The unkindest cut: castration, power, and early bioethical deliberations in ancient medicine and the Persian tradition

Mohsen  Shamsi; Mohammad Hossein  Asadi; Azam  Khosravi; Ali  Zarei; Saeed  Changizi-Ashtiyani

doi:10.18502/jmehm.v19i2.21706

Mohsen Shamsi Professor, Department of Health Education, School of Health, Arak University of Medical Sciences, Arak, Iran.
Mohammad Hossein Asadi PhD Candidate, History of Medical Sciences Department of the History of Medical Sciences, Institute for Studies in Medicine History, Persian and Complementary Medicine, Iran University of medical Science, Tehran, Iran.
Azam Khosravi Instructor, Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran.
Ali Zarei Assistant Professor, Department of Physiology, Estahban School of Paramedical Sciences, School of Nursing Hazrat Zahra (P.B.U.H) Abadeh, Shiraz University of Medical Sciences, Shiraz, Iran.
Saeed Changizi-Ashtiyani Professor, Department of Physiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/jmehm.v19i2.21706

Keywords: Eunuchs; History of medicine; Castration; Medical ethics; Persian medicine.

Abstract

This study investigates the history of male castration, tracing its evolution from an ancient practice used for punishment and court control in civilizations like Sumer and China to a topic of sophisticated medical and ethical debate in the Persian world. The research highlights the important work of Persian physicians such as Rhazes, Avicenna, and Jorjani, who carefully recorded and improved surgical techniques—including total removal (hence the Arabic term Khasi, meaning “castrated”), and blood vessel ligation—within a detailed medical framework. Significantly, these scholars developed a strong and systematic ethical stance opposing non-therapeutic castration, condemning it as a breach of the body's natural, divinely ordained condition. *Corresponding Author Saeed Changizi-Ashtiyani * Address: Department of Medical Physiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.. Postal Code: 14496-14535 Tel: (+98) 912 19 63 253 Email: ashtiyani@yahoo.com Received: 3 Oct 2025 Accepted: 24 Feb 2026 Published: 3 Jun 2026 Citation to this article: Shamsi M, Asadi MH, Khosravi A, Ranjbar M, Zarei A, Changizi-Ashtiyani S. The unkindest cut: castration, power, and early bioethical deliberations in ancient medicine and the Persian tradition. J Med Ethics Hist Med. 2026; 19: 2. Although earlier traditions expressed concerns about bodily integrity, their incorporation into a formal medical-ethical system marks a key milestone in medical ethics. This established the mentioned physicians as prominent advocates for bodily integrity, a concept that has often been challenging to political authorities. By combining historical and medical perspectives, the paper argues that castration should not be regarded merely as a social custom, as it unintentionally facilitated early advances in surgery and endocrinology. Ultimately, the study underscores the ongoing conflict between medical ethics and political power, offering a nuanced insight into the interplay of science, morality, and authority throughout history.