Abstract

The bahnames, an essential part of the Islamic medical corpus, generally address sexuality, sexual behavior, sexual dysfunctions, and protective, supportive and therapeutic applications in this field.
Our study investigated the oldest known Turkish bahname, translated by Musa b. Mes’ud during 15th century, in comparison with the current literature. Sexual health advices and treatment modalities in this bahname were evaluated and interpreted within the framework of current knowledge of sexology, urology, and andrology.
Although the work mostly mentions supportive and therapeutic practices in sexual health, it also provides advices on sexuality and sexual life. The author recommends many foods and compounds or specific drugs and  ointments to enhance sexual stamina and avoid erectile dysfunction. In addition, he also tries to find solutions to some other sexual health problems related to men and women. These issues are generally evaluated in the context of health; a religious perspective is also provided when needed. In comparison, a lot of the author’s recommendations on sexual health and herbal or animal drugs are consistent with the current literature. Nevertheless, some information and suggestions mentioned in the bahname are entirely irrational and unscientific.
This study is an original investigation of the first translated bahname into Turkish. There is no other study examining the bahnames with this method. Thus, we believe that our work will be a significant contribution to  the literature of Turkish-Islamic medical history.

Introduction

In the Islamic medical literature, works dealing with
sexual health issues are called “bahname”. The word
bahname is a combination of the Arabic word “bah”,
which means “sexual desire, lust, libido”, and the Persian
word “name”, meaning “book”.1

The Turkish Encyclopedia of Islam (TEI) defines bahname as “a type of book containing information about all kinds of sexual issues, including especially the  treatment of sexual disorders”.

The bahnames, an essential part of the Islamic medical corpus, generally address sexuality, sexual behavior, sexual dysfunctions, and protective, supportive, and therapeutic applications in this field. Additionally, such books may include social issues such as sexual life, family institution, marriage and pregnancy, measures to facilitate or prevent conception, problems during pregnancy, medical information about newborn children, and even child-rearing and upbringing.1

Many physicians wrote such works in different periods of Islamic and Ottoman medical history. Ali Haydar Bayat identified 45 different bahnames across all periods of Islamic civilization, including 21 in Arabic, 6 in Persian, and 14 in Turkish.2 Ilter Uzel also listed 51 works in Arabic, Persian, and Turkish.3,4Jabir ibn Hayyan, Jabril ibn Bukhtishu, al-Kindi, Hunayn ibn Ishaq, Qusta ibn Luqa, al-Razi, Ibn Sina, Ibn Maymun, Ibn al-Bitriq, and  Shayzari were among the most prominent Islamic scholars who wrote bahnames. According to the TEI, the oldest bahname in Turkish is a translation of the Bahname-i Padişahi with a dedication to the Sarukhanid Ya‘qub b. Dawla in the fourteenth century.Additionally, the first known Turkish bahname in the Ottoman Empire is the translation by Musa b. Mes’ud with the same title as the original Persian version of Bahname-i Padisahi

Among the Bahnames in Ottoman era, especially those presented to the Sultanes are decorated with colorful miniatures, while those written for the public include no pictures or figures. The Bahname-i Padişahi translated by Murat b. Mesud is one of the first examples of the Ottoman era. Unlike most of the bahnames, it does not contain pictures and figures. One of the most famous samples which include figures was Cemaleddin Revnaki’s book called Kitâbü’s-Safâ ve’s Bahnames included more figures and became more pornographic after the 19th century.1,5

This studyinvestigated the first translated bahname in the Ottoman Empire and concepts such as sexuality, sexual life, sexual desire/function disorders, and the protective, supportive, therapeutic applications in this work were compared to the current literature.

Materials and Methods

In this study, we submit the transcription of an original text in the Ottoman medical history and its comparative evaluation with the current literature.

The chapter and folio numbers mentioned in our study for the bahname that translated by Musa b. Mes‘ud refers   to the copy registered in the Library of Istanbul University Istanbul Faculty of Medicine under call number 3778, one of five known manuscripts of this manuscript (Fig. 1-2).

First, the original manuscript of the translation was transcribed in Latin. The final version of the transcribed text was analyzed in the results. In discussion, findings were examined and interpreted within the framework of current knowledge of sexology, urology, and andrology.

Results and Discussion

According to the index quoted by Uzel with reference to
Sehsuvaroglu, Musa b. Mes‘ud’s bahname translation
consists of seventeen chapters. Table-1 shows the index
of the bahname.

The topics of bahname can be grouped into two
categories:

  1. Issues related to sexuality and sexual life
  2. Protective, supportive and therapeutic applications for
    the protection of sexual life.

It is assumed that this work was written in the thirteenth
century and translated into Turkish in the fifteenth
century. Although bahname was compiled about eight
hundred years ago, we see that many of the foods and
drugs or practices in bahname are still valid today.
However, some of the recommendations put forward in
the bahname according to the medical theories, belief
values, and observational findings of the period
contradict today’s scientific knowledge and data.
Suggestions and preparations of drugs and food reported
above will be discussed in the following section in
comparison with the current medical literature.

First, unlike the general acceptance of the period, there is
no taboo concerning the ways of sexual intercourse in
bahname. It is also stated that it is religiously permissible
and lawful for husband and wife to have sexual
intercourse as they wish. Similar to bahname current
literature confirms that it is beneficial and sometimes
necessary for the sexual happiness of husband and wife
to excite and satisfy each other and to perform a sexual
activity in every position as they wish.

Although there is no prohibition on the forms of sexual
intercourse in the bahname, it is claimed that some
positions are harmful for various reasons in the
fourteenth chapter.

There is a remarkable example: it consists of intercourse
of the man lying on his back and a woman positioned on
top of him. Damages claimed to occur in this position
include diseases due to the discharge of female sexual
secretions onto the penis and the genital area of the man,

bladder pain and injury, liver swelling, and the spread of
these complaints to other organs. All these justifications
are factually inaccurate and cannot be confirmed by
current information and data. On the contrary, the type of
intercourse described in which the woman takes a riding
position is recommended, especially to treat dysfunctions
such as premature ejaculation.7Finally, sexology and
sexual psychiatry experts maintain that any position
desired and enjoyed by a healthy couple can be practiced,
and there is no position that is harmful to health.

Although it is permissible from a religious perspective
the author stated that it is not considered appropriate for a
man to look at his wife’s genitals during sex. It is
claimed that the boy born as a result of this sexual
intercourse will be lacking eyes. Additionally, it is
claimed that if a woman stimulates a man’s genital with
her mouth and then intercourse happens, the boy to be
born will be weak and weary. We can easily say that
these are nothing more than expressions of superstition
and nonsense.

The author criticizes the attitude that too much sexual
intercourse is harmful; moreover, he accuses those
holding this view of being ignorant. Current literature
leaves the spouses wholly free and does not set any limits
in terms of sexual frequency. In addition, false ideas such
as the suggestion that too much sexual intercourse will
harm male health or that every man has the capacity for a
certain limited number of ejaculations throughout his life
are no longer accepted.7 Besides, the author states that
there are six pleasures for people; five of them are the
senses of sight, hearing, taste, smell, and touch, and the
sixth one is sexual intercourse. He points out that all
senses and flavors are coming together in sexual
intercourse. From this observation, it can be concluded
that all five sense organs should be used in intercourse,
and the current literature also confirms this.

The author does not limit or prohibit sexual intercourse
timing; however, the work suggests the spring and the
daytime compared to other times. Current literature
confirmed that the level of androgen hormones, which
provide libido and increase sexual activity, rises in spring
and during the day in the diurnal rhythm of the
male.10Additionally, current literature revealed that
testosterone levels, sexual activity, and the number of
ejaculations decrease in winter.11

The author claimed that children born due to sexual
intercourse on certain days would be good-natured and
healthy; by contrast, he claimed that they would be sickly
and ill-natured on certain other days. The interpretations in this chapter are based on the theory of the four senses
of humor or astrological knowledge and beliefs in those
times. Based on the current literature, we can say that the
statements in this chapter are completely baseless
superstitions.

On folio-18a, the author recommends abandoning some
habits to protect male sexual health. It is claimed that
certain behaviors, such as delaying urination after sexual
intercourse despite feeling the need, running constantly
and walking too much, sweating profusely in the
bathhouse, or staying awake at night too long, when
becoming repetitive practices and habits weaken the male
genitalia. Another behavior that the author recommends
avoiding is exaggerated horse riding. An activity today
that could be compared to horse riding is the use of
bicycles. Indeed, modern urology shows that prolonged
cycling can adversely affect erectile function. Just like
riding a horse, cycling is a chronically traumatizing
factor for the perineum. In a meta-analysis investigating
the relation between cycling and erectile dysfunction
Gan et al. stated a positive correlation between cycling
and erectile dysfunction.12 The argument that horse riding
for long periods of time would reduce erection due to
chronic trauma caused during that time can only be
confirmed by careful observation and from a perspective
based on experience.

The work points out that if a man has sexual intercourse
on a day when he is overworked and tired, the heart will
work hard (possibly referring to tachycardia). Therefore,
the author doesn’t recommend having sexual intercourse
during such periods. Although this statement cannot be
considered completely correct with current knowledge,
modern urology has shown that there is a close
relationship between sexual activity and heart rhythm and
blood pressure. Sexual activity was found to be
equivalent to climbing a 2-storey ladder in 10 seconds in
terms of exercise load and the cardiovascular system’s
capacity. In this case, although the heart rate remains
below 130 beats and systolic blood pressure is below 170
mmHg, the workload required during sexual activity
increases in the presence of old age, obesity,
cardiovascular disease, and excessive food and alcohol
consumption.13 Similar to the literature, sexual activity
was determined in the bahname as an action that strains
the capacity for expending energy and the risk of being
tired and developing weakness during coitus.

Many simple or compound drug formulations and foods
for preserving sexual health, increasing sexual power and
the semen amount, and treatment of erectile dysfunction
are recommended in the bahname. Vegetables such as carrots, chickpeas, broad beans, onions, ginger, parsnips,
long pepper, milk, dates, mustard, and leeks; foods
containing animal and vegetable protein (red or white
meat varieties, eggs, milk, legumes, etc.), and dried fruits
such as pine nuts, hazelnuts, peanuts, almonds, coconut,
and pastes containing saffron, ginger, galangal, and long
pepper to obtain such benefits are recommended in
several chapters. It is possible to find studies in the
current literature confirming the bahname about almost
all of the foodstuffs listed in bahname. Current scientific
information on a few of these will be presented here:

Carrot (Daucus carota), mentioned in different chapters,
was proven to be positively contributing to sexual
functioning by increasing the level of sex hormones in
men and women and to be beneficial for all parameters of
female sexual functions such as desire, arousal, orgasm,
and satisfaction14, to increase testosterone levels in men,
trigger sperm production, and increase the reserve of
sperm cells in the tail of the epididymis.15

It has been revealed that saffron (Crocus sativus)
improves erection quality in men16-17 and also positively
affects sperm morphology and motility.18

Ginger (Zingiber officinale) has an aphrodisiac effect by
increasing the blood flow to the testicles, sperm count
and motility, testicular volume, and serum testosterone
levels.17 Additionally, Stein et al. reported that Ginger
(Zingiber officinale) significantly improves erection
quality and sexual satisfaction in middle-aged and older
men.19

Similarly, Galangal (Galanga officinalis) increases the
percentage of normal sperm, vitality, motility, and
testosterone levels;20 administered orally, according to
the current literature, it significantly increases the total
motile sperm count.21

Two separate experimental studies conducted with clove
(Syzygium aromaticum) revealed that sexual activity was
significantly and sustainably increased in male rats
receiving clove. Furthermore, it positively affected
sexual behaviors in male mice.22,23 Thus, certain current
studies support observations found in the bahname in
terms of medicaments.

The plant is known as Papaver somniferum in Latin,
sometimes called opium in the bahname and sometimes
poppy, causes the smooth muscles of the corpu
cavernosum to relax and triggers a strong erection due to
papaverine.24As a breakthrough development in modern
urology and andrology, achieving an erection by injecting papaverine into the spongy tissue of the penis
has been in clinical practice since the 1980s. The
papaverine injection not only induces an erection but also
leads to a longer than usual duration. Papaverine was
also beneficial in topical application to the penis and the
genital area.27 Moreover, papaverine injection is also
featured in leading publications in urology/andrology in
current reviews regarding the treatment of erectile
dysfunction.28,29 In addition to these selected examples
from the bahname, we can say as a general assessment
that the positive effect of almost all of the herbal or
animal extracts and preparations proposed is in line with
current scientific data.

The author recommended various administration methods
for the different plant, animal, and organic extracts and
mixtures. Furthermore, these cures were in different
forms such as solid food, oral paste, beverage, cream, and
ointment to be applied to the soles of the feet or genitals,
suppositories, enemas, and sublingual pills. Especially,
the sublingual application is quite remarkable, considered
from the current scientific knowledge. In an age when the
physiological absorption and action mechanisms were
not yet scientifically known, proposing this method based
on the absorption of drugs under the tongue to create an
effect on the target organ was possible only as a result of
the experiment, observation, and inference.

Chapter-7 explains the topical applications that work by a
transdermal mechanism of action with ointments, creams,
pomades, and plasters used to strengthen erection. Since
the 1990s, positive results obtained by applying a topical
gel containing the active substance to the penis and the
genital area in human patients and animal experiments.
These substances include papaverine and prostaglandin
E1.30 Current literature found that topical application of
both agents increases the penile blood flow significantly,
and potent erections are achieved after topical
application. Various reviews indicate that oral therapy is
a promising method for groups of patients who cannot be
treated by intra-cavernous injection due to drug
interactions or non-responsiveness, needle fear.

Another remarkable drug administration method
recommended to support erection is the application of a
preparation in the form of suppositories to be inserted
through the urethra. Since the 1990s, preparations
containing prostaglandin-E1 have been administered
through the urinary tract with this method, which is seen
as an ideal and practical treatment of erectile dysfunction
today, known under the name of MUSE. Although its
effectiveness is not as great as intra-caverneous
application, its ease of use and non-invasiveness make this a preferred method.35 Another preparation containing
prostaglandin-E1, which is also found in the current
literature, is administered by dripping it into the urethral
orifice recommended these topical preparations applying
to the penis, groin area, and testicles.33 Similarly, topical
gels are applied to the penis, perineum, and testicles in
modern transdermal erection therapy.27

Chapters-16 and 17 include a recipe intended to make the
vagina warm, soft, and even as tight as that of a virgin
girl, administration of the liquid prepared from some
drugs was suggested either in the form of a bath to sit in
or by inserting a woolen tampon soaked in the liquid into
the vagina. Current medical knowledge and scientific
literature do not include any pharmaceutical or herbal
drugs having such an effect.

Similarly, the seventeenth chapter says that some drugs
soaked up by wool and then inserted into the vagina will
ensure pregnancy immediately. Such a practice is not
found in modern science. In addition, the author claimed
that if a man applies tar or sesame oil on his penis before
sexual intercourse, the woman will not conceive, or even
if she becomes pregnant, she will have a miscarriage.
There is no corresponding information in the current
literature.

The bahname also described the artificial penis used by
women to masturbate, which is known as zıbık in the
Middle East and dildo in Western languages. Similarly,
modern sexology suggests the dildo using for therapeutic
purposes. Another version of a dildo that increases
pleasure through vibration is a vibrator subjecting many
scientific studies. Herbenick et al. reported that sex
devices such as vibrators and dildos are frequently
recommended to patients; another article stated that
vibrators are an important option in the hands of
clinicians to increase sexual function and respond to
certain sexual problems.36,37

Among the therapies used in treating sexual dysfunction,
especially female orgasm and arousal disorder, it is
reported in today’s scientific literature that erotic devices,
including dildos and similar items, contribute positively
to the solution of these issues.38

In case the erect penis did not soften again, the author
recommended washing with cold water. Similar to
bahname, the first step in priapism treatment is the
application of cold compresses, and in some cases, this
simple intervention can achieve the desired softening.
Pryor et al. also suggest cold compresses or a cold
shower as the first aid method that can be applied by the patient himself or by auxiliary health personnel.
Interestingly, a similar method was proposed in the
bahname six centuries ago.

Conclusion

We investigated the fifteenth-century translation by Musa
b. Mes’ud of the Bahname-i Padişahi, which is the oldest
known Turkish example of a bahname. We discussed the
preventive, supportive, and therapeutic practices
associated with sexuality, sexual life, and sexual health
issues mentioned in the bahname and analyzed the
suggested treatments and recommendations from a period
of about seven centuries in the light of the current
literature.

The author synthesized empirical information with
experiences from the past in the bahname while dealing
with sexual life and sexual health issues. These issues are
generally evaluated in the context of health; a religious
perspective is also provided when needed. In particular,
the author’s recommendations on sexual health and
herbal or animal drugs are consistent with the current
literature.

The work must have been written as a result of careful
observation and profound experience. In addition, we can
say that the author went beyond the generally accepted
beliefs he lived in, especially on issues of sexual life.
Nevertheless, some of the information and suggestions
included in the book are entirely irrational and
unscientific in the light of the current literature.

Finally, this study is an original and novel investigation
of the bahnames, which have not attracted the attention
they deserve in today’s academic studies, although they
are an essential part of the Turkish-Islamic culture
revealed all critical information in the bahname and
compared it with Turkish and international sources in the
current literature on urology, pharmacology, andrology,
and sexology. There is no other study examining the
bahnames with this method. Thus, we believe that our
work will be a significant contribution to the research
literature.

Acknowledgement

A wider version of this manuscript was published
previously in the Turkish Journal of Urology
DOI number: 10.5152/tud.2022.22104.

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