Objective: This article presents a historical, cultural, and medico-sociological analysis of the evolution of attitudes toward masturbation across the civilizations of the Ancient World (Ancient Egypt, Greece, Rome, China, and Judaic traditions) and the Middle Ages (Western Europe and Byzantium).
Methods: The study employs a comparative-historical and institutional analysis spanning the period from c. 3500 BCE to the late 15th century CE. Primary source materials, including religious, philosophical, and medical treatises, as well as canon law and contemporary sexological frameworks, were examined.
Results: The findings indicate that attitudes toward masturbation ranged from sacralization in Ancient Egyptian cosmogony to pragmatic utilitarianism in Classical Antiquity, where the practice was viewed as an inferior surrogate or a marker of low social status without being subjected to severe religious stigmatization. In Ancient China, the phenomenon was evaluated through the lens of medical and energetic hygiene (preserving vital jing energy). Conversely, the Judeo-Christian tradition initiated a radical paradigm shift by reinterpreting the Old Testament narrative of Onan and formulating a theological-legal framework centered on the “sin against nature” (peccatum contra naturam). Through Medieval Scholasticism (Thomas Aquinas) and penitential practice (Irish penitentials, canons of John the Faster), masturbation was institutionalized as a grave spiritual offense.
Conclusions: The evolution of societal perceptions of masturbation demonstrates a historical transition from the pragmatic and energetic regulation of bodily resources to strict moral-theological stigmatization, which laid the normative foundation for Western sexology up to the modern era.

Context and Background: Understanding the phenomenon of masturbation through a historical lens reveals how institutions of power, medicine, and religious dogma have shaped constructs of normative and deviant human sexuality. An analysis of sociocultural and medical discourses demonstrates that the perception of autoerotic activity was never static; rather, it evolved from sacred practices and energetic hygiene to severe religious and ethical stigmatization.

Significance and Literature Context: In modern sexology and the history of medicine, investigating the historical and evolutionary dynamics of sexual behavior remains a critical endeavor (M. Foucault, R. van Gulik, J. Stengers, etc.). However, a systematic comparative analysis of attitudes toward masturbation across the civilizations of the Ancient World and the Middle Ages requires further rigorous synthesis. The historical shift from ancient pragmatism to medieval legal-theological conceptualization established the foundational normative frameworks that governed Western sexology and medicine up to the 20th century.

Objectives: The objective of this study is to provide a comprehensive characterization of the social, psychological, and medical dimensions of attitudes toward masturbation in the Ancient World and the Middle Ages. To achieve this objective, the study addresses the following specific tasks:

1. To analyze the spectrum of attitudes toward masturbation in ancient civilizations—ranging from sacralization in Ancient Egypt to neutral, ironic, or utilitarian views in Ancient Greece and Rome.

2. To elucidate the medical-pragmatic approach to autoeroticism in traditional Chinese medicine and Daoist practices (specifically the concept of conserving vital jing energy).

3. To trace the emergence of religious and ethical taboos surrounding masturbation within Judaism and early Christianity (including the reinterpretation of the biblical narrative of Onan).

4. To characterize the institutionalization of masturbation as a “sin against nature” (peccatum contra naturam) in medieval Scholasticism and penitential traditions across Western Europe and Byzantium.

The Ancient World

The Ancient World (in general) spans the period from approximately 3500 BCE to 476 CE. Classical Antiquity (c. 800 BCE – 476 CE) forms an integral part of this era—a specific phase within the Ancient World referring to the Greco-Roman civilization across the Mediterranean (Greece, Rome, their colonies, and conquered territories). Antiquity is recognized as the final period of the Ancient World in this region. Attitudes toward masturbation in ancient times ranged from sacralization to taboo [1; 2]. Ancient Egypt. In Egyptian mythology, masturbation held a positive, creative status and was not considered shameful. On the contrary, it formed the very foundation of the cosmos. According to Heliopolitan cosmogony, the demiurge god Atum created the first deities (Shu and Tefnut) through masturbation. This act symbolized divine self-sufficiency and the transmission of the Ka life force. As noted in the Pyramid Texts (Utterance 527), Atum “clasped his phallus in his hand to produce orgasm” [3]. Ancient Greece. Masturbation was viewed neutrally or with irony, though excess was deemed a sign of intemperance. In Greek society, male sexual activity was closely tied to social status and self-control. Public masturbation was considered indecent for free citizens; however, Cynic philosophers (such as Diogenes of Sinope) practiced it openly as a demonstration of natural needs and independence from social conventions. Diogenes masturbated in the market square, famously remarking: “If only it were as easy to banish hunger by rubbing a full belly” [4]. Masturbation appears in Aristophanes’ comedies as a punchline targeting “losers” or those deprived of a partner. Philosophers often viewed it as an inferior surrogate to full sexual intercourse [5], serving merely as a means to satisfy desire in the absence of a partner. Ancient Rome. The prevailing attitude was largely disdainful, regarding it as a practice reserved for slaves or those unable to find a partner. Elite men were expected to demonstrate self-mastery. In Roman society, masturbation signaled sexual inadequacy or low status; a free man was expected to dominate a partner (a slave or prostitute), while “self-gratification” was fit only for slaves or those incapable of securing an object for domination.Roman morality prioritized preserving “male vigor.” Influenced by theories regarding the loss of vital energy, some medical treatises described masturbation as an undesirable depletion of semen that could theoretically cause physical weakness [6, p. 45]. However, this was not accompanied by the intense stigmatization characteristic of the Middle Ages. The poet Martial mocked those who engaged in the act in his epigrams, viewing it as an imitation of genuine sex and scolding Ponticus for “wasting his life with his own hand,” framing it as a loss of potential offspring [7]. Ancient China. In Daoist practices, the attitude toward masturbation was restrained and pragmatic. Excessive loss of semen was believed to deplete vital energy, placing the primary emphasis on moderation. Judaism. The attitude toward masturbation (both male and female) was strictly negative. The biblical narrative of Onan was interpreted as a prohibition against the “futile spilling of seed,” which later exerted a profound influence on Christian morality. Although the original context concerned the refusal of a levirate marriage, later rabbinic tradition interpreted it as an absolute prohibition on any emission of semen outside an act leading to conception. It is well known that, under the Jewish law of levirate marriage, Onan was required to have sexual relations with the widow of his deceased elder brother. However, he did not want her to conceive by him, as any children born from this union would be legally recognized as his brother’s offspring. Therefore, during sexual intercourse, he avoided intravaginal ejaculation by spilling his seed on the ground. Thus, this passage does not describe masturbation, but rather withdrawal or coitus interruptus [8].  According to the concept of the “futile spilling of seed” [9], the main religious and legal foundation for the prohibition of male masturbation became the account of Onan in the first book of the Bible, Genesis [10, p. 34], where the following is recorded (Genesis 38): “6. And Judah took a wife for Er his firstborn, whose name was Tamar. 7. And Er, Judah’s firstborn, was wicked in the sight of the Lord; and the Lord slew him. 8. And Judah said unto Onan, Go in unto thy brother’s wife, and marry her, and raise up seed to thy brother. 9. And Onan knew that the seed should not be his; and it came to pass, when he went in unto his brother’s wife, that he spilled it on the ground, lest that he should give seed to his brother. 10. And the thing which he did displeased the Lord: wherefore he slew him also.” Thus, the Bible itself contains no explicit directives regarding the sinfulness of masturbation.  In contrast to ancient Chinese medical pragmatism, the rabbinic tradition views the preservation of reproductive potential through the lens of religious ethics and individual metaphysical responsibility. To understand the attitude toward masturbation in Judaism, one must also examine the Halakhic prohibitions in the Talmud. In the Babylonian Talmud, masturbation is regarded as a grave transgression equated with bloodshed. Specifically, the tractate Niddah underscores the severity of the punishment for self-stimulation [11]. The rabbis emphasized that the hand that causes ejaculation “should be cut off”—a metaphorical expression underlining the gravity of the sin. The attitude toward female masturbation was as follows. Although there is no direct prohibition of masturbation for women in the Torah, Talmudic literature mentions the practice of “women who rub against each other.” This practice, which can be categorized as homosexual petting, was considered among the “deeds of Egypt” that contradicted the modesty and purity of the Jewish family [12]. Christianity. In the Christian world, the belief in the sinfulness of masturbation was widespread, fostered by the theological framework of several prominent theologians. In this context, Augustine (4th century CE) is frequently cited; he held that every sexual act and ejaculation must occur naturally and be aimed at procreation. Because masturbation did not lead to procreation, it was categorized as a sinful act [8].  Views on the Harm of Masturbation in Ancient Medicine [2]. In ancient medicine, masturbation was not always singled out as a specific pathology; rather, it fell under the broader umbrella of “sexual excess.” The underlying concept was that semen represented the quintessence of vital bodily fluids. As Michel Foucault notes in his work [13], ancient health ethics were built upon a strict economy of bodily resources; any uncontrolled waste of semen was perceived as a direct threat to physical strength and mental acuity. In Hippocratic medicine, moderation was viewed as the key to health, while excess was seen as a cause of seminal depletion. Hippocrates and representatives of later ancient medical schools, particularly Galen, associated excessive seminal loss with physical exhaustion, regarding semen as a fundamental source of vital energy.The Hippocratic Corpus—a collection of roughly 60–70 Ancient Greek medical treatises [5th century BCE – 3rd century CE] attributed to Hippocrates, though written by various authors—mentions the loss of semen as a factor influencing health, but the emphasis was most often placed on general excess (including excessive sexual intercourse) rather than on the act of masturbation itself [14]. According to Hippocrates, excessive loss of seminal fluid could lead to a condition known as “spinal consumption” (tabes dorsalis in older terminology). In his Selected Works [15], it is described that semen passes through the spinal cord, and its excessive emission “dries up” the neural channels, causing weakness and pain in the limbs. This idea was further developed by Galen in his treatise On the Usefulness of the Parts of the Body [16], where he asserted that semen possesses a “spiritual force” (pneuma), and its irrational expenditure deprives the brain and heart of essential nourishment. Historians of sexology emphasize that ancient society was more pragmatic [17]. Michel Foucault, in his works on the history of sexuality, notes that for the ancient mind, the central issue was not the “sinfulness” of the sexual act, but its ethics (the use of pleasures) [13]. Masturbation did not fit into the ethical framework of the proper “use of pleasures” because it excluded interaction with another subject; this rendered it “insignificant” for serious moral analysis, yet acceptable in private life. In Eastern traditions, medicine took a stricter stance on the potential adverse effects of masturbation on human health. Robert van Gulik, in his monograph [18], points out that Daoist physicians viewed semen (jing) as the root of longevity. Masturbation was considered harmful because it led to the loss of male Yang energy without receiving the corresponding female Yin energy, which, in their view, caused premature death and kidney disease. Similar perspectives are reflected in the analysis by J. Stengers and A. Van Neck [19], who emphasize that prior to the advent of Christian morality, the harm of masturbation was justified not by sin, but specifically by biological exhaustion.  In the medical and philosophical traditions of Ancient China, the attitude toward masturbation differed fundamentally from Western religious dogma. Instead of the concept of “sin,” Chinese medicine relied on the concept of the pragmatic conservation of the body’s resources [20]. The primary focus was placed on preserving male vital energy (jing), which was considered a finite resource. Masturbation accompanied by ejaculation outside of sexual intercourse was viewed as a futile loss of this energy, which, according to Daoist practices, led to the depletion of brain energy and a general weakening of the organism [21].  In Ancient Chinese medicine and sexology, particularly in the archaic treatises Fangzhongshu (“Arts of the Bedchamber”) [22], the primary emphasis was placed on the preservation of vital energy (jing). Consequently, the issue of energy loss was thoroughly examined. Semen was believed to be the concentration of vital force; thus, masturbation was condemned not as a “sin,” but as an aimless dissipation of this energy [21]. Furthermore, Daoist practices advocated the idea metaphorically termed “returning the semen to nourish the brain” (the principle of huan jing bu nao). 

Masturbation resulting in ejaculation outside of sexual intercourse with a partner was considered a cause of physical exhaustion leading to disease, memory loss, and premature aging [23].  Thus, in Ancient China, the prohibition of masturbation was pragmatic and medical rather than moral and ethical. It was regarded as a “hygienic error” that disrupted the body’s internal balance.  In contrast to male masturbation, female masturbation in Ancient Chinese texts—such as the medical records of the Han Dynasty [24]—is mentioned more neutrally. Since it was believed that women did not lose a “finite” resource (unlike male semen), such practices were sometimes even described in the context of maintaining health, provided they helped balance Yin energy.

The Middle Ages

The beginning of this period is dated to 476 CE, officially marked by the fall of the Western Roman Empire. Its conclusion spans the second half of the 15th century. Although there is no single agreed-upon end date, scholars generally reference 1453—the fall of Constantinople (the collapse of the Byzantine Empire)—or 1492, the discovery of America by Columbus (the onset of the Age of Discovery). Thus, the Middle Ages lasted approximately 1,000 years. This concept primarily applies to Europe and the Near East; for other regions (China, India, pre-Columbian America), the term “Middle Ages” is used less frequently or with substantial qualifications, as their development followed different trajectories. The period is typically subdivided into the Early (late 5th century – mid-11th century), High/Classical (mid-11th century – late 14th century), and Late Middle Ages (15th century, sometimes including the 14th century).  The transition to the Middle Ages marked a radical paradigm shift: from the “energetic hygiene” of the East and the “social status” of Antiquity to a rigid legal and theological classification of masturbation as a sin. The focus shifted from bodily health to the salvation of the soul [17]. The principal source for establishing norms during this period became the penitentials (penitential books)—manuals of rules prescribing specific penances for corresponding transgressions.

1. The Early Middle Ages: Irish and Anglo-Saxon Penitentials.

In the 6th–8th centuries, Irish monks developed a detailed system of penance. Masturbation was viewed as a form of “spiritual adultery.” The severity of the punishment depended on the status of the sinner (layperson or cleric) and the frequency of the act. In the Penitential of Cummean (7th century), it is stated: “If anyone defiles himself with his own hand, he shall fast on bread and water for forty days” [25].

2. The High Middle Ages: Scholasticism and the “Sin Against Nature.”

In the 13th century, Thomas Aquinas systematized Church doctrine, defining masturbation as a type of “sin against nature” (peccatum contra naturam). The underlying logic was that ejaculation had a single purpose—procreation. Any other use of semen was considered a violation of the divine order. In the Summa Theologiae, Thomas Aquinas asserts that after the sin of murder, the second position is occupied by the “sin against nature,” under which he includes “impurity committed alone” [26]. 

3. The Byzantine Tradition: Canons of John the Faster. 

In the East (Byzantium), the attitude was similar, but the emphasis was placed on internal purification and extended prayer. The 8th Rule of John the Faster prescribes for “hand-pleasuring” a penance of forty days consisting of xerophagy (dry eating) and performing one hundred full prostrations daily [27]. 

The Middle Ages laid the foundation for the severe attitude toward masturbation that persisted well into the 20th century.

The results of this study indicate that:

1. Diversification of Ancient Perspectives: In the Ancient World, attitudes toward masturbation ranged from sacralization in Ancient Egyptian cosmogony to pragmatic evaluation in Greco-Roman civilization. Classical Antiquity did not treat autoeroticism as a religious taboo. Rather, it evaluated the practice through the lenses of social status, self-mastery, and the ethics of pleasure. In ancient medicine (Hippocrates, Galen), concerns were directed toward the excessive loss of semen as a vital force, rather than the moral categorization of the act itself.

2. The Pragmatic-Energetic Paradigm of the East: In Ancient China, restrictions on male masturbation were strictly medical and pragmatic. Within Daoist practices and Fangzhongshu treatises, ejaculation outside of sexual intercourse was viewed as an irrational expenditure of a finite resource—vital jing energy—leading to physical exhaustion. Conversely, female masturbation was viewed more neutrally, often as a means of balancing Yin energy.

3. Paradigm Shift in Judeo-Christian Thought: A strictly negative attitude toward masturbation emerged within Judaism and Christianity. The Old Testament narrative of Onan, which originally described coitus interruptus in the context of levirate marriage, was reinterpreted by rabbinic tradition as a universal prohibition against the “futile spilling of seed.” In medieval theology (Augustine, Thomas Aquinas), masturbation was systematized as a “sin against nature” (peccatum contra naturam) because it detached sexual activity from its procreative intent.

4. Medieval Institutionalization: The Middle Ages marked the definitive transition from energetic hygiene and social pragmatic evaluation to a rigid legal and theological classification. Through the implementation of penitential books in Western Europe and canonical rules in Byzantium, masturbation was institutionalized as a grave spiritual offense requiring strict penance. The moral-theological framework established during this era laid the long-term foundation for the subsequent medicalization and stigmatization of masturbation in Modern era medicine.