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510 SAMJ VOLUME 69 12 APRIL 1986

History of Medicine
On the sexual intercourse drawings
of Leonardo da Vinci
A. G. MORRIS
.,
Summary
Leonardo da Vinci's marvellous anatomical drawings
have been praised by both artists and medical
historians over the centuries. Specific reference is
made here to Leonardo's drawings of the act of
sexual intercourse. It is shown that his illustrations
are not based purely on original observation. Rather,
they are an attempt to illustrate and clarify anatomy
and physiology as presented in the textbooks of the
time.
S Atr Med J 1986; 69: 510-513.
One of the most celebrated non-events in the history of
anatomy was the failure of Leonardo da Vinci (1452 - 1519) to
publish his proposed anatomical textbook. Over a period of
more than 20 years Leonardo accumulated at least 200 pages
of notes and drawings but he was not able to organize the
manuscript into a publishable form. The artistic standard of
his work has been praised by all who have viewed the pages,
and some of his biographers have gone as far as to say the
proposed book would have become the standard anatomical
reference well into the centuries following his death. Sadly, da
Vinci did not finish his book and the drawings and manuscripts
were lost to the world of scholars until the late 18th century.
The publication of the first modern anatomical text had to
wait until the appearance in 1543 of De HlImani Corporis
Fabrica by Andreas Vesalius.
But are the praise singers of da Vinci truly justified in their
emphasis on Leonardo as a man so far ahead of his time?
There can be no doubt that da Vinci was both marvellously
observant and imaginative in his diagrammatic presentation,
and his engineering and artistic innovations are indeed great,
but the anatomical knowledge demonstrated in his observations
is full of imperfections. Da Vinci's work is that of a brilliant
artist whose anatomical observations were clouded by pre-
conceived ideas, while Vesalius was a master of dissection who
broke new ground in the originality of his observations. To be
fair to Leonardo, it must be noted that his later works were
more accurate, bur many of the errors remain. O'Malley and
Saunders
1
have described Leonardo's anatomical enterprise as
the 'revelations of a groping mind seeking emancipation from
debased medieval Aristotelianism ...'. He came close to this
goal, but complete freedom eluded him. Nowhere can this be
bener illustrated than in his drawings of male and female
anatomy in the act of coition. These pictures are a special
mixture of fact and fancy, an objective basis overlaid with
traditional theories.
Department of Anatomy, University of Cape Town
A. G. MORRIS, PH.D.
Leonardo's anatomical background
Pan of the folklore about Leonardo da Vinci is his reputation
for being a persistent dissector who anatomized numerous cadavers.
Da Vinci himself declares in his notes that he dissected ten bodies
and Taiana
2
quotes contemporary sources to indicate that the
figure may have been as high as thirty. O'Malley and Saunders
l
have closely examined da Vinci's original notes and drawings to
see if they can verify these numbers and have come to the
surprising conclusion that Leonardo's experience was much less
than is usually described. He did a full srudy of the body of an old
man, the 'centenarian', in Florence in 1503 and of a child of two
years at about the same time. It seems likely that he also dissected
a second elderly male, a younger male, and a human ferus of about
7 months post-conception. Other dissections were of parts of
human bodies; a head and neck during his first stay in Milan and
perhaps a leg at a later date. He certainly srudied a number of
animal cadavers and it is probably true that he observed human
dissections performed by other people. The evidence therefore
suggests that da Vinci dissected only four or five individuals and
the remainder of his 'ten human bodies' were bits and pieces of
human material that he was able to obtain from time to time.
Even more important is the fact that Leonardo did not have
constant access to dissection material during his career. The young
Leonardo resided in Florence from about 1470, first as an appren-
tice to the famous del Verrucchio, and then as an artist in his own
right. The Florentine medical school had been moved to Pisa in
1470 and it is unlikely that he could have participated in human
dissections during these early years. The siruation was not much
better in Milan where he moved in 1482 or 1483. His patron,
Lodovico Sforza, required his constant services as an engineer and
much of Leonardo's spare time was taken up in designing monu-
mental architecrure for the Duke. During this rime Leonardo
dabbled in anatomy, but the drawings that can be dated to this
period are very inaccurate. The poor quality suggests that da Vinci
was relying on textbook anatomy and his opportunities for dissec-
tion must have been rare indeed.
In 1499, da Vinci's Milanese patron was expelled from the city
by the French, and Leonardo embarked on a period of wandering
which took him from Milan to Venice and into the service of the
infamous Cesare Borgia. In Venice he had access to a medical
school with a professional anatomist in anendance, but he does
not appear to have taken advantage of the siruation. Finally in
March 1503, da Vinci returned to Florence and began his period
of most active anatomical research. It was here that he met the
centenarian at the Hospital of Santa Maria Nuova and was at his
bedside when the old man died. Leonardo's active interest did not
slacken when he moved again to Milan in 1506 and he was a
frequent visitor to the Hospital Maggiore. The content of
anatomical drawings dated to this period testify to da Vinci's
improved knowledge and new-found originality of observation,
and there can be no doubt that he had gained first-hand experience
as a dissector. Towards the end of his life Leonardo left Milan and
journeyed first to Rome, then to Florence, and finally to Frahce
where he died in 1519.
The anatomical drawings of Leonardo da Vinci span the years
between 1487 and 1513, but only in the laner half of this time did
Leonardo have detailed knowledge gained through dissection. Da
Vinci's source of information in the early years could only have
been gleaned from textbooks and, as a result, Leonardo spent
much of his time producing drawings which tried to explain the
conflicting viewpoints presented in these books. In his notes, da
Vinci lists his literary possessions and this gives us some idea of
SAMT DEEL69 12APRIL1986 511
Fig. 1. Torsos in coition, from sheet C III 2 recto.
the kind of texts he had read. Chief among Leonardo's reference
books was a 1493 edition of Johannes de Ketham's Fasciculo di
Medicina.
3
This was a compendium. of medical information that
included a complete translation of Mondino di Luzzi's AnOlhomia.
Mondino's book, originally wrinen in 1316, was the text favoured
by most medical schools and the Fasciculo edition was the first to
be published in Italian. Da Vinci's poor command of Latin made
earlier versions unavailable to him.' The Mondino publication was
typical of 15th cenrury medical books in that it was essentially an
unchecked reissue of ancient anatomical manuscripts. Its only
claim to originality was in its dissection manual format, but the
information it contained was based on Arabian writings which
were translated from Arabic into Latin in about 1150. The most
famous of these writers was Avicenna who in rurn had derived his
information from translations of Galen and pre-Galenic Greek
texts. Ketham's version of Mondino was therefore a summary of
ancient Greek knowledge fIltered through at least three major
translations. By reading this book and others, Leonardo gained
access to the ideas of Hippocrates, Aristotle, Plato and Galen, but
these were intermixed with the later views of both Avicenna and
Mondino. Direct translations of the original Greek texts into
Latin and European secular languages were not available until
1525, six years after da Vinci's death.'
The coition figures
Illustrations of figures engaged in sexual intercourse appear on
four pages of da Vinci's notebooks. Interest in these picrures has
always been great and they were among the first of Leonardo's
drawings to be described. C III 2 recto* depicts three pairs of
human torsos cut longirudinally to show the anatomical features of
the genitalia. The largest figure (Fig. I) seems to be a preliminary
sketch for a more complete drawing (described below). On the
*The pagination of da Vinci's notebooks is based on the number given them in their first
detailed description. Da Vinci did not number his pages and the inheritors of the documents
made no attempt to keep them in a specific order. The pages containing the sexual intercourse
drawings are all from Folio C published in six volumes between 1911 and 1916. I,) The roman
numeral refers to the volume number and the specific page follows. Only rarely did Leonardo
use one side of the page alone, so recto and verso refer to the front and back surfaces.
verso of this leaf is a diagram of the male and female generative
organs in coition (Fig. 2). The quickly scrawled illustration is on
the corner of a page filled with mechanical drawings of cranes,
pulleys and levers. C III 3 verso contains the largest and most
complex of the coition figures (Fig. 3). The style of the drawing is
clearly based on the torso figures described above, but the anatomy
is much more detailed. A small accompanying drawing of the
penis at the bottom of the page is presented here as Fig. 4. The
last of the coition illustrations is a set of scattered sketches (C III
12 verso) showing the sexual organs either in coition or separately.
A group of these drawings are included here as Fig. 5.
Leonardo dated very few of his picrures, but the notes can be
sorted into a rough chronological order by means of progressive
changes in the paper, ink and pen used, and by the altered style of
his handwriting over the years. O'Malley and Saunders' have
considered these clues and suggest that the preliminary coition
torsos were drawn about 1493 or 1494, while the more complete
,.
Fig. 2. Generative organs during coitus, from sheet C III 2 verso.
512 SAMJ VOLUME 69 12 APRIL 1986
Fig. 4. Detail of penis, from sheet C III 3 verso.
anempt to include the Galenic view that the testes manufactured
sperm from the blood. He has therefore mixed Galenic and
Aristotelian arguments and has provided an appropriate anatomy
for both theories. An interesting omission in the male fIgure is the
prostate gland. This organ is not mentioned in any of the medical
books available to da Vinci, and it does not appear in Leonardo's
drawings of masculine anatomy.
The medieval and ancient Greek theoretical overlays are also
present in da Vinci's depiction of female anatomy. In Fig. 3 the
uterus is rather poorly sketched and has a corrugated appearance.
The cause of the corrugations becomes obvious when the chrono-
logically earlier drawings (Figs 1 and 2) are viewed. Here the
uterus is clearly made up of a number of cells. This strange
uterine morphology is drawn from the description of Mondino
who maintained the common medieval misconception of a womb
with seven chambers. Leonardo discarded this idea with time, and
the later drawing (Fig. 5) shows a uterus of more normal appear-
ance. Even more extraordinary is the addition of a blood vessel in
Fig. 3 connecting the fundus of the womb with the breast.
According to medieval thought, this hypothetical vessel carried
the suppressed menstrual blood to the mammary glands where it
caused the enlargement of the breasts and the production of
milk.
I
,3 The absence of ovaries in the drawing reminds us again of
Leonardo's great confusion between Aristotelian and Galenic
theories. The Aristotelian belief presented the fema1.e as just the
soil into which the male seed was planted and the "ovaries were
given no reproductive role. In later years da Vinci subscribed to
the Galenic approach in which the female testicles (ovaries)
produced their own sperm which intermingled with the masculine
sperm in the uterus. An imaginary passage called the vas
seminarium delivered the female sperm from the ovary to the
cervical junction of the uterus and the vagina.
Two features about the depiction of the sex act itself are also of
interest. The penis is shown by da Vinci to protrude through the
cervix and into the uterine cavity in all drawings except Fig. 3,
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illustration is from about 1500. The scanered drawings of dis-
embodied generative organs are later, perhaps around 1503 or
shortly after. These dates imply that all but one of the drawings
was executed before da Vinci had obtained an appreciable know-
ledge of anatomy through dissection. The drawings have major
imperfections in their detail, and in each case the errors are the
result of Leonardo's anempt to illustrate 'textbook' anatomy.
A brief glance at the male character in Fig. 3 reveals the
amazing internal 'plumbing' designed by Leonardo to describe
Aristotelian physiology. He has drawn two canals in the penis, the
lower of which is connected to the urogenital tract via the urethra,
while the upper canal passes to the spinal cord by means of three
vessels. The close-up of the penis (Fig. 4) demonstrates these two
canals in fIne detail. In ancient Greek writing, the 'essence' of a
baby was provided by the 'universal seed stuff' of the male.
6
This
procreative ingredient was derived from animal spirit, a physio-
logical material necessary for muscular activity. The animal spirit
was manufactured from arterial blood at the base of the brain and
was transferred to all parrs of the body through the nerves. Hence
da Vinci's spinal connection to the penis. Aristotle taught that the
testes played no role in procreation other than to provide a saliva-
like humor to lubricate the vagina during intercourse. Leonardo
appears to have disagreed with this concept, and he has drawn a
large blood vessel passing from the hean to the testicle in an
Fig. 3. Figures in coition, from sheet C III 3 verso.
12 APRIL 1986 513
I. O'Mallcy 0, aundcrs JB. Uonardo da Vinci on rlu Human Body. 'IOW
York: Henry chuman, 1952.
2. Taiana JA. The anatomical drawings of Leonardo da Vinci. In: Richardson
RC, cd. Abbollempo in ReviertJ. Amsterdam: Abbott niversaJ, 1970.
3. Keel KO, Pedrerti C. Leonardo da Vinci: orpur of rlu Anatomical rudi.. in
rhe Col/ccrion of Her Majtsly rlu Q n ar Windsor Uurle. London: Johnson
Reprint Co., 1979 - 1980.
4. Wallacc R. TIu World of Leonardo. Am terdam: Time-Life, 19 2.
5. inger C. A Sharr Hillory of Anaromy from the Grub ro Harvey, 2nd cd.
'ew York: Dover, 1957.
6. McMurrich JP. Leonardo da Vinci: TIu An romlfl. Baltimore: Williams &
Wilkins, 1930.
fLe nard I kn wledg
REFERE 'CE
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and the uterus is consistently illustrated as being inflated. This
embracing of the glans penis by the cervix and the expan ion of
Fig. 5. Generative organs during coitus, from sheet C III 12 verso.