The earliest known records of intentional human castration date to the Sumerian city of Lagash around 2100 BC. From there, the practice spread across nearly every major civilization for roughly four thousand years, used to create palace servants, temple devotees, harem guards, and court officials. The methods varied significantly by culture, ranging from crude crushing techniques performed on infants to precise surgical operations carried out by trained specialists.
What “Castration” Actually Meant
Ancient sources use the word loosely, but the procedures fell into three distinct categories: removal of the testes alone, removal of the penis alone, or complete removal of all external genitalia. In most archaeological and historical contexts, castration referred to removal of the testes. This was the most common form across Greece, Rome, and the Ottoman world.
China’s imperial eunuchs, by contrast, underwent complete genital removal. The distinction mattered enormously for the person’s body afterward. Removing only the testes eliminated testosterone production and fertility while leaving the anatomy otherwise intact. Complete removal created additional complications, particularly with urination, that required lifelong management. The choice between these approaches often depended on the cultural purpose behind the castration. Religious self-sacrifice, as in the cult of the goddess Cybele, sometimes involved the most extreme form. Palace service in China demanded total removal as proof of absolute compliance.
The Byzantine Crushing Method
Byzantine medical texts describe two primary techniques, and the simpler of the two was crushing. The youngest infants were placed in a sitting position over a container of hot water to relax the tissues. While the child sat in the warm bath, the practitioner crushed the testicles between their fingers until the organs dissolved and were no longer detectable by touch. No incision was required.
The seventh-century physician Paul of Aegina documented this method but actually advised against it. He noted that crushing sometimes left portions of testicular tissue intact, which meant the person could retain some sexual drive later in life. Paul preferred the surgical alternative because it offered more certainty.
The Byzantine Surgical Method
The excision technique Paul of Aegina favored was more precise. The person was placed on a raised platform. The practitioner pulled the scrotum taut with one hand, then made two vertical incisions with a lancet, one over each testicle. As the cuts opened, the testicles were pushed out through the incisions, separated from their surrounding membranes, and removed while leaving the blood supply structures behind. This approach gave the practitioner direct visual confirmation that the organs were fully extracted, solving the reliability problem of the crushing method.
China’s Imperial Procedure
The castration of eunuchs for China’s imperial court, particularly well documented during the Qing Dynasty, was the most elaborate and ritualized version of the procedure. It was performed by a specialist known as a “knifer,” assisted by three helpers. The operation was far more radical than the Byzantine approach: the scrotum, penis, and testes were all removed together in a single cut of a knife.
Immediately after the cut, a pewter or bamboo plug was inserted into the urethra to prevent it from closing as the wound healed. The newly made eunuch was kept without any food or water for three days to minimize complications during the initial healing period. The removed tissue was carefully preserved in a container called the “bao,” treated almost as a treasure. This wasn’t sentiment. The tissue had to be produced later as physical proof of emasculation, required for appointment to palace positions and, traditionally, to be buried with the eunuch at death so he could be “restored” to wholeness in the afterlife.
The procedure was ideally performed on prepubertal boys, who were considered purer and likely tolerated the operation better than adults. Families in financial desperation sometimes volunteered their sons for the procedure, as palace eunuch positions offered economic security that was otherwise unattainable.
Pain Management Was Minimal
Ancient practitioners had limited options for controlling pain. Wine and opium were available in some cultures and periods, but the historical records of castration procedures rarely mention their use in any systematic way. The Byzantine crushing method on infants relied partly on the hot water bath to relax tissues, but this was more about making the procedure physically possible than about comfort. China’s knifer system prioritized speed over pain relief. A single, fast cut was itself a form of damage control, since a drawn-out operation meant more bleeding and greater risk of infection.
The three-day period without food or water following the Chinese procedure would have compounded the suffering considerably, but it served a practical purpose. Reducing fluid intake meant less urine production, giving the urethral wound time to stabilize around the plug before being exposed to liquid.
The Question of Ancient Egypt
Egypt is often assumed to have practiced castration, and there are scattered references in ancient texts. The priest-historian Manetho, writing in the third century BC, mentioned that Pharaoh Ammenemes of the 12th Dynasty was murdered by his eunuchs. However, the physical evidence is thin. The mummy of Pharaoh Meneptah, son of Ramses II, was found with the scrotum removed, but closer examination revealed the wound was fresh at the time of death, most likely inflicted after death and before embalming rather than as a surgical procedure during life. Another mummy, Nekht-Ankh, was found with the penis detached, but scholars have found no compelling evidence this represented intentional castration either. The current scholarly consensus is that there is no solid support for the idea that Egyptians routinely performed castrations, despite the presence of eunuchs in later Egyptian court records, who may have been imported from neighboring cultures.
Religious Self-Castration
Not all castration was imposed by others. The cult of the Phrygian goddess Cybele involved ritual self-castration by her male devotees, inspired by the myth of Attis. In the Phrygian version of the story, Attis emasculates himself completely and dies. In the later Hellenistic retelling, he survives and becomes a eunuch-priest devoted to the goddess. These two versions of the myth may reflect two different real-world practices: complete genital removal as an act of total self-sacrifice, and removal of the testes alone as a survivable initiation into priestly service. If the goal was to completely sever ties with conventional male identity, the more extreme form may have been more common in these religious contexts than historians once assumed.
Why Methods Varied So Widely
The differences between cultures came down to purpose, available knowledge, and who was performing the procedure. Byzantine physicians like Paul of Aegina approached it as a medical operation, comparing techniques and recommending the more reliable one. Chinese knifers were specialized tradesmen who passed their skills within families and operated outside the formal medical establishment. Religious devotees of Cybele acted in ecstatic ritual states without any practitioner at all. Each context produced its own technique, its own risks, and its own survival outcomes. What remained constant across all of them was that castration served as a tool of power: over palace servants, over religious identity, and over the bodies of people who rarely had a say in what was done to them.