and often very

1
biased. (2) Our contemporary sources are limited by the fact that, unless

we believe whispers behind closed doors that will probably never be

opened, children are no longer routinely castrated in our modern world.

This rules out the possibility of direct comparison between Byzantine and

modern castrates.

Even so, modern medicine and experimental science may offer some

insights into the topic. In today's world individuals are born with

ambiguous genitalia which is often "corrected", but these children cannot

necessarily serve as a model for the Byzantine eunuch. Men with severe

prostate cancer are often castrated or treated with testosterone

destroying drugs. They can provide a partial model for us, though a

model that only deals with the later years of the adult male life. Finally,

there are a few rare genetic defects that produce males that can be

considered a kind of modern eunuch. Here, however, the literature about

these individuals, who are generally treated with testosterone, is focused

on "correcting" their defect rather than on exploring the results of non-

treatment. Despite these caveats, we can gain some intriguing insights

from today's medical and biological sciences.

Most studies of Byzantine eunuchs assert that the act of

castration, that is the removal of the testicles, penis, or both, deprives

the body of testosterone and thus changes the physical nature of the

individual. While this is an obvious truism, modern medical research

indicates that this approach is much too simplistic. A brief summary of

the findings of this research will facilitate further discussion of a number

of points.

The differentiation of the male and female begins in the womb with

the development of what is called the hypothalamic-pituitary-gonadal axis.

2
The hypothalamus and pituitary, both located at the base of the brain, are

formed by the 4th or 5th week of fetal life and soon are producing

gonadotropic hormones: luteinizing hormone (LH), follicle stimulating

hormone (FSH), and gonadotropin releasing hormone (GnRH). By the 8th

week of gestation the Leydig cells (the cells that make testosterone) in

the fetal testes have differentiated. By the 12th week these cells'

production of testosterone is at its peak, effecting the further

development of the male sexual organs. It is believed that testosterone

also is involved in brain development during this period, flooding the brain

with hormones and "priming" it in a male direction. Sex differentiation in

the embryo is regulated by at least 70 different genes that govern the

mechanisms that differentiate the primordial gonadal tissue, which is

bipotential, that is, it can become either male or female. At this point in

fetal life irregularities of the genetic makeup, or external factors, like

chemical pollution, can produce individuals with ambiguous genital

development.

By the end of the fetal period the hypothalmic-pituitary-gonadal

axis is well developed, with a regulating system called the hypothalamic

GnRH pulse generator that discharges intermittent bursts of GnRh into the

system. In infancy this system operates at a frequency that is typical of

the adult male, and it stimulates the leydig cells of the child to secrete

testosterone. At about two years of age the above system becomes

quiescent until puberty. Given that castration rarely took place this early,

this phase of testosterone-related development in male children is

something experienced by virtually all potential eunuchs. The

mechanisms for turning this system on and off are not yet completely

understood.

3
 There is considerable variation in the timing of male puberty. It

begins when the hypothalamic GnRh pulse generator again begins to

release GnRh, resulting in an increase in production of LH (luteinizing

hormone) by the pituitary. In male humans an elevation of LH and

testosterone signals puberty, the testis increase in size, producing

increasing amounts of testosterone, reaching adult values at 14 or 15

years of age. Spermatogenesis can be established at some time between

the 12th and 16th year of life.1 This is the phase of testosterone related

development that is missed by eunuchs castrated prior to puberty.

Recent studies in the areas of developmental neuroscience and

neuropsychology indicate that puberty has a significant impact on the

human brain, and especially the male brain. Just as testosterone in the

infant acts to differentiate neural circuits in the brain, it continues to act

on the brain during puberty. There is evidence that the male brain,

influenced by steroid hormones, and, in the male, testosterone in

particular, is significantly remodeled during puberty in ways that impact

higher-order brain functions, including cognitive functions and emotion

regulation.2 The brain is a very "plastic" organ and it develops new

circuitry and prunes unneeded circuitry throughout puberty and young

adulthood.

1
Audrey M. Cummings and Robert J. Kavlock, "Function of Sexual Glands and Mechanism
of Sex Differentiation," The Journal of Toxicological Sciences, vol. 29, no. 3, (2004):
167 – 178.
2
Judy L. Cameron, “Interrelationships between Hormones, Behavior, and Affect during
Adolescence: Understanding Hormonal, Physical and Brain changes Occurring in
Association with Pubertal Activation of the Reproductive Axis. Introduction to Part III,”
Annals of the New York Academy of Sciences, 1021 (2004): 110-123 (2004); J. D.
Wilson, "Androgens, Androgen Receptors, and Male Gender Role Behavior," Hormone
Behavior, v. 40, no. 2 (Sept. 2001): 358-366.

4
 What significance does this have for the study of eunuchs? Many

of the eunuchs in our sources are “artificial creations” in that they were

normal males who were deliberately castrated for a variety of very

specific purposes. Others, however, were individuals whose development

was congenitally faulty, leaving them with incomplete male sexual organs.

These are sometimes referred to as "natural" eunuchs in our sources.

Another group includes men who were castrated in an attempt to cure

one of several medical conditions afflicting the male genitalia. Finally,

there are eunuchs whose castration is the result of an accidental injury.

For all of these groups age of castration is critical for future physical and

neural development.

In the Byzantine world men must have known that the age at which

castration was performed effected the kind of eunuch that was formed.

Castration between infancy and puberty, for example, will profoundly

effect the appearance of the individual, but he will still be oriented in a

masculine direction, though just how is difficult to determine. He will not

experience normal puberty. His voice will remain high-pitched, he will

have little or no facial hair and the hair on his head will be thick and

luxuriant throughout his life. His face and body will have a very distinctive

appearance and his life will probably be short, since he will be afflicted

with osteoporosis, diabetes, and heart and vascular problems. He will

have little or no interest in sexual behavior. His personality will be

different from that of a normal man, though it is difficult, at this historical

distance, to determine exactly how it will be different.

On the other hand, if he is castrated at, say, 17, he will experience

much less change in appearance and, though infertile, may retain limited

sexual function. If castrated as an adult, a eunuch will retain most of the

5
qualities of an adult male, with the exception of those features that are

regulated directly by testosterone: fertility, sexual potency, maintenance

of muscular strength, and the growth patterns of body and facial hair.

When visitors from Western Europe began to visit Constantinople in

the early middle ages, one of the first things they noticed was the

presence of eunuchs. Castration was rare in the west, and the very fact

that castrations took place in Byzantium made this culture appear to be

eastern, suspect and "other." The reasons that the Byzantines castrated

healthy, normal boys and created a place for them in elite society are

complex. In my own work I have suggested that the Byzantines were

attempting to create a "perfect servant", attractive, obedient, educated,

unfailingly loyal, an individual without external family ties, and an individual

who was undefiled by sexuality (unless he was desired by his master). A

parallel construct existed within the world of the church and was validated

by the assumed ascetic qualities attached to the religious eunuch.3

While for centuries Byzantine society created important niches for

eunuchs, the authors of our sources were usually uncomfortable with the

act of castration. We know a great deal about the lives of many eunuchs,

but almost nothing is said about their castration. Even the great eunuch

patriarch Methodios claimed to have been castrated by God.4 The

historian Prokopios goes to great lengths to explain that the eunuch

Solomon had not been castrated but rather that his genitalia had been

damaged in a nursery accident.5 Rhetorically, at least, the Byzantines

claimed that they never did castrations – the castrators were always

3
Kathryn M. Ringrose, The Perfect Servant: Eunuchs and the Social Construction of
Gender in Byzantium (Chicago: University of Chicago Press, 2003), ch. 5.
4
Skyl. p. 86, l. 51; Kedrenos, Compendium historiarum, vol. 2, p. 147.
5
Prokopios, Wars, vol. 3, ch. 11, l. 5.

6
“others” –usually people like the Arabs or the Persians. Likewise the

Arabs claimed that they never castrated and that their eunuchs were

prepared and purchased in Byzantium. It is interesting to compare

attitudes toward castration in Byzantium to those in China. In China

castration was practiced both as a punishment and as a route to a career.

It had to be publicly proven through the display of the severed organs. In

Byzantium castration was almost never used as a punishment and the

severed organs were not preserved. It was a hidden act, a necessary evil,

and was never mentioned publicly.

Despite the rhetorical façade, however, we know that castrations

were performed in the Late Antique and Byzantine worlds. The seventh

century surgeon, Paul of Aegina, has left us a detailed description of a

testicular ablation, prefaced by the comment that he hated to have to

perform this surgery and only did so under pressure. Since castrations

were technically illegal, they were often billed as surgery to correct a

serious medical condition, hernia. It is quite possible that in fact this

practice was not exceptional.

Among the treatments that could result in castration was the repair

of both inguinal hernia, scrotal hernia, and umbilical hernia. Doctors began

with a less invasive attempt to cure hernias using compression and

bandages, but if this failed, physicians did resort to surgery. Paul of

Aegina describes a surgical technique that included cauterization. It was

probably reasonably effective and spared the testicles. Skilled surgeons

7
in the Hellenistic world had long understood these techniques, which can

be found in the writings of Celsus, a surgeon of the first century AD.6

Though testicle-sparing surgery for hernias continued to be

practiced in the Byzantine empire, practitioners were increasingly of the

opinion that castration was the best hope of curing hernia. This was

certainly true in Western Europe until the Renaissance, and was probably

true in the less urbanized parts of the Byzantine empire.7 This is the

inference we can draw from the many examples in Byzantine sources of

boys and men with hernias and ailments of the genitalia whose miraculous

cures saved them from the castrator. In the life of saints David, Symeon

and George of Mitilini on the island of Lesvos8 we find the story of Leo, a

friend of the holy man, who brought his youngest son to him for healing.

The boy was suffering from a hernia and was about to be turned over to

the castrator when he was saved by the saint, who healed him. The life

of St. Artemios offers a number of healing miracles involving male

genitalia.9 In the twenty-fourth miracle10 a man named George is urged to

see a doctor and have his testicles removed to heal a testicular disorder.

The saint heals him. In the twenty-eighth miracle,11 a child injures his

testicles and is cured by the saint. When his mother realizes that he has

been cured, she runs her hands along his thighs and assumes the cure

6
Niki S. Papavramidou and Helen Christopoulou-Aletras, "Treatment of "Hernia" in the
Writings of Celsus (First Century AD)," World Journal of Surgery, 29 2005): 1343 –
1347.
7
John G. Lascaratos, Constantine Tsiamis, Alkiviadis Kostakis, "Surgery for Inguinal
Hernia in Byzantine Times (A.D. 324-1453): First Scientific Descriptions," World Journal
of Surgery 27 (2003): 1165-1169.
8
J. van den Gheyn, Acta graeca SS.Davidis, Symeonis et Georgii Mitylenae in insula
Lesbo, AB 18 (1899): p. 240, l. 11.
9
Crisafulli, "The Miracles of St. Artemios"
10
Ibid., p. 145.
11
Ibid., p. 155.

8
involved removing his testicles. The forty-third miracle12 is similar. In the

forty-fourth miracle13 a man with diseased testicles is considering having

them removed but is healed by the saint. The saint appears to him in the

guise of a physician who did hernia surgeries. The saint bound up the

man's testicles with a cord, an action that mimicked one technique for

castration.

Thus there was in Byzantine culture an acceptable medical façade

that legitimized castration. Hernia certainly offered an excuse that could

be trotted out for rhetorical purposes. It is even feasible that hernia

problems were sufficiently prevalent to account for a significant number

of medically legitimate castrations. Just last year a group of Iranian

researchers published a study of 3205 elementary-school boys, aged 6 to

12 years.14 The subjects live in the province of Lorestan, which is

situated north and west of Tehran on the eastern slope of the Zagros

mountains. The boys were examined for abnormalities of the groin or

genitalia and abnormalities were found in 6.64% of the children. The

problems included hernia, retractile testes, undescended testes,

hydrocele, and hypospadia. This is a significant percent of this study

group. In the Byzantine world, with the exception of the child with

hypospadia (a condition in which the urethra does not exit the penis in a

normal way) any of these children who received medical treatment would

probably have been made eunuchs.

12
Ibid., p. 219
13
Ibid., p. 219.
14
R. A. Yegane, A. R. Kheirollahi, M. Bashashati, N. Rezaei, M. J. Tarrahi, and J. A.
Khoshdel, "The Prevalence of Penoscrotal Abnormalities and Inguinal Hernia in
Elementary-school Boys in the West of Iran," International Journal of Urology, v. 12, no.
5 (2005): 479-483.

9
 A certain number of Byzantine eunuchs are identified as "natural

eunuchs" who presumably were not actually castrated. While these

individuals are rare in any culture, they do exist. They usually suffer from

genetic deformities that suppress the formation of external genitalia or

the utilization of testosterone. Ever since the publication of the Pulitzer

Prize winning novel Middlesex15 we have become more familiar with one of

these rare genetic conditions called 5alpha-Reductase Deficiency. In the

male it is the cause of male hereditary pseudohermaphroditism. During

fetal development, at the cellular level testosterone is converted to

5alpha-dihydrotestosterone and binds to a high-affinity receptor protein

in the cell nuclei. From embryogenesis through puberty 5alpha-

dihydrotestosterone is responsible for: (1) the development of the male

external genitalia, urethra, and prostate (2) at puberty, the growth of

facial and body hair and the maturation of the external genitalia (3) the

loss of scalp hair later in life. At birth individuals with this defect appear

to be girls or hermaphrodites with minimal male genitalia since they have

had little or no chance for the development of male genitalia during the

prenatal period. At puberty, however, the male external genitalia begin to

develop and these children are increasingly virilized. As children, if their

condition is not recognized, they are reared as females. After puberty,

when they develop noticeable male genitalia, some elect to live as infertile

males, following their chromosome makeup, others as females in

accordance with their rearing.

15
Jeffrey Eugenides, Middlesex: A Novel (New York: Picador, 2002).

10
 In the Byzantine world individuals of this sort would be classified as

"natural eunuchs."16 In today's world, where infant and childhood

castration are no longer practiced, these individuals are the subjects of

much research, since their experience directly addresses questions about

the importance of nature versus nurture. Though most of these

individuals are reared as females, more than half of them elect to live as

males after puberty.17 For historians they serve as a research "stand-in"

for eunuchs.

Another group of potential "natural eunuchs" includes individuals

with the more severe forms of Klinefelter Syndrome. These men have the

usual 47 chromosomes, but have an added X chromosome (47XXY).

Today we know that about 1 in 1000 males are born with this genetic

anomaly, and it is a disorder that accounts for 3% of male infertility. Men

who are affected typically suffer from, in decreasing order of frequency:

infertility, small testes, decreased facial hair, gynecomastia, (the

development of small breasts) decreased pubic hair, and a small penis.

They have unusually long legs and may have a feminized body. In

adulthood, without diagnosis and androgen replacement therapy, they can

suffer from loss of libido, decreased muscle bulk and tone, decreased

bone mineral density, and a tendency to suffer from thromboembolism,

diabetes and cardiovascular complications. Most of these symptoms

16
Jean D. Wilson, James E. Griffin, and David W. Russel, "Steroid 5alpha-Reductase 2
Deficiency," Endocrine Reviews, v. 14, no. 5 (1993): 577-593; B. B. Mendonca, M.
Inacio, I. J. Arnhold, E. M. Costa, W. Bloise, R. M. Martin, F. T. Denes, F. A. Silva, S.
Andersson, A. Lindquist, and J. D. Wilson, "Male Pseudohermaphrodistism due to 17
Beta-hydroxysteroid Dehydrogenase 3 Deficiency. Diagnosis, Psychological Evaluation,
and Management," Medicine, v. 79, no.5 (Baltimore, 2000): 299-309.
17
P. T. Cohen-Kettenis, "Gender Change in 46,XY Persons with 5alpha-Reductase-2
Deficiency and 17 beta-Hydroxysteroid Dehydrogenase-3 Deficiency," Archives of Sexual
Behavior, v. 34, no. 4 (2005): 399-410.

11
match traits associated with eunuchs in our sources. In one regard,

however, they do not resemble eunuchs, who are often presented as

intellectually adept – men with Klinefelter Syndrome often suffer from

cognitive deficits, especially in language comprehension, speech, and

gross and fine motor coordination18

In the Late Antique and Byzantine worlds natural eunuchs were

rarely identified as such. An exception to this, however, was the famous

second century eunuch Favorinus. Favorinus appears to have been born

with at lease one of the many androgen insensitivity syndromes described

above. He is described as a eunuch having a penis but no testicles.

Rather than hiding his affliction, Favorinus capitalized on his unusual

appearance and high voice, setting a new style for orators of the period.

He is the eunuch who is the subject of Lucian's The Eunuch.19

Unless some hagiographer or biographer wanted to clean up the

origins of a famous eunuch by citing accident or medical necessity, our

sources rarely say much about how a man became a eunuch. Thus there

is no way of knowing how many eunuchs there were in Byzantium at any

given time, nor can we know what percentage of them were "natural"

eunuchs as opposed to eunuchs who were the result of deliberate

castration.

However ambivalent our sources are about eunuchs, it is clear that

a significant number were deliberately castrated before puberty, when the

surgery is much easier and safer than later in life. Eunuchs castrated

18
Daniel J. Wattendorf and Maximilian Muenke, "Klinefelter Syndrome," American Family
Physician, v. 72, no. 11 (2005).
19
Maud W. Gleason, Making Men, Sophists and Self-Presentation in Ancient Rome ,
(Princeton; Princeton University Press, 1995). p. 3.

12
before puberty or during early puberty developed a distinctive appearance

that, I would argue, was aesthetically favored at court. Here, too, modern

medical research supports some of the ambiguous evidence for

physiological distinctiveness. Individuals who suffer from extreme

testosterone deprivation develop a distinctive physical appearance.

During the neonatal period androgens react with growth hormones to

produce the male growth pattern that will emerge at puberty. At

puberty, after a quiescent childhood, growth and development begins

again. What triggers puberty is still a matter of conjecture.20

"In an uncastrated male puberty is characterized by a striking

increase in circulating testosterone, which is converted to

dihydrotestosterone, increases in circulating androgens associated

with an increase in muscle mass, enlargement of the testicles and

phallus, development of acne, and a male pattern of hair

development including facial hair, axillary hair, and pubic hair, as well

as an overall increase in the size and darkening color of most other

body hairs."21

At puberty various sex steroids mediate both the development and

maintenance of long-bone tissues and the development of the bones in

the face. Both estrogen and testosterone are important for this process,

and the lack of testosterone in eunuchs at puberty results in the

development of bone material that is porous. Since testosterone

regulates the circumference of the long-bones, in its absence they will

tend to be unusually thin and fragile, a condition I will come back to when

I discuss the aging of eunuchs. At the end of puberty testosterone

20
G. Bradley Schaefer, "Neuroendocrine and Neurophysiologic Changes of Adolescence ,"
Cleft Palate-Craniofacial journal, v. 32, no.2 (1995): 95-98.
21
Ibid., p. 97.

13
regulates the closing of the epiphyseal (growth) plates in the long bones.

Lacking testosterone, these growth plates do not close promptly after

puberty. This is especially apparent in the long bones of the arms and

legs which, in a eunuch, appear to be unusually long compared to the rest

of the body.22 At the same time, in a eunuch, the bones of the jaw and

the part of the face that extends from the lower jaw to the ear tend not

to develop during puberty, creating an individual whose face appears to

be abnormally wide. In fact, its width is correct, since the measurement

between the eyes does not change from infancy. The eunuchoid face

appears to be wide because the lower face has not lengthened at

puberty. In our world of modern medicine, if a boy with a condition that

severely reduces the levels of his testosterone is diagnosed early enough

testosterone treatments will "normalize" facial growth in the vertical

dimension and will increase the anterior facial height.23

I am convinced that the Byzantines aesthetically appreciated the

appearance of boys at the cusp of puberty. Such boys were

stereotypically graceful, feminine without being female, and sexually pure.

Their skin was still clear, they had no beards, their voices were high-

pitched, their faces, which had not yet taken on a masculine appearance,

were short and broad. Given the normal inevitability of puberty, these

22
D. Vanderschueren, L. Vandenput, and S. Boonen, "Reversing Sex Steroid Deficiency
and Optimizing Skeletal Development in Adolescents with Gonadal Failure, Endocrine
Development, v. 8 (2005): 150-165; M. K. Lindberg, L. Vandenput, S. Moverare, S.
Skritic, D. Vanderschueren, S. Boonen, R. Bouillon, and C. Ohlsson, "Androgens and the
Skeleton," Minerva Endocrinology, v. 30, n. 1 (2005): 15-25.
23
A. Verdonck, M. Gaethofs, C. Carels, and F. Zegher, "Effect of Low-dose Testosterone
Treatment on Craniofacial Growth in Boys with Delayed Puberty," European Journal of
Orthodontics, v. 21 (1999): 137-143; Ronald N. Spiegel, A. Howard Sather, and Alvin B.
Hayles, "Cephalometric Study of Children with Various Endocrine Diseases," American
Journal of Orthodontics, v. 59, n. 4, (1971): 362-375.

14
qualities were recognized to be ephemeral – present in a boy today and

gone from the young man tomorrow.

These are also the physical attributes of individuals who

transcended the pollution of the mundane physical world. Through

castration this aesthetic could be captured and preserved, at least for a

time. It is important that we not impose our cultural biases on the

Byzantine world. The eunuchoid face may not be desirable today, but it

seems to have had positive connotations in the past. Current

investigations of facial shape and its relationship to testosterone show

that, at least subconsciously, people notice facial shape as an indication

of "manliness." Women today, despite what we might assume, find

pictures of the faces of men who have very high testosterone levels to be

unattractive.24 The pubescent face of the Byzantine eunuch is readily

seen in the images of angels and youthful warrior saints in Byzantine art.

It is unmistakable in our one good portrait of a Byzantine eunuch, Leo the

Sakellarios.25 It is worth noting in this connection that Byzantine art

clearly contrasts that society’s two categories of non-reproductive

individuals. One, the ascetic holy man, is depicted with a long, narrow,

bearded face that would be typical of an individual with high levels of

testosterone. This reinforces the trope that says that holiness lies in

overcoming the pleasures of the world, including sexual pleasures. The

alternative image of holiness is the beardless, almost triangular eunuchoid

24
John P. Swaddle and Gillian W. Reierson, "Testosterone Increases Perceived Dominance
but not Attractiveness in Human Males," The Royal Society, Proceedings in Biological
Sciences, Nov. 2002: 2285-2289.
25
Die bibel des Patricius Leo: Codex Rginensis Graecus 1 B, ed. Suzy Dufrenne and Paul
Canart (Zurich, 1988), fol. 2v.

15
face we find in images of angels –beings by definition free of human

sexuality.

The use of castration to prolong youthful innocence is

complimented in Byzantine sources by the fact that they rarely talk about

the aging or death of eunuchs. For the Late Antique period, where our

sources are dominated by tales of evil eunuchs like Eutropius, we

occasionally learn how they died. Valentinian burned his chief eunuch in

the Hippodrome.26 Ammianus Marcellinus mentions Eutherius, whom he

considers an exception to the rule that all eunuchs are evil, who died in

comfortable retirement in Rome.27 Similarlty, not much is said about

eunuchs' health. An exception to this is found in Ammianus Marcellinus,

who describes "the throng of eunuchs beginning with the old men and

ending with the boys, sallow and disfigured by the distorted form of their

members."28 Ammianus is clearly making observations about the health

of eunuchs. There is also an intriguing tradition that compares a eunuch

to a rose – he is beautiful in youth, flowers, then withers and dries up. His

skin is compared to a crumpled, drying flower. He becomes wrinkled and

dried up with age. Themes like this appear in John Chrysostom's Vanity

of Vanities sermon on the eunuch Eutropius.29 This raises two interesting

questions. First, what can modern medical science tell us that might shed

light on the aging process among eunuchs, and second why do our later

Byzantine sources say so little about the end of life among eunuchs?

Recent advances in the treatment of prostate cancer have led to a

flood of relevant articles. Androgen destroying medications are now used

26
Eunapius of Sardis, Fragmenta historicorum graecorum, ed. K. Muller, vol. 4, n. 30.
27
Ammianus Marcellinus. Ed. and trans. John C. Rolfe. Vol. 1 (1935), XVI 7, 2-5.
28
Ammianus Marcellinus, vol. 1, 1935, XIV 6, 17.
29
PG 52, cols. 392-414.

16
to shrink the prostate and retard the growth of the tumor, a technique

that allows fragile elderly patients to avoid surgery. This has led to other

medical problems that appear to parallel those suffered by eunuchs as

they age. Osteoporosis is the most prominent. The bulk of adult bone

mass is laid down during puberty. If a child is castrated before puberty,

his chance of retaining sufficient bone mass to last into old age is slim.

Modern studies of prepubertal boys suffering from hypogonadism indicate

that with testosterone supplements bone mass can be rapidly laid down

during young adulthood.30 Conversely for elderly men treated with

androgen destroying drugs, bone mass is lost rapidly, even if it was

adequately laid down at puberty. The degree to which osteoporosis

might disable the Byzantine eunuch clearly depends on the age at which

castration took place. Chinese eunuchs, for example, seem not to suffer

from osteoporosis because they were usually castrated after puberty.

Since Byzantine eunuchs were castrated at a variety of ages, only some

of them would suffer from osteoporosis. Court eunuchs, were probably

castrated before puberty, both to preserve their youthful appearance and

to preserve their voices, which were valued in the imperial choirs.

Osteoporosis would be a serious problem for them. Peter Phocas,

however, a great eunuch soldier whose exploits on the field of battle are

described in several sources, was almost certainly castrated as an adult.31

For him osteoporosis would be a lesser issue, at least until extreme old

age.

30
Eishin Ogwa, Uriko Katsushima, Ikuma Fuiwara, and Kazuie Iinuma, "Testosterone-
Induced Changes in Markers of Bone Turnover in Adolescent Boys with Testicular
Dysfunction," Clinical Pediatric Endocrinology, v. 12, n.2 (2003): 81-85.
31
Leo the Deacon, Leonis diaconi Caloensis historie libri decem. ed. C.B.Hase, Bonn,
1828, pg. 107.

17
 Elderly men treated with androgen destroying drugs often suffer

from weight gain, the result of a decrease in lean muscle mass and an

increase in fat. This is a phenomenon characteristic of castrated men and

animals. They also frequently suffer from anemia, perhaps explaining why

Ammianus Marcellinus describes eunuchs as sallow. With anti-androgen

therapy the body's metabolism changes, especially its sugar metabolism.

There is a rise in insulin indicating a decrease in insulin sensitivity, leaving

low androgen individuals at risk for diabetes. Recently scientists are

learning that there may be associations between low androgen and heart

and circulatory problems. Lack of androgens seems to lead to a stiffening

of the arteries as indicated by elevated blood pressure. In studies based

on castrated rats, lack of androgens leads to serious heart problems.32

As interesting as the physiological results of castration may be, the

most intriguing questions that modern medical science may help us with

involve the cognitive skills and personality of eunuchs. Today there is a

great deal of interest in the effect of gonadotrophic hormones on

puberty. This has been driven by the observation that some neurological

32
L. X. Oian, L. Hua, H. G. Wu, Y. G. Sui, S. G. Cheng, W. Zhang, J. Li, and X. R. Wang,
"Anemia in Patients on Combined Androgen Block Therapy for Prostate Cancer," Asian
Journal of Andrology, v. 6, n. 4 (2004): 383-384; T. Nishiyama, F. Ishizaki, T. Anraku, H.
Shimura, and K. Takahashi, "The Influence of Androgen Deprivation Therapy on
Metabolism in Patients with Prostate Cancer," Journal of Clinical Endocrinology and
Metabolism, v. 90, n. 2 (2005): 657-660; K. L. Golden, J. D. Marsh, Y. Jiang, and J.
Moulden, "Gonadectomy Alters Myosin Heavy Chain Composition in Isolated Cardiac
Myocytes," Endocrine , v. 24, n. 2 (2004); 137-140; J. C. Smith, S. Bennet, L. M. Evans,
H. G. Kynaston, M. Parmar, M. D. Mason, J. R. Cockcroft, M. F. Scanlon, and J. S. Davies,
"The Effects of Induced Hypogonadism on Arterial Stiffness, Body Composition, and
Metabolic Parameters in Males with Prostate Cancer," Journal of Clinical Endocrinology
and Metabolism, v. 86, n. 9 (2001): 4261-4267; M. R. Smith, "Changes in Fat and Lean
Body Mass During Androgen-deprivation Therapy for Prostate Cancer," Urology, v. 63, n.
4 (2004): 742-745; F. Debruyne, "Hormonal Therapy of Prostate Cancer," Seminar on
Urology and Oncology, v. 20, n. 3, supl. 1 (2002); D. Baltogiannis, X. Giannakopoulos, K.
Charalabopoulos, and N. Sifikitis, "Monotherapy in Advanced Prostate Cancer: An
Overview," Experimental Oncology, v. 26, n. 3 (2004): 185-191.

18
diseases, like schizophrenia, appear at puberty, and by the elevated death

rate of teen-agers in much of the world. Scientists have begun to ask

whether the use of steroids by young athletes or the delayed puberty

found among gymnasts and ballet dancers can effect the development of

personality and adult behavior.33 Studies of animals indicate that, in many

species, the neurotransmitter systems of the brain, and especially the

pre-frontal cortex, are significantly remodeled during puberty. In humans

this rearrangement is thought to be connected to adolescent changes in

decision-making, risk taking, planning, drug sensitivity and reward

incentive. Clearly, a male who fails to go through puberty will not have a

typically masculine personality – an aspect of the Byzantine eunuch that

is noted in many sources.

Scientists are still not clear about exactly what triggers puberty in

humans. It seems to be related to GnRH, a decapeptide produced by

specialized neurons in the hypothalamus. These act on the pituitary,

causing it to release LH and FSH which make the testes and ovaries

develop. These then release hormones that act on the brain. Obviously

this has serious implications for those eunuchs who are castrated before

puberty. Since they lack testes this circular hormone-driven system

cannot develop. To what extent might castration reshape these eunuchs'

mental processes and personalities? Perhaps the pejorative writings that

say that eunuchs have personalities that differ from those of testiculated

men should be given some credence.34

33
Russell D. Romeo, Heather N. Richardson, and Cheryl L.Sisk, "Puberty and the
Maturation of the Male Brain and Sexual Behavior: Recasting a Behavioral Potential,"
Neuroscience and Biobehavioral Reviews, v. 26 (2002): 381-391.
34
L.P. Spear, "The Adolescent Brain and Age-related Behavioral Manifestations,"
Neuroscience and Biobehavioral Review, v. 24 (2000): 417-463; C. L. Sisk, and D. L.

19
 The most obvious neural developments that are of interest

regarding eunuchs are those that shape sexual behavior. The neural

circuitry that differentiates males from females is laid down during the

prenatal period. At puberty, however, the gonadal steroids both activate

and further organize this neural circuitry. If this does not take place, no

amount of hormone replacement or sexual experience can reverse this

deficit. This is clear in modern studies of animal models. Those castrated

before puberty never become sexually active, nor do they develop

behaviors that are associated with mating behavior, even if they are

treated with hormones. Those castrated after puberty, if treated with

hormones, develop some measure of sexual behavior. The ancients

realized this,35 even though they rarely make a linguistic distinction

between eunuchs castrated before puberty and those castrated after

puberty – at least they do not make a distinction that we can detect.

Leaving aside sexual behavior, which is fairly obvious, does lack of

normal puberty in the pre-pubertial castrate lead to any other differences

in cognitive ability or personality? Studies using tests that target the

orbital prefrontal cortex, an area that is extensively remodeled at puberty,

show that men with low levels of testosterone approach problems in a

careful, conservative way and resist the temptation to take chances.36

They also perform better when faced with spatial tasks, and may have

Foster, "The Neural Basis of Puberty and Adolescence," Nature Neuroscience, v. 7, n. 10

(2004): 1040-1047.
35
See, for example, Alexander of Aphrodisias, Problematum physicorum et medicorum
eclogae. Libri 1-2. In Physici et medici graeci minores, ed. J. L. Ideler, vol. I: p. 8, sec. 9.
1841-42. (Reprint, Amsterdam, 1963).
36
Rebecca Reavis and William H. Overman, "Adult Sex Differences on a Decision-Making
Task Previously Shown to Depend on the Orbital Prefrontal Cortex," Behavioral
neuroscience, v. 115, n. 1 (2001): 196-206.

20
superior mathematical ability.37 In rats lack of testosterone leads to an

increased fear response.38 These reflect characteristics attributed to the

Byzantine eunuch. He is credited with having certain specific intellectual

gifts and assumed to be "cowardly" in his behavior. As to the eunuch's

personality, modern neurosciences do not as yet offer enough information

for us to make any inferences. There is speculation, however, that during

adolescence a network develops in the brain that regulates the processing

of social information. If this regulatory process does not develop and

work properly, an individual can develop mood and anxiety disorders.39

It is easy to assume that the pejorative language that our sources

use about eunuchs reflects a social world that is dominated by masculine

values and thus devalues anything or any one who exhibits traits that

might appear to be feminine. It is also easy to assume that this

pejorative language has its roots in envy. Yet medical science offers

insights that urge us to reevaluate some of the rhetoric that our sources

use about eunuchs. To some Byzantine observers they appear to be

unhealthy and deformed. To others they exhibit youthful grace and

beauty. Both are medically possible, reflecting stages in a eunuch's life.

It is clear that many Byzantine observers find eunuchs' personalities

disagreeable. Given what medical science can tell us so far, it is quite

possible that many eunuchs had immature, unstable personalities.

37
Catherine Gouchie and Doreen Kimura, "The Relationship Between Testosterone Levels
and Cognitive Ability Patterns," Psychoneuroendocrinology, v. 16, n. 4 (1991): 323-
334.
38
J. A. King, W. L. De Oliveira, and N. Patel, "Deficits in Testosterone Facilitate Enhanced
Fear Response," Psychoneuroendocrinology, v. 30, n. 4 (2005): 333-340.
39
E. E. Nelson, E. Leibenluft, E. B. McClure EB, and D. S. Pine, "The social re-orientation
of adolescence: a neuroscience perspective on the process and its relation to
psychopathology," Psychological Medicine, v. 35, n. 2 (2005): 163-174.

21
 In any case, it is clear that the Byzantine eunuch is different from a

normal man. His is a constructed gender category, and he, himself, is the

result of a deliberate act of creation, an act of man rather than of God.

This leaves us with a wealth of questions that can still be asked about the

Byzantine eunuch. To what extent did Byzantine society consider

castration to be a creative act? To what extent did the Byzantines

understand the importance of the age at which castrations took place?

Did they create eunuchs specifically for particular social roles – perfect

servant, skilled warrior, bureaucrat, attractive court decoration, etc.?

Why are the Byzantines so reluctant to talk about castrations, eunuchs'

medical problems, their deaths? Is it because eunuchs are perceived to

be created beings who are ephemeral, who live outside the normal human

life cycle of birth, reproduction, and death, with the result that these

facets of their lives cannot be mentioned? What does all of this suggest

about the Byzantines' attitudes about what is natural and unnatural,

whether it is morally right to manipulate a mans' body and use it to create

something new? Finally, what does it tell us about the Byzantines'

attitude toward sexuality? If we are to judge by the presence of eunuchs

in Byzantine society, sexuality is a privilege, not a right. It is something

that can legitimately be dispensed with in order to achieve higher spiritual

and aesthetic goals.

22