Hektoen International

A Journal of Medical Humanities

The castrati: a physician’s perspective, part 1

James L. Franklin
Chicago, Illinois, United States


A modified version of this paper was presented on March 1, 2010 to the Chicago Literary Club.

“The castrati: a physician’s perspective” will appear in two installments. The first one in this issue details the history, sociology and musical history relevant to the rise of the castrato in the 17th and 18th century. The second part, which will appear in the next issue of the journal, will explore the medical and scientific aspects and include an analysis of the voice of the castrato. The article will conclude with a perspective on the medical ethics as it relates to this subject.  

Stefano Dionisi as Farinelli in the film Farinelli - Il Castrato (1994)

Stefano Dionisi as Farinelli in the film Farinelli – Il Castrato(1994)


The phenomenon of the castrati enters the history of Western music in the latter half of the 16th century, becoming a dominant factor in Italian music through most of the 17th and 18th centuries, and then gradually fading during the 19th century. To understand who the castrati were and to locate their place in Western culture we should explore the anthropology of human castration and when it was first employed in the service of vocal art. This will include a look at the attitude of the Church toward the castrati as well as their contribution to the history of opera. We will seek to understand the conditions that persuaded parents to submit their children to these procedures and the sociology of the castrati as a profession. Then there are those subjects germane to the field of medicine – how and by whom were these operations performed and what were the biological and pyschological consequences? What was the nature of their vocal art and what made their singing so appealing to the audiences of their day?
In 1977, Meyer M. Melicow, the Given Professor of Uropathology at Columbian-Presbyterian Medical Center in New York wrote that castration was one of the most common operations performed in the United States.1 At that time the operation was performed for prostate cancer and had entered 20th century practice of medicine as a result of the Nobel Prize winning discovery by University of Chicago urologist Charles Brenton Higgins, who discovered that the growth of prostate cancer was dependent on the stimulation of testosterone and that a significant remission could be induced by orchiectomy (removal of the testes). Writing on the history of castration, Dr. Melicow noted that through the ages the operation had been performed to retain supremacy of male elders, as revenge against enemies on the battlefield, on slaves serving as eunuchs in harems or seraglios, as punishment for rape, seduction and adultery, as part of self-inflicted religious rites, and to preserve a boy’s treble voice into adulthood.2 Ancient as well is the history of castration in the domestication of animals serving to produce capons, geldings and oxen and for taming our favorite pets.
History does not record when it was first recognized that the treble voice of a boy could be preserved and cultivated for singing by prepubescent castration. Vocally-gifted eunuchs were present in the early dynasties of the Imperial Chinese court and gelded choristers appeared in the Byzantine Empire as early as 400 AD. Mention of their highly sophisticated style of singing disappears after the sacking of Constantinople in 1204 during the 4th Crusade.



“The Sacred” (Church History)

A Byzantine castrato from the 11th century

A Byzantine castrato

from the 11th century

Source:  Wikipedia

To account for the appearance of castrati in Italy during the second half of the 16th century, certain points must be mentioned. From its inception, women were not allowed to sing in the church, sanctioned by St. Paul’s injunction in his letter to the Corinthians (I Corinthians 14:34): “let your women keep silence in the churches for it is not permitted for them to speak…” During the middle ages, sacred music was dominated by plainsong (Gregorian chant) that was well suited to the male voice. The growth of polyphony during the 16th century created the need for soprano voices. Soprano parts were taken either by young boys with good voices and musical ability or by male contraltos i.e. falsettists. This solution was less than satisfactory in the case of young boys since their voices lacked the strength and timbre of an adult and the investment in training was lost when their voices “broke” during puberty. There was a tradition of Spanish falsettists, part of the Mozarabic tradition in the Spanish Church. These singers traced their roots to the Byzantine castrati who migrated first to Sicily and hence to Spain when Sicily fell under Argonese hegemony in 1282. The first castrati to appear in the churches of Italy during the second half of the 16th century were imported from Spain. Castrati also found their way into Italy from other parts of Europe. Richard Sherr documented the efforts of Gulglielmo Gonzaga, the third Duke of Mantua, a musician and composer, to obtain castrati from Northern France during the years of his reign 1555-1587.3 Castrati in France occupied high-paying positions at Court and this is surprising in light of the “Gallic horror of the singers [castrati] so evident in the seventeenth and eighteenth centuries.”
There is reference to the presence of castrati in the Sistine Choir during the years 1565 – 1598 but the first castrato officially named in the Sistine Chapel choir was Jacomo Vásquez, admitted on May 27, 1588.4 In 1589 the Papal Bull, Cum pro nostro pastorali munere, of Pope Sixtus V organized the Cappella Giulia of St. Peter’s Basilica in Rome. Conducted by Palestrina, it was to include among its twenty voices, “four soprano eunuchs, if skilled ones can be found.”5 The established falsettists, equivalent to modern countertenors, were less than pleased but the new voices rapidly found favor and papal sanction. Pope Clement VIII (reigned 1592 – 1605) opined: “the creation of castrati for church choirs was to be held ad honorem Dei [to the honor of God].” The castrati outshone the reedier and thinner timbre of the falsettists and also the comparatively transient beauty of the boy choristers. Part of the policy of Pope Clement VIII was to free the Papacy from Spanish influence as he soon dismissed the Spanish falsetitas (the Spanish term) from the Sistine choir. The first homegrown Italian castrato joined the Sistine Chapel choir in 1599 and by 1640 it could be said that castrati were members of all the chief choirs in Italy.

The Church was deeply conflicted in its position on castrati. The admission of castrati in the late 16th century to the Sistine Chapel as part of the priesthood had earlier been in effect forbidden by the First Ecumenical Council of Nicea in 325 A.D. Castration was against Canon Law that stated: “amputation of any part of the human body is never lawful except when the whole body cannot be saved from destruction in any other way.” Yet mutilation in the form of amputation including castration as punishment was sanctioned by secular rulers throughout Europe as well as in the Papal States.
Theologians addressed the issue of the castrati throughout the 17th and 18th centuries and the leading voices starting with the German, Paul Laymann (1574 -1635) condemned the practice. A contrary opinion was held by some. The Sicilian Jesuit Thomas Tamburini (1591-1675) affirmed: “…it is lawful, provided that there is no mortal danger to life, and that it is not done without the boy’s consent…” He reasoned that “they served the common good by singing the divine praises more sweetly in churches…” Rober Sayer (Sayus in Latin), an English Benedictine moralist of the late 16th century who spent his last years in Venice, reasoned that the voice was a faculty more precious than virility as it distinguished man from the animals and justified doing without impiety what was necessary to suppress virility to enhance the voice. The new sopranos were considered necessary in the praise of God.


Maestro Lorenzo Perosi with his choir.

Don Perosi with his Sistine Choir (c. 1905)

During the 18th century anyone who performed castration or was associated with the practice was excommunicated by the Church. Clement XIV (1769 – 1775) forbade castration and in an effort to suppress the passion for the castrato voice, allowed women to sing in both the churches and the theaters of the Papal States. Castrati continued to sing in the Sistine Chapel throughout the 19th century. The official posed photograph of the Sistine Chapel choir taken on March 4, 1898 in celebration of the 30th anniversary of the coronation of Pope Leo XII shows them in their clerical finery and includes seven members who were castrati. A rivalry between a castrato, Domenico Mustafa, who was the director of soloists and Maestro Lorenzo Perosi who was the director of the choir came to an end during an audience with Pope Leo XII on February 3, 1902 when Perosi, acting out of strong moral conviction, convinced the 92-year old pontiff for the first time in three centuries to ban the use of castrati in church music. The December 28, 1902 issue of the Rome newspaper La Tribuna reported: “A decision ex audentia sanctissima taken three months earlier and kept secret until now, has just been transformed into a decree that will come into operation at once: as a result those singers who, let us say are ‘imperfect’ on a physical plane although … complete as singers are totally excluded from the Sistine Chapel.” This meant that “the famous inscription which could be read a century earlier outside a barber’s shop in the Bianchi Vecchi [of Rome]: ‘Boys castrated here for the Papal Chapel,’ became an archeological memory.”6


“The Profane” (Opera)

The castrato Carlo Scalzi, by Joseph Flipart (1737).

The castrato Carlo Scalzi, by Joseph Flipart, c. 1737

Source: Wikipedia

Not only did the year 1600 mark the appearance of castrati in the Sistine Chapel, it also coincides with the advent of a new art form, that of opera. Performed that year in Florence, Jacopo Peri’s setting to music of the pastoral-mythological verse play Euridice, by Ottavio Rinuccini, became the first surviving opera.7 Opera evolved from an aesthetic philosophy of the Florentine Camerata whose members included Vincenzo Galilei, father of the astronomer Galileo. The Camerata sought to recreate a vision of ancient Greek dramaturgy that stressed the singing of a single melody by a soloist capable of moving the listener through the natural expressiveness of the voice. The first performance of Euridice, written to celebrate the marriage in Florence of King Henri IV of France and Maria dei Medici, included three castrati, two of whom sang female roles. Casting castrati in female roles would continue in the early operas of the 17th century as exemplified by the three great operas of Monteverdi.8 Centered in the theaters of Venice, opera became a growth industry in Italy that spread throughout Europe. It was the development of Opera seria that propelled the castrati on a course that would give them a ‘rock-star’ status that allowed them to command unheard of fees and to be sought after in the major capitals of Central Europe, Russia and England. Opera seria, set to Italian libretti, most notably those of Apostolo Zeno and Pietro Metastasio, featured situations and characters drawn from ancient mythology and classical history. The gods and heroes in these works appealed to aristocratic audiences who valued their lofty diction and elevated sentiments and who found the otherworldly (heavenly) timbre of the castrato voice ideally suited to this genre.
Sources often state that during the 18th century, as many as 4000 boys a year were castrated in Italy to preserve their treble voices into adulthood. Readers of Voltaire may recall the Old Woman’s Tale in Candide where we read: “I was born in Naples he told me, where they caponize two or three thousand children every year; some die of it, others acquire a voice more beautiful than any woman’s, still others go on to become governors of kingdoms.”9
This estimate may have been an exaggeration. In an article, The Castrati as a Professional Group and Social Phenomenon, 1550-1850, the English historian and musicologist John Rosselli surveys existing church records throughout Italy in an effort to clarify these numbers. While admitting that a precise calculation is not possible, he notes: “at any time between about 1630 and 1750 there must have been living several hundred castrati, nearly all Italians…. In Naples, Rome, Bologna, and Venice… and in some smaller towns (Padua, Assisi, Loreto), there were groups of castrati large and stable enough to be a feature of every day life.”
Rosselli goes on to ask:

… what led ordinary people and adults in authority to condone such a drastic step? Europe during the early 17th century was in a period of severe economic crisis. For Italy the years around 1620 marked a servere depression followed by war and plague. Landholding was the main source of income and the upper classes sought to safeguard the line of descent. During this period there was a dramatic increase in the numbers of monks and nuns.10

Getting a child into the clergy became a source of security for middling and poor people. Rosselli observes: “celibacy was on the increase in the period 1600-1750 through the workings of economic hardship and the efforts of families to safeguard property…” Quoting Joseph Jérome LaLande’s Voyage en Italie (1766), the practice of castration “attracts no notice in a country where the population is huge in relation to the amount of work available” and concludes: “To become a castrato – still more, to make your son become one – need not in these conditions seem a total misfortune.” Richard Somerset-Ward in Angels & Monsters: Male and Female Sopranos in the Story of Opera, 1600-1900 observes:

A caricature of Farinelli in a female role by Pier Leone Ghezzi 1724.

A caricature of Farinelli in a female role by Pier Leone Ghezzi 1724

Source: Wikipedia

The province of Apulia is on the Adriatic side of Italy, in the southeast corner. In the seventeenth and eighteenth centuries it accounted for a large part of the kingdom of Naples and it faithfully reflected the economic and social conditions of the time – widespread poverty, dominance of the Church, and an economy in which owning land was the only real source of security. These were also the conditions that gave rise to the phenomenon of the castrati, and it is not surprising that Apulia was one of the place from which many of them came including, Farinelli from Andria and Caffarelli from Bitonto.

Castrati could become fabulously rich, perhaps one out of a hundred, but those who did not, would be able to support themselves through employment in the Church and in either case send money home to their families. Somerset-Ward speculates that this goal was reached in only 10 or 15 percent of families “but in largely impoverished communities those were attractive odds nonetheless.”
In explaining the vocal art of the castrati, two factors need to be considered. The anatomical changes resulting from the operation are widely recognized and will be discussed shortly, but also the intensive training that promising young singers received, though less well recognized, played an important part in the their success. Boys who were castrated before the onset of puberty did not experience a break in their voice and therefore from a very young age were able to receive intensive and uninterrupted music training. This advantage gave them a head start over intact male and female singers of their day. In Naples, the center of musical training for eunuchs during this era, there were four conservatories devoted to training of intact singers and castrati. These institutions often entered into written contracts with the parents of these boys, stipulating that in return for the payment of the surgery, room, board, and musical training, all income from their singing for extended periods of time would revert back to the school. Alternate agreements were made between the parents and music teachers or noble patrons who paid for the operation and training. Requests for castration were required of boys eight to ten years of age indicating their willingness to accept the operation and devote their lives to the Church. In 1687, one Silvestro Prittoni petitioned the Duke of Modena:

Silvestro Prittoni, servant of Your Serene Highness, finds himself in the state of rejoicing in a voice sufficiently good to practice music and wishing to retain it, begs Your Serene Highness on his goodness to make it such that he is without those instruments, which would allow the change in voice to take place with advancing years; that he might receive all this as charity, it being the case that he cannot find the means of being able to do this because of his poverty.

The petition was granted, May 11, 1687 and the Duke authorized the payment of four doble to Silvestro “for the aforementioned purpose” with the precaution that the treasurer was to state it was issued “for reasons known to us.” Contracts also assigned penalties to the parents, if the boys attempted to run away.
The training of young castrati was intensive and thorough. Not only did they receive extensive training in the art of singing, but instrumental training including keyboard instruments, theory and composition. They also were educated in literature and drama. A famous castrato Geatano Majorano Caffarelli (1710 – 1783), gives us this account of the daily routine in the conservatory:

Morning, 1 hr. of singing passages of difficult execution; 1 hr. of letters (values of words etc.); and 1 hr. of singing passages in front of a mirror, to practice deportment, gesture and guard against ugly grimaces while singing; afternoon ½ hr. theoretical work; ½ hr. of counterpoint on a canto fermo (practice in improvisation); 1 hr. studying counterpoint with the cartella (a board on which musical notes were written); and 1 hr. studying letters. The rest of the day spent in exercise at the harpsichord and the composition of motets and psalms.

Alessandro Moreschi, c. 1880

Alessandro Moreschi, c. 1880

Source: Wikipedia

Within the conservatories, the castrati dressed in separate and finer uniforms than those of their intact contemporaries and received preferential treatment in their accommodations and diet. At Sant’Onofrio, one of the four conservatories in Naples, we read these pithy observations: “the refectory was in common; but, especially in the winter, they took care to guard the little nightingales-in-training from the rigors and changes in temperature, and so they were fed in their own rooms; moreover the food prepared for them differed from the food for the other boys. Eggs, broth, boiled chicken, a generous wine habitually filled these delicate stomachs: even the clothes these preferred boys wore were such to protect them much better from the seasons’ inclemencies.”

By the age of 16, castrati were often ready to make their operatic debut and frequently assumed female roles, playing their parts with great success. The memoirs of Giacomo Casanova are replete with libidinous anecdotes about castrati that also speak to this point:

In the middle of the confusion, I saw a priest with a very attractive countenance come in. The size of his hips made me take him for a woman dressed in men’s clothes, and I said so to Gama, who told me that he was the celebrated castrato, Beppino della mamana. The abbe called him to us, and told him with a laugh that I had taken him for a girl. The impudent fellow looked me in the face, and said that, if I liked, he would shew me whether I had been right or wrong.

Honoré De Balzac in his novella, Sarrasine, of 1830 capitalizes on this sexual ambiguity in a gothic tale depicting a corrupt European culture during this era.

The second part of this article, which will be featured in the next issue, will cover the scientific and medical aspects and include an analysis of the voice of the castrato. The article will conclude with a perpective on the medical ethics as it relates to this subject.



I would like to acknowledge the friends with whom I have discussed this paper and benefitted from their input:

David J. Buch, PhD, Visiting Professor in the Committee on Theater and Performance Studies at the University of Chicago; Donald Zimmerman, MD, Chairman of Pediatric Endocrinology, Children’s Memorial Hospital, Professor Pediatrics, Northwestern University Feinberg School of Medicine;

Robert W. Carton, MD, Emeritus Professor of Medicine, Rush University Medical Center;

Special thanks to Jonna Peterson, MLIS, Reference Librarian, Library of Rush University Medical Center.



  1. Meyer M. Melicow, “Castration Down the Ages,” New York State Journal of Medicine, 77, 804-806, Aril 1977.
  2. Castration has not been limited to men, oophorectomy (removal of the ovaries) has also been successful in the treatment of estrogen dependent breast cancer in women.
  3. Richard Sherr, Gugliemo Gonzaga and the Castrati, Renaissance Quarterly, 33 (1), Spring 1980, pp. 33-56.
  4. Cappella dei Cantori Pontifici was the official designation of the Sistine Chapel Choir. The original papal schola cantorum (school of singers) dated from the 4th century, while the Sistine Chapel derived its name from Pope Sixtus IV (reigned from 1471-1484), who had the chapel built.
  5. Anthony Milner, “The Sacred Capons, Musical Times,” 114:250-252, 1973 (an excellent reference on Castrati and the Church)
  6. Patrick Barbier, The World of the Castrati, tr Margaret Crosland, Souvenir Press, London 1996, p.239.
  7. An earlier opera, Daphne of 1597, by Peri and Rinuccini has not survived, but is often credited as the first opera.
  8. Orfeo produced in Mantua in 1607 and his subsequent operas, Il ritorno d’Ulisse in patria and L’incoronazione di Poppea, performed in Venetian theaters in the 1640’s.
  9. Voltaire is referring to the castrato Farinelli (1705-82) who came to exercise considerable influence over the Kings of Spain, Philip V and Ferdinand VI.
  10. John Roselli, “The Castrati as a Professional Group and as a Social Phenomenon, 1550-1850,” Acta Musicologica, 60,143-179, 1988.



JAMES L. FRANKLIN, MD is a gastroenterologist and Associate Professor Emeritus at Rush University Medical Center. He is also a member of the Hektoen International Editorial Board and serves as the President of the Chicago Society of Medical History & Humanities.


Highlighted in Frontispiece Spring 2010 – Volume 2, Issue 2
Spring 2010  |  Sections  |  Music Box

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