Oribasius and Rufus treat men's sexual health

Rufus of Ephesus was likely practicing in ancient Alexandria or in ancient Ephesus. Some of his writings are preserved by Oribasius and Aetius, and in some of those, Rufus preserves patient concerns. Here, he records his interactions with several young men who are concerned about their sexual health, and the testimony provides some examples of how Rufus thinks through diagnosis and treatment. The text is part of a larger section in book 11 of Aetius on drugs related to sexual health and well-being.

Oribasius’ Sexual Stimulants

Equal parts of pepper, parsley, filings from dried deer’s testicle, and terebinth. Combine with honey and give with wine to drink.

Another. Burn a gecko, grind, then add it to oil. Rub the oil onto the big toe of your right foot and have sexual intercourse. If you want to stop the effects, wash your toe.

Another from the same. Rub hare’s suet or lion’s lard onto your genitals. Then take three grains of pepper together with juice of tragacanth gum, and apply to your testicles, perineum, and lower back.

From the works of Rufus, an effective ointment that excites the genitals.

Take one drachma of myrrh, unburnt sulphur, and the inner part of the knēkō plant, two obols of pyrethrum, two drachmas of melanthinon, thirty grains of pepper, and twenty grains of nettle, cleaned. Chop them up and grind with one drachma of squill, melt one ounce of wax and with eight ounces of castor oil; add also three ounces of honey and use [1]. After intercourse, the areas are wiped clean with a cloth. Some also apply this ointment to their buttocks.

Rufus also adds the following: “it is easy,” he says, “to find a therapy here for those who are unable to engage in sexual activity. A youth came to me once and said that he really wanted to have sex, but when he enaged in it, he could not ejaculate and lost a great deal of breath. I took this as an indication of dryness of the spermatic vessels and the treatment showed that I was right. For by using a moist diet productive of good humours, he was able to ejaculate. Another twenty-year-old youth said that when he had sex with a woman, he was not able to ejaculate, but when he was asleep, he frequently had wet dreams. It seemed to me that the spermatic parts we not being heated during intercourse due to the excessive moisture accompanied by cooling [2], since the heat is being dissipated along the surface of the body. During sleep, on the other hand, they become hotter, because dreams are able to heat the inside parts of the body and cool the outside parts. So I recommended that this man exercise his lower parts and ride horses, drink castoreum, and adopt a diet that was wholly warm and dry.”

Ὀριβασίου ἐντατικόν.

Πεπέρεως, πετροσελίνου, ἐλαφείου αἰδοίου ῥινίσματος ξηροῦ, τερεβινθίνης ἴσα· μέλιτι ἀναλάμβανε καὶ δίδου πίνειν μετ' οἴνου.

Ἄλλο· Ἀσκαλαβώτην καύσας, λεάνας, εἶτα ἐπιβαλὼν ἔλαιον, χρίσον τοῦ δεξιοῦ ποδὸς τὸν μεγαδάκτυλον καὶ συγγίνου· εἰ δὲ βούλει παύσασθαι, ἀπόπλυνε τὸν δάκτυλον.

Ἄλλο τοῦ αὐτοῦ. Λαγωοῦ πιτύαν ἢ λέοντος στέαρ χρίε τὸ αἰδοῖον· εἶτα τρία ἅμα πεπέρεα μετὰ χυλοῦ τραγακάνθης, χρίε τοὺς διδύμους καὶ περίναιον καὶ ὀσφῦν.

Ἐκ τῶν Ῥούφου χρίσμα ἐνεργὸν, ἐντεῖνον τὸ αἰδοῖον.

Σμύρνης, θείου ἀπύρου, κνήκου τοῦ ἐντὸς ἀνὰ 𐅻 αʹ, πυρέθρου ὀβολοὺς βʹ, μελάνθιον 𐅻 βʹ, πεπέρεως κόκκοι λʹ, κνίδιοι κόκκοι κεκαθαρμένοι κʹ· κόψας καὶ λεάνας ἅμα σκίλλης 𐅻 αʹ, καὶ τήξας κηροῦ οὐγγ. αʹ μετὰ ἐλαίου κικίνου οὐγγ. ηʹ ἐπίβαλε καὶ μέλιτος οὐγγ. γʹ, καὶ χρῶ· μετὰ δὲ τὴν μίξιν ὀθονίῳ ἀκριβῶς ἐκμασσέσθωσαν οἱ τόποι· ἔνιοι δὲ καὶ τῷ χρίσματι τούτῳ τῆς ἕδρας προσάπτονται.

Προστίθησι δὲ ὁ Ῥοῦφος καὶ ταῦτα· εὔκολον δέ φησι κἀντεῦθεν θεραπείας εὑρίσκεσθαι τοῖς οὐ δυναμένοις ἀφροδισιάζειν· νεανίσκος γάρ τις ἀφικόμενος πρὸς ἡμᾶς ἔφη, καὶ πάνυ μὲν ἐφίεσθαι μιγῆναι, μισγόμενος δὲ γονὴν μὲν μὴ ἀφιέναι, πνεύματα δὲ πολλὰ ἀπολλύειν. Τούτῳ ἐτεκμαιρόμην ξηρότητα εἶναι τῶν σπερματικῶν ἀγγείων, καὶ ἔδειξεν ἡ ἴασις· ὑγρᾷ γὰρ καὶ εὐχύμῳ διαίτῃ χρησάμενος ἐξέκρινε τὴν γονήν. Ἕτερος δὲ νεανίσκος εἰκοσαέτης ἔλεγεν, εἰ μὲν μίσγοιτο γυναικὶ, μὴ δύνασθαι γονὴν ἀφιέναι, καθεύδοντι δὲ πολὺ ὑπέρχεσθαι τοῦ σπέρματος. Ἐδόκει δέ μοι διὰ πολλὴν ὑγρότητα μετὰ ψύξεως μὴ θερμαίνεσθαι τὰ σπερματικὰ μόρια, ἐν ταῖς μίξεσι χεομένης περὶ τὴν τοῦ σώματος ἐπιφάνειαν τῆς θερμασίας, ἐν τοῖς ὕπνοις δὲ θερμαίνεσθαι πλέον, καθότι δύνανται ὕπνοι τὰ μὲν ἔσωθεν θερμαίνειν, τὰ δὲ ἔξωθεν ψύχειν. Ἐκέλευσα δὲ τοῦτον γυμνάζεσθαι τὰ κάτω μέρη καὶ ἱππάζεσθαι, καστόριον δὲ πίνειν καὶ διαίτῃ πάσῃ κεχρῆσθαι θερμῇ καὶ ξηρᾷ.

Aetius of Amida, Medical Books XI.35, p. 581 & 126 Rouelle

[1] It is not stated explicitly when the ingredients are mixed in with the oil.

[2] The word can also mean “embarassment,” but I’m wary to read it this way.

Rufus of Ephesus on Sexual Health

On Sexual Activity from the works of Rufus (of Ephesus).

Sex is indeed a natural act, while nothing natural is harmful. But intimacy becomes harmful when it is immoderate and frequent and when it is engaged in at inappropriate times. Frequent intimacy is especially harmful for those who have weakness in the nerve-like parts, such as the chest, kidneys, lower back, hip region, or legs. Here also are some indications [it is harmful]: a person's whole strength becomes weaker during intimacy, but strength is the innate heat within us, hence concoction does not happen as well for those engaging in intercourse, and they become extremely pale and do not see or hear as they should, nor do they have any other strong sensation. Indeed, such people are forgetful and trembling, their joints painful, especially in the hip area; some also develop kidney disease, others have illness in the bladder, some develop thrush-like sores around the mouth, tooth pain, or inflammation of the tonsils; many men ejaculate blood after excessive sexual activity, some due to the violent retention and tension of pneuma, some due to the interaction of the veins and arteries running from the chest to the testicles. Women however ejaculate very little blood during intercourse due to the overall moistness of their bodies, due to the fact that they do not exert themselves as much during intercourse, and due to their regular discharges below, so that even if a woman happens to ejaculate blood, the discharges are a great healing factor for her. For these reasons, the good doctors will recommend that if any of the illnesses mentioned are present or if they are anticipated due to the natural weakness of the person, that they should abstain from sexual activity.

So far, I have spoken about the harms and co-affections (lit. sympathies) of sexual activity, to the extent that as I was able to do so succinctly. Now, we must speak about its benefits. For sexual activity is not always harmful if one takes into consideration the timing, measure, and overall health of the person engaging in intimacy. The benefits of sexual activity are these: to relieve fullness, to provide the body with lightness, to stimulate growth, and to bring about a more manly appearance. And for those in a hardened (tense) state, intimacy at regular intervals is beneficial: it softens (relaxes?) the organs, widens the pores, and removes some phlegm; it breaks up coagulated thoughts and relaxes intense desires. Hence, for a melancholic, depressed, and misanthropic person, sexual intercourse can serve as the most significant and suitable remedy. It can bring to a more moderate state of mind those driven mad in other ways, halt some epileptic symptoms, and relieve those suffering from a weary head and those with pains brought about during puberty. Hippocrates said, in a word, that sexual activity, “is the best remedy for illnesses from phlegm.” Many weakened people have been restored to health from illnesses due to intimacy, with some people’s breathing becoming easier instead of more difficult, and some people's appetite becoming better instead of worse. Some have even been freed from frequent nocturnal emissions. Natures suitable for sexual activity are warmer, more moist, and more actively disposed to intimacy than others, while least suitable are dry and cold; and the nature of those in their prime is right for it, but not the nature of those in their old age.

In terms of seasons, spring is appropriate, while autumn and summer are inappropriate. Winter is not too good either because it is cooling. Moreover, a warmer and moister diet is productive for sexual activity, while a drying and cooling diet is unproductive. Diets suitable for intercourse are appropriate for those who are unable to perform during intercourse. Therefore, the diet should be moist and warm, exertion should be moderate, and food should be plentiful. Wine therefore should be tawny in color and light in body, breads should be freshly baked and pure, meats, of young goats, lambs and pigs, poultry such as hens, thrushes, partridges, geese, and duck; of fish, octopus and whichever are called soft-bodied; of vegetables, sage, erysimon, rocket and turnip that is difficult to cook and has become tender (for these are also given as drugs); of legumes, bean, chick-peas, ochroi, phasiloi, pissoi, and loboi that are full of pneuma and provide plenty of nutrition. I also encourage adding the extremely excellent grape into the current diet; for it moistens and fills the body with blood and pneuma. But someone about to engage in sexual activity must avoid doing it on a full stomach, or with indigestion, drunkenness, or a lack of food. For it is bad to have intercourse when there are residues, one should avoid fatigue from the gym and bath, and recent vomiting and diarrhea from the belly. For these can be chronic when sexual activity causes dryness. The best intercourse happens with food but not after becoming full. For it contributes to strength and the chilling that occurs become less. If someone eagerly desires sex after breakfast, they should wait until the food settles; but if after dinner, it is necessary to sleep for a while. I do not encourage intense desires, and I rather recommend one resist them, especially those for whom it is an illness and are easily harmed by intimacy.

Περὶ ἀφροδισίων ἐκ τῶν Ῥούφου. Φυσικὸν μὲν ἔργον ἡ συνουσία ἐστίν, οὐδὲν δὲ τῶν φυσικῶν βλαβερόν· παρὰ δὲ τὴν ἄμετρόν τε καὶ συνεχῆ χρῆσιν καὶ κατὰ καιρὸν τὸν οὐ προσήκοντα παραλαμβανομένη βλαβερὰ γίγνεται, πολλῷ δὲ μᾶλλον βλαβερὰ ἡ συνεχὴς χρῆσις γίγνεται τοῖς τὸ νευρῶδες ἀσθενὲς ἔχουσιν ἢ θώρακα ἢ νεφροὺς ἢ ὀσφὺν ἢ ἰσχιάδα ἢ πόδας. ἔστω δέ σοι τεκμήρια καὶ τάδε· σύμπασα γὰρ ἡ ἰσχὺς τοῦ ἀνθρώπου ἀσθενεστέρα γίγνεται ἐν τῇ χρήσει· ἡ δὲ ἰσχύς ἐστι τὸ ἐν ἡμῖν ἔμφυτον θερμόν· ὅθεν αἱ πέψεις οὐκ ἀγαθαὶ τῷ μισγομένῳ καὶ ἔξωχροι γίγνονται καὶ οὔτε δεόντως ὁρῶσιν οὔτε ἀκούουσιν, ὡς χρή, οὐδὲ ἄλλην τινὰ αἴσθησιν ἐρρωμένην κέκτηνται καὶ μὲν δὴ καὶ ἐπιλήσμονες οἱ τοιοῦτοι καὶ τρομώδεις εἰσὶ καὶ τὰ ἄρθρα ὀδυνηροί, μάλιστα τὰ τῶν ἰσχίων, καὶ οἱ μὲν νεφριτικοὶ γίγνονται, οἱ δὲ καὶ κατὰ κύστιν νόσημα ἔχουσιν, τοῖς δὲ καὶ στόματα ἀφθώδη γίγνεται καὶ ὀδόντων πόνοι καὶ γαργαρεώνων φλεγμοναί· πολλοὶ δὲ ἄνδρες ἐπὶ τοῖς πολλοῖς ἀφροδισίοις καὶ αἷμα ἔπτυσαν, τὸ μέν τι τῇ βιαίῳ κατοχῇ τε καὶ ἐντάσει τοῦ πνεύματος, τὸ δέ τι τῇ κοινωνίᾳ τῶν ἀπὸ τοῦ θώρακος ἐπὶ τοὺς ὄρχεις φερομένων φλεβῶν καὶ ἀρτηριῶν. γυνὴ δὲ ἥκιστα ἐπὶ ταῖς μίξεσι πτύει αἷμα τῇ τε ἄλλῃ τοῦ σώματος ὑγρότητι καὶ τῷ ἧσσον πονεῖσθαι ἐν τῇ μίξει, καὶ διὰ τὰς εἰωθυίας κάτω καθάρσεις, ὥστε κἂν τύχῃ γυναῖκα πτύσαι αἷμα, μέγα ἴαμα αἱ καθάρσεις αὐτῇ γίγνονται. διὰ ταῦτα μὲν δὴ τὰ εἰρημένα παρακελεύονται τῶν ἰατρῶν οἱ ἀγαθοί, ἤν τε πάρεστι τι τῶν εἰρημένων νοσημάτων, ἤν τε προσδόκιμον ᾖ διὰ τὴν φυσικὴν ἀσθένειαν τοῦ ἀνθρώπου, ἀπέχεσθαι τῶν ἀφροδισίων.

ἄχρι μὲν δὴ τούτων τὰς βλάβας καὶ τὰς συμπαθείας, ἐφ' ὅσον δυνατὸν ἦν ἡμῖν διὰ βραχέων εἰπεῖν, εἰρήκαμεν· ῥητέον δὲ νῦν καὶ τὰς ὠφελείας· οὐ γὰρ παντάπασι κάκιστα τὰ ἀφροδίσιά ἐστιν, ἐὰν καὶ τὸν καιρὸν τῆς χρήσεως καὶ τὸ μέτρον καὶ τὴν ὑγιεινὴν κατάστασιν τοῦ χρωμένου σκοπεῖν ἐθέλοις. ὠφέλειαι δὲ αἱ ἐκ τῶν ἀφροδισίων εἰσὶν αἵδε· πλησμονήν τε κενῶσαι καὶ ἐλαφρὸν παρασχεῖν τὸ σῶμα καὶ εἰς αὔξησιν προτρέψαι καὶ ἀνδρωδέστερον ἀποφῆναι. καὶ τῇ δὲ σκληρᾷ ἕξει ἐκ διαλειμμάτων πλειόνων ἡ χρῆσις ὠφέλιμος· μαλάσσει γὰρ τὰ ὄργανα καὶ ἀνευρύνει τοὺς πόρους καί τι τοῦ φλέγματος ἐκκαθαίρει, καὶ συνεστηκότα δὲ λογισμὸν διαλύει καὶ ὀργὰς μεγίστας ἐπανίησι. διὸ καὶ τῷ μελαγχολικῷ καὶ κατηφεῖ καὶ μισανθρώπῳ ὄντι ὥς τι μέγιστον ἴαμα ἐπιτηδειότατον μίσγεσθαι. καθίστησι δ' εἰς τὸ σωφρονέστερον καὶ τοὺς κατ' ἄλλον τρόπον ἐκμανέντας καί τινας ἐπιλήπτους ἔπαυσε καὶ βαρυνομένους τὴν κεφαλὴν καὶ ἀλγοῦντας μεταβολῇ τοῦ ἡβάσκειν. Ἱπποκράτης δὲ ἑνὶ λόγῳ “τοῖς ἀπὸ φλέγματος νοσήμασιν εἶναι κράτιστα” ἀφροδίσια ἔφη. πολλοὶ δὲ καὶ ἐκ νόσων ἄτροφοι ἀνεκομίσθησαν ἐπὶ τῇ χρήσει· οἱ δὲ καὶ εὐπνούστεροι ἀντὶ δυσπνουστέρων ἐγένοντο, καὶ εὐσιτότεροι ἀντὶ ἀποσίτων· οἱ δὲ καὶ ὀνειρωγμῶν συνεχῶν ἀπηλλάγησαν. φύσεις δὲ πρὸς ἀφροδίσια ἐπιτήδειοι αἱ θερμότεραι καὶ ὑγρότεραι καὶ πλέον τῶν ἄλλων εἰς τὴν χρῆσιν εὔφοροι, ἥκιστα δὲ αἱ ξηραὶ καὶ ψυχραὶ καὶ ἡ μὲν τῶν ἀκμαζόντων εὔθετος, ἡ δὲ τῶν γερόντων οὐδαμῶς.

ὥρα δὲ τὸ μὲν ἔαρ ἐπιτήδειον. ἄθετον δὲ τὸ φθινόπωρον καὶ τὸ θέρος. ἀλλ' οὐδὲ ὁ χειμών ἐστιν ἀγαθὸς τῷ ψύχειν. καὶ δὴ καὶ δίαιτα ἡ θερμοτέρα καὶ ὑγροτέρα εἰς λαγνείαν εὔφορος, δύσφορος δὲ ἡ ξηραίνουσα καὶ ψύχουσα. αἱ γὰρ δίαιται πρὸς μίξεις τῷ ἀδυνάτῳ μίσγεσθαι ἐπιτήδειοι. χρὴ τοίνυν τὴν μὲν δίαιταν ὑγρὰν καὶ θερμὴν ὑπάρχειν· εἴη δ' ἂν πόνων μὲν μετριότης καὶ σίτου εὐωχία. οἶνος μὲν οὖν ἔστω κιρρὸς τῇ χροιᾷ, λεπτὸς δὲ τῇ συστάσει, ἄρτοι καθαροὶ ἰπνῖται πρόσφατοι, κρέα ἐρίφων καὶ ἀρνῶν καὶ χοίρων, πτηνὰ ἀλεκτορίδες ἀτταγῆνες πέρδικες χῆνες νῆσσαι· ἰχθύων δὲ οἱ πολύποδες καὶ ὅσα μαλακόσαρκα λέγεται· λαχάνων δὲ ὅρμινον ἐρύσιμον εὔζωμον γογγυλὶς δύσεφθος καὶ τακερὰ γενομένη (ταῦτα γὰρ καὶ ὡς φάρμακα δίδοται), ὀσπρίων δὲ κύαμοι ἐρέβινθοι ὦχροι φάσιλοι πισσοὶ λοβοὶ πνεύματός τε ἐμπιπλῶντες καὶ ἀφθονίαν τροφῆς παρασκευάζοντες. μεγάλως δὲ ἐπαινῶ καὶ τὴν καλλίστην σταφυλὴν εἰς τὴν νῦν δίαιταν· ὑγραίνει γὰρ καὶ αἵματος καὶ πνεύματος ἐμπίπλησι τὸ σῶμα. τὸν δὲ μέλλοντα ἀφροδισίοις χρῆσθαι πλησμονὰς προσφάτους φυλάττεσθαι χρὴ καὶ ἀπεψίας καὶ μέθας καὶ ἐνδείας. κακὸν γὰρ ἐπὶ περιττώμασι μίσγεσθαι καὶ ἀπὸ γυμνασίων καὶ λουτρῶν καὶ κόπους δὲ φυλακτέον καὶ ἐμέτους γεγενημένους καὶ διαρροίας γαστρὸς προσφάτους. τὰς γὰρ χρονίους ἐστὶν ὅτε ξηραίνει τὰ ἀφροδίσια. κάλλιστον δὲ τὸν μισγόμενον ἐπὶ σίτοις μίσγεσθαι μὴ ἐμπλησθέντα· καὶ γὰρ πρὸς ἰσχὺν συμφέρει καὶ αἱ γιγνόμεναι ψύξεις ἧσσον γίγνονται καὶ εἰ μὲν ἐπὶ τῷ ἀρίστῳ τις προθυμηθείη, ἀναπαύσασθαι χρὴ μέχρι καταστῇ τὸ σιτίον, εἰ δὲ ἐπὶ τῷ δείπνῳ ὑπνοῦν ἀνάγκη πρὸς ὀλίγον. καὶ τὰς σφοδρὰς δὲ ἐπιθυμίας οὐκ ἐπαινῶ ἀλλὰ κελεύω δὴ πλέον ἀντέχειν καὶ μᾶλλον οἷς νόσημά ἐστι ῥᾷον ἐκ τῆς χρήσεως βλαπτόμενον.

Rufus of Ephesus, quoted in Aetius of Amida, Medical Books, 3.8, 265,13–268,12 Olivieri

Also in Daremberg’s Oeuvres de Rufus d'Ephèse, pp. 318–325