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Archive Papers

Sexology: From Italy to Europe and the World

by Erwin J. Haeberle

Summary Italy can very well be considered the mother country of modern sex research. Ancient Greek and Roman knowledge about human sexual anatomy and physiology was preserved by Islamic physicians and scholars. Their works, together with those of Hippocrates, Galen, Soranus and others, formed the basis for the curriculum of the Medical School at Salerno which, beginning in the 13th century. set the standards for the rest of Europe. In the late 15th and early 16th centuries, Leonardo da Vinci, "the first sexologist", was one of the scientific pioneers who began to dissect and explore the human sexual and reproductive anatomy. In the 16th century, Gabriele Fallopio and his colleagues produced revolutionary advances in this new field. In the late 19th century, Paolo Mantegazza broadened the traditional medical approach by developing an anthropological perspective of human sexuality, thereby becoming the first true sexologist in the modern sense. Italy also produced the first scientific journal devoted entirely to sexual questions: "Archivio delle psicopatie sessuali", edited by the Naples psychiatrist Pasquale Penta (1896). These precedents finally allowed the Berlin physician Iwan Bloch in 1907 to develop the concept of sexology as an interdisciplinary science in its own right. His colleague Magnus Hirschfeld in 1908 then edited the first Journal of Sexology, and it is no coincidence that he solicited and received contributions from the "grand old men" Mantegazza and Lombroso. The German sexologists, in turn, whose work was destroyed by the Nazis, themselves set a precedent for the rebirth of sexology in the USA. Indeed, some of its most prominent and influential figures like Harry Benjamin, Ernst Gräfenberg and Hans Lehfeldt had come to New York from Berlin. The success of American sexology restimulated corresponding efforts in Europe, and today sexology is an international academic enterprise with a promising future. In 1992, Italy again played a pioneering role as the host country of the first congress of a new European Federation of Sexology.

The first sexologist in the modern sense of the word also proved to be a great patriot when he said: "There is more and better love in Italy than in all the rest of the world because ours is the country of beauty and art" (Mantegazza, 1936: 236).

This man had spent many years in South America and had traveled widely from Lapland to India. He was not only an expert on love, but also a physician, anthropologist, politician and writer, and judging from his literary style, he was an energetic, enthusiastic, indeed passionate man, a bold innovator and fearless crusader for the human right to the pursuit of happiness. In short, Paolo Mantegazza (1831-1910) was not only a pioneer in his time, but can still serve as a role model for sexologists in our own time. This does not mean that we still have to accept all of his ideas. Indeed, some of them have, in the meantime, become truly unfashionable. Whether he was right about Italy, we foreigners may discover in the course of this congress.

However, before we take a closer look at Mantegazza, we should perhaps briefly recall the historical antecedents of sex research in Italy. After all, Rome was the cradle of our Western civilization, its art and its science, and even after the decline and fall of the Roman empire, much of its culture survived into the Middle Ages.

Ancient Greek and Roman sexological knowledge was preserved and expanded by Islamic physicians, not only in the Middle East, but also in Europe. Moorish Spain, Sicily and other parts of the Mediterranean profited from Islamic scholarship, especially under the reign of the Hohenstaufen Emperor Frederick II, who assembled great minds from many cultures at his court in Sicily. The ancient health resort of Salerno, under the influence of Arabic writings, gradually became a center of progressive medicine and thus earned the name Civitas Hippocratica or Hippocratic city. In 1224 the emperor gave it the sole right to award medical degrees, and thus its standards were eagerly followed everywhere. The extensive Islamic and Jewish sexological literature of the time cannot be summarized, let alone analyzed, here. Suffice it to say, that, by way of Italy, it eventually reached and influenced most European universities.

Still, it was only 200 years later that a beginning Renaissance of original Greek and Roman ideals prompted a critical reexamination of traditional teachings and led to independent new research. Again, Italy played the pioneering role and produced a rare flowering of artistic and scientific talent. The greatest of these was undoubtedly the very model of "the Renaissance man", Leonardo da Vinci. Excelling in both the arts and the sciences, he turned his attention not only to the appearance, but also to the inner workings of the human body.

Leonardo began his anatomical studies in Milan in the late 1480s, continued them in Florence and eventually right here in Rome, apparently at the Ospedale di Santo Spirito. However, as a result of slanderous rumors spread by a jealous German mirror-maker, he was eventually barred from the hospital and thereafter did not return to these studies. He left Rome in 1515. It seems that the number of bodies that he was personally able to dissect was small, but he probaly attended other dissections as an observer. Indeed, it seems that he had planned to publish an anatomical treatise. Unfortunately, like so many of his other works, it was never completed. Nevertheless, he left a magnificent collection of anatomical drawing which, due to the vicissitudes of history, came into the possession of the English royal family. Today, they are kept at Windsor castle, and various expensive as well as more popular editions have been printed. Indeed, Leornardo's drawings of coitus and the developing fetus have become staple features in many modern sexological textbooks.

From the standpoint of modern science, the drawings are not always correct, but their artistic value is now appreciated as perhaps never before. In any case, they are a lasting testimony to the inquisitiveness of a great mind which recognized no conventional boundaries and thus naturally also tried to solve the mysteries of sex. In this sense, it is undoubtedly correct to consider Leonardo a pioneer of sexology (Dalma, 1972).

Three pioneers who explored the human sexual anatomy

1. In Milan, Florence, and Rome: Leonardo da Vinci (1452-1519). [70K]	2. In Padua: Andreas Vesalius (1514-1564). [71K]	3. In Padua: Gabriele Fallopio (1522-1562). [56K]

The exact anatomical details of the male and female bodies were revealed shortly thereafter by the first great anatomists, especially the Belgian-born Andreas Vesalius at the University of Padua and his successors. One of the most interesting of these is Gabriele Fallopio, the discoverer of the ovarian tubes now bearing his name (Fallopian tubes). He was also an early expert on the new luetic infections and, in this context, is said to have invented the forerunner of the condom. In his book "De Morbo Gallico" (the French disease), published in 1564, two years after his death, he writes:

"As often as a man has intercourse, he should (if possible) wash the genitals, or wipe them with a cloth; afterward he should use a small linen cloth made to fit the glans, and draw forward the prepuce over the glans; if he can do so, it is well to moisten it with saliva or with a lotion.... I tried the experiment on eleven hundred men, and I call immortal God to witness that not one of them was infected (Fallopio, quoted in Himes, 1970: 190)".

Later improvements on this invention gradually made it more similar to the condom we know today, but until well into the l9th century it was mainly used for its original purpose as a protective device against infection. Its use as a contraceptive was a late development, and, in the meantime, this development has come full circle: Many many goverments all over the world today recommend it mostly for the protection against sexually transmitted diseases, especially AIDS. It was also in Padua, by the way, where Hieronymus Fracastor in 1530 had written his poem "Syphilis", which gave the Morbus Gallicus its now more familiar name.

For a considerable time thereafter, the Italian medical schools and universities remained models for the rest of the world, and one has only to mention the name of Galileo Galilei to be reminded that Italy continued to make significant contributions to the development of modern science. However, as far as the study of human sexuality is concerned, nothing really revolutionary happened anywhere in Europe until well into the 19th century.

Paolo Mantegazza (1831-1910)	American edition of Mantegazza's "Gli amori degli uomini".

In 1854, the young Italian physician Paolo Mantegazza wrote a substantial book on the "Fisiologia del Piacere" (Physiology of Pleasure), a work that would prepare him for the monumental task of writing the "Trilogy of Love" for which he is still remembered today. At the height of his academic career, he produced three volumes which made him both famous and infamous outside the academic world: "Fisiologia dell' amore" (1872), "Igiene dell' amore" (1877), and "Gli amori degli uomini" (1885). Already the first of these is no dry professonial treatise on anatomy and physiology, but a quasi-philosophical essay on the many facets of love through the ages and in many cultures, its written and unwritten laws, customs, joys and sorrows. The praise of Italy I quoted at the beginning is taken from this book which contains many more maxims, aphorisms and observations, for example this one:

"Marrying to spite someone is like killing one's self to take revenge on an enemy" (Mantegazza, 1936: 217) or:

"When a young man marries an old woman and an old man a young woman, it is almost always a business deal..." (op. cit.: 218) or:

"Never believe a woman who wants to know all about your past, swearing to love you just the same. Sincerity and frankness do not require you to serve a friend with the mud from your shoes, and who hasn't acquired a little mud in some bog of the moral world?" (ibidem).

As we can see, Mantegazza did not only want to provide information, but also give practical advice based on wide experience and long reflection. This becomes even more apparent in the two following volumes. Especially the third and last volume on the many forms of love among human beings analyzes and distills vast amounts of historical and ethnological information in order to arrive at some practical sexual philosophy that would benefit the average reader.

It is this third volume that constitutes the first true sexological work in our modern sense. True, Wilhelm von Humboldt, about 50 years earlier, had planned a similarly thorough and ambitious work, a "History of Dependency in the Human Race" exemplified by the relations between women and men. This would have been the original sexological classic, but Humboldt never executed his plan (Humboldt, 1908). Thus, the title of pioneer goes to Mantegazza.

In order to appreciate his accomplishment, one should see it in its biographical context: Mantegazza, as a result of his own ethnological studies in South America, became interested in cross-cultural studies. Thus, he became one of the founders of the new science of anthropology and was, indeed, the first professor of anthropology in Florence, the founder of the first Italian Society of Anthropology, the creator of the first Italian Museum of Anthropology and the editor of an anthropological journal. He was also active in politics, first as a deputy in the Italian parliament, later as a member of the senate. His active interest in public health is evident in his study of poverty and infectious diseases. In fact, to his contemporaries he was known as the "Apostle of State Hygiene". In this, as in other respects, he very much resembled his contemporary Rudolf Virchow in Berlin, who was also a pioneer in public health and was active in politics. For both Virchow and Mantegazza, moreover, anthropology and medicine were twin sciences, each helpless and forlorn without the other, and in this respect they had a much larger vision of their academic duties than most of their successors.

In the case of Mantegazza, his broader view allowed him to study sexual phenomena outside the narrow confines of traditional medicine. He saw that many prohibited and condemned forms of human sexual activity were and always had been universal, and that greater tolerance, if not approval, was called for even in the Christian occident. In other respects, however, he remained an uncritical child of his time. His condemnation of masturbation and love between men, for example, are cases in point. Even so, he lovingly provided so many touching case histories and historical examples that very often he undermined his own argument. And in South America he himself innocently acquired a habit that would win him few friends today: "I prefer a life of ten years with Coca to a life of centuries without Coca" (Mantegazza quoted in Robinson, 1935). In later life, his close collaboration with the now widely discredited Cesare Lombroso also calls into question some of his judgement.

Nevertheless, some of his other pronouncements are as topical as ever. For example, his respect for other cultures does not prevent him from condemning certain ancient customs:

"The clitoris was, and still is, cut off in many countries and among many different races, with the sole purpose of rendering women less voluptuously inclined and therefore more readily faithful....lt would be hard to imagine a more selfish form of perversion, when one stops to think that love is a joy meant for two, and that to suppress our companion's pleasure in the act is cruel and barbarous...." (Mantegazza, 1935: 121-122).

Not only this last volume, but the whole "Trilogy of Love" is a mixture of such radical and many conventional ideas, and as such it is a unique document of sexology in its nascent state. At the time, Mantegazza was mercilessly attacked and vilified for his efforts. Indeed, there was talk of depriving him of his professorship and his seat in the Italian Senate. At one point, he felt like "packing (his) luggage and emigrating" (8). In the end, however, he stayed, and the storm of public indignation died down. Reading the work today, we become aware of the difficult birth of our science, of the many external obstacles it had to overcome, but also of the internal, everpresent danger of unqestioned assumptions. Of course, today we also make such assumptions, and therefore, a hundred years hence, our own conclusions will also seem dated.

The fact that Mantegazza truly stands at the beginning of our science is perhaps best illustrated by a curious, apparently negligeable, but actually very significant circumstance over which he had no control. As repeatedly mentioned, his trilogy was devoted to the study of love, or, in the Italian original, "amore": The Physiology of Love, The Hygiene of Love, and The Loves of Mankind. For the American edition of this latter work, the original title "Gli amori degli uomini", was translated as "The Sexual Relations of Mankind" (Mantegazza, 1935). This, at first glance, innocuous change from "amori" to "sexual relations" actually marks a profound conceptual shift that occurred in the Western world at the time. It defined the very moment when the ancient ars amatoria was cast aside in favor of a new scientia sexualis. "Love" mysterious and ever elusive, seemed too vague and emotional a subject to be approached by science. In its place now appeared "sex" a more technical and neutral, less disturbing phenomenon, that could be examined in a more sober and controlled fashion. "Love" had lent itself to philosophizing, "sexual relations" could be classified and counted. Soon, all sorts of other, more " modern" terms made their appearance. Greek love became "homosexuality", lovemaking turned into "sexual intercourse", vice into "sexual psychopathology", attractiveness into "sex appeal", chastity into "hyposexuality" or "lack of sexual desire". Learning to understand one's own body was now called "sex education", teaching the art of love, "sex therapy". A new science of sex started to measure, to calculate, and to add up; it conducted surveys about "sexual behavior", wanting to know how many women and men did what how often with whom. In short, there began an era of quantification, of numbers and percentages that created its own terminology, indeed its own objects of study.

It took a long time until the new sexologists realized that the new concept of "sexuality" was just as elusive as the old one of "love" had been, that it was not a solid object so much as a projection of their own new view of the world. In fact, both the concept of "sexuality" and sexology, the science devoted to its explanation, were creations of l9th-century Western civilization. Both were unthinkable before this time and anywhere else on the globe. The same is true, of course, for several other modern sciences, such as sociology and its object "society", psychology and its object "psyche", economics and its object "economy", or political science and its object "politics". In each case, the research object is not anything real found in the natural world, but a cultural construct arising out of a specific historical situation, namely that of the Western industrialized countries at a certain stage of productivity. In other words, in the cases mentioned, the seemingly solid and immutable scientific object is produced, defined and maintained by the research methods invented for and applied to it.

The construct of "human sexuality" may actually be the most informative example in this respect. It characterizes our present culture as clearly as the idea of "love" had characterized the preindustrialized world. Mantegazza stood at the threshold of our new world. He still spoke of love, but was translated as having spoken of "sexual relations". Thus, probably inspite of himself, he is a truly pivotal figure in Western intellectual history.

Interestingly enough, there are some indications that the dominance of the global concept of "sex" over our scientific thinking may gradually come to an end. When, in the 1950s, John Money began to differentiate between "sex" and "gender " and more recently even began to speak of "love sickness" and "love maps", he may very well have heralded another conceptual shift that could reveal its full implications in the next millenium. But before we speculate about our future, let us return once more to our past.

Once Mantegazza had enlarged the traditional medical perspective, the foundation was laid for a more comprehensive science of sex in its own right. It was Iwan Bloch, a Berlin dermatologist, who, in 1907, introduced the concept of "Sexualwissenschaft" or sexology, an interdisciplinary academic enterprise that would combine the approaches of both the natural and the social sciences. Bloch, a man of enormous erudition with a private library of ca. 40 000 books, realized that sexual phenomena had to be studied in their socio-historical context, and that the mere collection and interpretation of medical case histories could never discover their true significance. The phenomenon of prostitution, for example, could never be understood by merely studying prostitutes and their customers. It was equally important to examine the history, present organization, legal status and economic role of prostitution in any given society. Certainly, in the sexual transaction itself there were biological factors to be studied (the individual sexual capacities and motivations of the persons involved), but its true meaning could be revealed only by considering the larger cultural issues. Thus, prostitution, like the ancient Roman god Janus, had two faces, one of which looked toward the natural, the other to the social world. Therefore, only the collaboration between natural and social scientists could hope to do justice to both. And this was true of any other manifestation of human sexuality.

Bloch's new concept was eagerly embraced by his colleagues, and thus only one year later, in 1908, Magnus Hirschfeld was able to publish the first "Zeitschrift für Sexualwissenschaft" (Journal for Sexology). This pioneering journal solicited not only medical articles - among them contributions by Mantegazza and Lombroso -, but also ethnological, legal, historical, philosophical, literary and philological essays. Most important in our present context, it contained a lengthy tribute to yet another Italian sexological pioneer:

Pasquale Penta (1859-1904), a psychiatrist in Naples, had been the first to publish a scientific journal devoted entirely to sexual questions, the "Archivio delle psicopatie sessuali". This journal appeared for eight years from 1896 to 1904, when the untimely death of its editor abruptly ended its most promising run. Penta not only printed orignal contributions, but tried to familiarize his readers with all relevant sexological research - whether Italian or foreign - by means of regular, objective summaries. It was especially this last feature that most impressed his fellow sexologists (Näcke. 1908).

Two publications by Pasquale Penta: Left: "Male Sexual Perversions" (1893) - Right: The journal "Archive of Sexual Psychopathologies" (1896)

Hirschfeld's journal survived for only one year, but was refounded in 1914 by Bloch and Albert Eulenburg. Later taken over by Max Marcuse, it continued to appear until 1932, when the growing Nazi menace forced it to cease publication. Hirschfeld, in 1919, had opened the first Institute for Sexology in Berlin, and in 1921 had convened the first international sexological congress in that same city. A second Berlin congress, organized by Albert Moll in 1926, even held its opening ceremony in the plenary hall of the Reichstag. However, when Hitler came to power in 1933, the first great phase of sexology quickly came to an end (Haeberle, 1981; 1982; 1983; 1984; 1985). Hirschfeld, Moll, Marcuse and many of their colleagues were Jews, and when Hirschfeld's Institute was plundered and closed by the Nazis, nearly all of them fled into exile, some to Palestine, Egypt, France, the Netherlands, Switzerland, Scandinavia or the Soviet Union, and some to the United States. The Berlin-born Harry Benjamin, for example, who had emigrated to New York as early as 1913, was now able to welcome some distinguished colleagues, first Hirschfeld, who only travelled through, and later Ernst Gräfenberg and Hans Lehfeldt who stayed. The former, a pioneer of the IUD ("Gräfenberg-Ring") has now become better known as the discoverer of the "Gräfenberg spot" (G-spot); the latter was instrumental in founding the Society for the Scientific Study of Sex (SSSS) and in organizing the first World Congress of Sexology in Paris 1974. Four years later, in 1978, this congress took place right here in Rome. The rest of the story of sexology in the USA is too well known to be repeated here. The names of Alfred C. Kinsey, Masters & Johnson, Helen Kaplan and John Money may suffice to hint at the enormous progress that has since been made. Let me therefore return to Europe and close by calling your attention to another sexological milestone in Italy. Four years ago, in 1992, Taormina hosted the first congress of a newly founded European Federation of Sexology, which by now, has over 60 member institutions and organizations, and which, in the meantime, has held two more congresses in Copenhagen and Marseille. Not only that: Italy, France, Spain, Belgium, Great Britain and Sweden - to name only member countries of the European Union - now have various academic training programs leading to legitimate academic degress in medical and non-medical sex therapy as well as in sex education. Similar programs exist in the USA and several Latin American countries. Even the Far East can now boast of an Asian Federation for Sexology. All of this augurs well for the future of sexology in the next millenium.

Will the expected scientific advances also mean an increase in human happiness? Here in Italy, it seems obvious to me that Mantegazza was right: "However science may progress, love will always remain an art" Mantegazza, 1936: 237).

Bibliography

Dalma, J.. 1972, "Leonardo da Vinci, precursor de psicología, neurofisiología, biodinámica de las poblaciones, sexología", Boletín de la Academia Nacional de Ciencias Córdoba. 49: 80-112.

Haeberle, E. J., 1981, "Geschiedenis en koncept van de seksuologie", Tijdschrift voor Seksuologie, 6, 2: 71-78.

Haeberle, E. J., 1981, "Swastika, Pink Triangle, and Yellow Star: The Destruction of Sexology and the Persecution of Homosexuals in Nazi Germany", Journal of Sex Research, 17, 3: 270-287.

Haeberle, E. J., 1982, "The Jewish Contribution to the Development of Sexology", Journal of Sex Research, 18, 4: 305-323.

Haeberle, E. J., 1983, Anfänge der Sexualwissenschaft, Berlin, de Gruyter.

Haeberle, E. J., 1984, "Sexology: Conception, Birth and Growth of a Science", in Segraves, R. T.. Haeberle, E. J. (Eds.), Emerging Dimensions of Sexology, New York. Praeger: 9-28.

Haeberle, E. J., 1985, "Sexualwissenschaft als Kulturwissenschaft: Zur Diskussion vor 1933", in Gindorf, R. and Haeberle, E. J (Eds.). Sexualität als sozialer Tatbestand, Berlin, de Gruyter: 37-54.

Himes. N., 1970 (orig. 1936), Medical History of Contraception, New York, Schocken Books.

Humboldt, W. von, 1908 (orig. 1826/27), "Geschichte der Abhängigkeit im Menschengeschlechte", Humboldt, Gesammelte Schriften, 7, Berlin, Königlich Preussische Akademie der Wissenschaften: 653-654.

Mantegazza, P., 1935, The Sexual Relations of Mankind, New York, Eugenics Publishing Company, tr. it. "Gli amori degli uomini", 1885.

Mantegazza, P., 1936, Physiology of Love, New York, Eugenics Publishing Company. tr. it. "Igiene dell'amore", 1877.

Näcke, Paul, 1908, "Penta als einer der besten Kenner und Förderer der Sexualwissenschaft", Zeitschrift für Sexualwissenschaft, 1, 2: 7481.

Robinson, V., 1935, "Introduction", in Mantegazza, 1935, The Sexual Relations of Mankind (see above).

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