Hypospadias, a congenital defect in the development of the penis and urethra, was well-described in ancient Greek medical literature. Aristotle, in 4th century BC, was the first to describe it. He pointed out the false impression that boys have of male and female genitalia due to the fact they urinate seated: “there have been instances of boys in whom the termination of the penis has not coincided with the passage through which the residue from the bladder passes out, so that the passage came too low; and on this account they sit in order to pass water, and when the testes are drawn up they seem from a distance to have both male and female generative organs.”1 Centuries later, the eminent Greek physician Galen (130-c.201 AD) introduced the term “hypospadias.” Its origin is from the Greek word “hypo” which means under and “spadon” which denotes a rent or fissure. Galen also mentioned the problems of chordee and the difficulty in ejaculation.2 The malformation was also reported by several Greek physicians, such as Heliodorus (1st century AD), Antyllos (2nd century AD) and byzantine physician Oribasius (c.320–400 AD). They described, classified and proposed a therapeutic approach.3 However, only one representation of hypospadias in ancient Greek art can be identified. This is the case of the so-called “phallus-vulva” vase, dated back to circa 610 BC, which is part of the archaic Greek pottery of Chios and was discovered at Naucratis in Egypt in an unspecified sanctuary, probably belonging to Aphrodite (Fig. 1). Fig. 1. The so-called “phallus-vulva” vase. Part of the archaic Greek pottery of Chios. This unique type of phallus in ancient Greek art, due to its imperforated hole at the base of the penis, led archeologists to conclude that the hole was the representation of a vulva, which was reinforced by the small-dot decoration around it. Therefore, it was believed that this decoration depicted male and female genitals seeking fertility. Moreover, in a cult or sexual context, it was associated with the god Dionysus and goddess Aphrodite.4 Williams considered that this phallus was in reality a vase, which could be filled up with two other fragments. He compared it with perfume vases in the shape of male genitalia known from eastern Greece and Attica. He noted that Athenian potters in late 6th and early 5th century BC were forming male genitals as a foot in cups. About its use, he believed that it was a special drinking vessel dedicated to Aphrodite and used in religious ceremonies.5 On the surface of this 14.6 cm phallus, we observe a variety of decorations, such as an eye on the glans, a broken meander, red tongues alternating with white ones and the posterior part of a goat’s leg seen in the lower left. These were popular decorative elements at the period of the phallus creation (the archaic period, 800 to 480 BC) and they covered the phallus surface, to be presented as a fully decorated artefact. Concerning the eye motif on the glans, except being a popular symbol of the archaic period, it had also an “apotropaic” character to protect from evil spirits, to relieve suffering and to help bring health back or to encourage fertility. The median raphe, also depicted in the phallus, does not have a special meaning and it can be assumed that it was created to emphasize the affected area and to facilitate the construction of the hole in the base of the penis.4 Regarding the retracted prepuce, it was used in ancient Greek art to point out the erection and it must not give us the impression of a circumcision, as this procedure was performed in ancient Greece only in phimosis cases. There are no elements in this phallus to suggest phimosis or circumcision.4 From our point of view, this phallus has the typical characteristics of a third degree penoscrotal hypospadias. The absence of the chordee is not problematic and the place of the meatus denotes an erected form to unveil the hole. This is a unique case, as other examples of hypospadias representation in ancient Greek art are not known.
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