Hektoen International

A Journal of Medical Humanities

The donkey in culture, science, and medicine

The donkey (Equus asinus), though often overshadowed by the horse, has played an essential role in the development of civilizations for roughly six thousand years. Descended from an earlier ancestor, the African wild ass, which likely originated from the Horn of Africa, it has been domesticated for its endurance and ability to survive with little food or water. In ancient times, it enabled farmers and merchants to move materials over long distances. Before wheeled transport became widespread, it was the most dependable pack animal available.

Donkeys hold a notable place in literature, religion, science, and medicine. They have appeared in myths, fables, religious texts, novels, and poetry, variously representing humility, patience, wisdom, or quiet strength. In ancient Egypt, they symbolized agricultural prosperity and commercial success. Egyptian tomb paintings often depict caravans of donkeys transporting grain, wine, and precious minerals. Greek literature portrayed donkeys humorously, as in Aesop’s fables, where they appear as hardworking yet sometimes naïve creatures. The Golden Ass by Apuleius (second century CE) tells the story of Lucius, a man transformed into a donkey through a magical mishap, who endures a series of degradations and adventures before being restored to human form by the goddess Isis. He becomes a vehicle for a satire on human vanity, cruelty, and superstition.

In the Bible, Abraham travels with donkeys, Balaam’s donkey miraculously perceives an angel invisible to its master, and Mary rides a donkey to Bethlehem. Jesus enters Jerusalem on a donkey rather than on a warhorse, a prophesied sign of humility and peace. In Miguel de Cervantes’ Don Quixote, Sancho Panza’s donkey, Dapple, serves as a practical counterpart to Don Quixote’s idealistic horse, Rocinante. In A Midsummer Night’s Dream, the buffoonish weaver Bottom is given the head of an ass, and the queen of the fairies, Titania, is enchanted into loving him. In Travels with a Donkey (1879), Robert Louis Stevenson turns the donkey Modestine into a travel companion when hiking through the Cévennes (1879). In Animal Farm by George Orwell (1945), the elderly donkey Benjamin recognizes tyranny but will not act. Children’s literature also features memorable donkey characters, such as Eeyore in Winnie-the-Pooh, who is famous worldwide. Across North Africa and the Middle East, donkeys have historically been indispensable companions in village life. In Mediterranean folklore, the donkey often appears as an intelligent animal, underestimated because of its quiet nature.

Unfortunately, in many modern languages, the word “donkey” has become an insult implying stupidity. Scientific studies of donkey behavior, however, show that this stereotype is inaccurate. Indeed, for thousands of years, donkeys were engines of economic development. Before trucks and railroads, donkey caravans connected cities and villages. They transported salt, grain, textiles, spices, metals, ceramics, and construction materials. Even today, donkeys remain an essential means of transportation in mountainous regions where motor vehicles cannot travel. Throughout history, donkeys worked in mines, carrying ore and supplies through narrow tunnels. In Europe, the Middle East, and Latin America, they contributed significantly to the extraction of coal, copper, silver, and gold. In modern times, they remain valuable in developing nations.

According to current behavioral sciences and contrary to popular belief, donkeys are highly intelligent. Unlike horses, they rarely panic. When confronted with danger, they typically pause to assess the situation before responding. This has historically been misinterpreted as stubbornness. They possess excellent long-term memory, strong problem-solving ability, remarkable spatial awareness, and excellent recognition of individual humans and animals. They are exceptionally adapted to harsh environments. Physiological adaptations include efficient water conservation, tolerance of extreme heat, ability to digest coarse vegetation, and strong, durable hooves suited for rocky terrain. These characteristics explain why donkeys remain indispensable in deserts and semi-arid regions.

Genetic research has also clarified the relationship among horses, donkeys, and mules. Donkeys possess 62 chromosomes, whereas horses have 64. When crossed with horses, the resulting mule usually has 63 chromosomes, explaining why most mules are sterile. Donkeys differ from horses in ways that matter clinically. They metabolize certain drugs differently and mask pain and illness more effectively, a trait inherited from their ancestry from a time when visible weakness would have endangered survival. Modern genomic studies are helping scientists preserve endangered donkey breeds by understanding the genetics of disease resistance.

The composition of donkey milk resembles human breast milk but has a relatively low fat content. It has been investigated as an alternative food for infants who cannot tolerate the proteins in cow milk and may contain antimicrobial substances that inhibit bacterial growth and support immune function. For centuries, donkey milk has been used in soaps, creams, and skin treatments. Legend holds that Cleopatra VII Philopator bathed in donkey milk to maintain soft skin. In traditional Chinese medicine, donkey-hide gelatin, known as ejiao, has been used for centuries, prepared by stewing and refining donkey skin into a gelatin block, and prescribed to “nourish the blood”. In Jane Austen’s Sanditon, the wealthy and thrifty Lady Denham keeps milch donkeys on her property and views their milk as a remedy for various ailments.

Despite their historical importance, donkey populations have declined in many parts of the world because of mechanization, habitat loss, and changing agricultural practices. Conversely, several countries have experienced intense demand for donkey skins used to produce ejiao, contributing to rapid declines in donkey populations, threatening rural livelihoods, and prompting governments and international organizations to strengthen conservation and animal welfare measures. Protecting this remarkable species is both an ethical responsibility and an investment in cultural heritage, sustainable agriculture, scientific knowledge, and global health.


GEORGE DUNEA, MD, Editor-in-Chief

Summer 2026

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