THE HEALTHCARE NEEDS Of MEDIEVAL WOMEN ......$5 insight into their social status. Sicilian laws from 1231 prohibit explicitly the rape of nuns and novices, “Even for the purpose

THE HEALTHCARE NEEDS Of MEDIEVALWOMEN

Franklin J. Griffen

rFHE average person in the medieval period lived a life which byour standards seems horrendous. Women’s lives at times seem

even worse. Generally denied entrance into armies or defenseforces, much less military training of any kind, women largelydepended on men for safety and defense. When that defense failed,they suffered horrors and torments worse than death. Even inpeacetime, medieval Europeans faced famine and disease, lookingforward to Eternal Salvation with little hope of improving their lot inthe world. Of course, they found their happinesses: they ratherenjoyed a good party (finding plenty of causes in the Church’s feastand holiday calendars to hold them), and ingested quite a lot ofalcohol in the course of a normal day. Even so, the average personstruggled through life and the average woman even more. Constrained in their agency and sense of self by legal and social strictures, women occupied specific roles: generally obedient daughtersand housewives, which often meant acting as nurse and nanny aswell. In addition to the needs of those around them in their household and community, restricted from access to male medicalpractitioners by a variety of factors women needed to monitor theirown special health concerns as well. With the men in their livesoften prohibited or simply uninterested in learning about basicgynecology or obstetrics, and equally often considering such mattersof little import, women found themselves in a dangerous situation.The dangers ofbearing children, one of the primary responsibilitiesfor women throughout medieval Europe, necessitated specializedmedical knowledge often marginalized by academic medicine andleft in the hands of nonprofessional, often female, empirical andtraditional practitioners. Because of the state ofmedical science andthe legal and social mores of the time, women, in order to surviveand thrive in medieval Europe, took a more active and self-informedrole in their health and healthcare than men.

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The idea for this paper existed in a primitive form in an earlierwork on the effects of increasing professionalization in medievalEuropean medicine, which contained a few pages on the changingstatus of women in the medical profession. Though this paper andits argument contain some elements of feminist historiography, andcertainly relies on the concept of agency, it avoids certain corecomponents. The intention here is not to shift any paradigms,launch any moral crusades, fiercely criticize any cultures, or makequalitative judgments about the past. This paper also avoids deeptheoretical examinations ofmale gaze, construction ofgender roles,or privilege and power discourses. It accepts the societies examinedas they were, as the facts on the ground, and works within them touncover a new shade of knowing. It seeks only to reexamine andclarify an overlooked facet of the complex nature ofwomen’s agencyin medieval Western Europe.

Discussing Western Europe as a whole allows for the best use oflimited sources. Obviously, few documents of female authorship oreven specifically about women from the period survive. Even fewersurvive which focus specifically on what we call healthcare and thehealth sciences, and those originate from all across Western Europe.Emilie An-it’s Women’s Lives in Medieval Europe collates manywomen-specific primary sources, crafting an invaluable and insightful portrait of female health in medieval Europe which provedinvaluable to this project. Surveys of medical history often focusnearly exclusively on professional practitioners, leaving knowledgeregarding midwives at the periphery, but the works of Monica H.Green and Beryl Rowland aided immensely in filling the gaps.

Further comment on the overall state of scholarship regardingmedieval European women is worthwhile. My research uncoveredno thorough, accessible general treatise on the subject in English.Some secondary work exists, as just mentioned, with Monica H.Green leading the pack recently. Katharine Park has also done somework on the very late middle ages, but usually focuses more on EarlyModern Europe. The thesis I present here is probably not verycontroversial, nor is it meant to be; we are long overdue for anoverview work on medieval European women’s health, a critical facetof our understanding of Medieval Europe, and I consider this paperand others like it to be inklings of foundation for such an endeavor.

In general, women existed in a confusing place in medieval life.In some ways protected, in others left vulnerable, and often lceptsubject, they at once occupied a special status as objects of desireand sanctity but also as lesser persons, utterly less capable andvaluable than men. Laws from the period in particular provide some

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insight into their social status. Sicilian laws from 1231 prohibitexplicitly the rape of nuns and novices, “Even for the purpose ofmarriage”.’ The law punished rapists of prostitutes, although inrather demeaning terms:

We favor the glory of peace by defending one from another, bothmen and women...Therefore, those miserable women who aremarked as prostitutes by their quest for shame should rejoice ingratitude for our favor that no one may force them to satisfy hiswill if they are unwilling.2

The idea that prostitutes all “quest for shame” displays littlesympathy for the plight of women driven to the world’s oldestprofession by necessity, but considering their conditions, someprotection seems better than none. The code also proscribes rape ofvirgins and widows.3 All instances of rape merits capital punishment, and those who fail to intervene to stop or prevent a rape suffera fine of four augustates.4 A contemporary legal code in Normandyprohibits rape but allows rapists vindication via trial by ordeal andmarriage of the victim (the latter ofwhich the Sicilian code explicitlyforbids), and, conversely, conviction via duel. Rapists of prostitutessuffer merely the indignity of repaying the prostitute for servicesrendered, and for any damages owed should he have torn her clothesin the act.5

The codes provide other protections and exclusions and specialcrimes for women, but importantly both say, implicitly and explicitly, that women by their nature require special aid and protections.The Normandy laws put widows under the care of the Church, likeorphans; the Sicilians specify that women “injured because of theweakness of their sex” deserve special aid by the throne and itsofficials, and also make special exceptions for women who mightinadvertently break the law “on account of the weakness of their

‘Laws ofSicily, Boolc I.XX, in Women’s Lives in Medieval Europe, ed. Emilie Amt,(New York: Routledge, 1993), 6o. from 1231AD. Rape “for the purpose of marriage”probably here refers not only to sexual violence in situ but also abduction, acomponent of the meaning of the word “rape” which has largely fallen away inmodern American parlance.

Ibid., Book l.XXI, in Amt, 6o.Ibid., Book 1.XXII, in Amt, 6i.

‘Ibid., Boolc 1)0(111, in Amt, 62.Ibid., Book 1)0(11, in Amt, 6i and Norman Laws, Chapter L, in Women’s Lives in

Medieval Europe, ed. Emilie Amt, (New York: Routledge, 1993), 56-57. from the earlythirteenth century AD.

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sex”.6 Overall, medieval Europeans held what to modern sensibilitiesseems like a condescending and insensitive view ofwomankind andtheir role in society. Aside from outliers like Joan of Arc, stories ofwomen performing manly daring seem to serve as entertainment.An excellent example is a tale from the siege of Peralda in 1283wherein a woman unhorses an errant French knight, takes himcaptive, and earns a hefty ransom. The King ofAragon later bids thewoman come to court to reenact the story over and over again, muchto the delight of the Infante (young prince).7 These examples show,though, women still needed to live up to expectations and participate in society as fully as possible, despite their socially constructedhandicap.

Burchard ofWorms’ “Corrector and Doctor” part of his compilation of canon law intended as a field reference for priests seeking outerror in their communities, lists errors of all kinds, ranging from theplausible to the bizarre to the probably apocryphal, includinginjunctions against believing one can walk through walls or committelekinetic murder, and against slathering oneself in honey for thepurpose of rolling in grain with which to bake poison bread.8 Amore realistic item concerns abortion and contraception:

Have you done what certain women are used to doing who, when theyare fornicating and they want to kill their embryo, take action as theuterus is conceiving and, using their enchantments (maleficia) andtheir herbs, they abort it so that either the conceived child is killed orknocked loose, or if they have not yet conceived, they take action toprevent conception?. . . whenever a woman prevents conception, she isguilty of homicide.9

A few items following no. 147 clarify the crime, create gradations ofseverity, worse for prostitutes, less serious for poor women due to“the hardship of raising the child,” and admonish accessories to

6 Laws ofSicily, Chapter III, in Amt, and Book 11.XLI-XLIV, 63-64.Don Ramon Muntaner, “Chronicle,” in L(fe in the Middle Ages, ed. G. G. Coulton,

(New York: The MacMillan Company, 1931), 11.67-68. From the fourteenth centuryAD.

8 John Shinners, ed., Medieval Popular Religion, 1000-1500: A Reader (Toronto:Higher Education University of Toronto Press Inc., 2008), and Burchard ofWorms, Corrector and Doctor, in Medieval Popular Religion, iooo-ioo:A Reader, ed.John Shinners (Toronto: Higher Education University ofToronto Press Inc., 200$), no.15$ and 469 and 471-472. Circa ioo8 AD.

Burchard of Worms, Corrector and Doctor, 467.

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abortion or contraception.1° The Visigothic Code of mid-seventhcentury Spain contains specific and varied punishments, categorizedalong gender and free/slave lines, and prescribe death for parents,male or female, seeking abortion, for they do so “Unmindful of theirparental duties;” the same section also notes concern that, “Thiscrime is said to be increasing throughout the provinces of ourkingdom.” Such a rise seems sensible, though no less tragic, in theface ofpolitical and social turmoil following the collapse ofWesternRoman power and the ensuing, sometimes violent, chaos. Thisattitude pervaded Western Europe in the medieval period. However,the wording of Burchard’s injunction, as well as the perpetuation ofabortive procedures in medical scholarship and an analysis offertility data indicates the practice continued.’2 In a society withoutaccess to contraceptives as reliable as modern options—and indeed,strictures against contraceptives of any kind—and with poorhygiene, poor nutrition, and poor medical care, prevention andinterruption of pregnancy are often essential to improving andsaving lives. In our modern world as well, pregnancy presentssignificant health risks even to wealthy women with access to top-quality medical care; pregnancy requires a massive amount of energyand resources from the mother to proceed correctly, and malnutrition ran rampant for the average person in the medieval period.

Due partially to poverty and partially to the accepted wisdomregarding human dietary needs, people often suffered deficiencies ofvitamins A, D, E, K, and C, even more so during a famine, and thepoorest of the poor needed to resort to eating desperate “foods” likegrape seeds, fern roots, and common grass.’3 The preponderance ofyouthful remains in cemeteries gives us an inlcling of the high infantmortality rate of the time—not unexpected for a pre-industrialsociety with poor medical care and pervasive malnutrition.’4 Childabandonment became a common occurrence, with churches andhospitals establishing special wards and depositories for unwanted

Ibid., items 147-150, 467-468.Visigothic Code, Book Vl.3 §‘. Accessed from

http://libro.uca.edu/vcode/visigoths.htm. § indicates it is the product of FlaviusChindasuinth (“FLAVIUS CHINTASVINTUS, KING.”), rather than simply copied frominherited Roman law or Gothic custom (‘ANCIENT LAW.”), and thus we mayreasonably hold that the concern was recent as well.

Beryl Rowland, Medieval Woman’s Guide to Health: The First English Gynecological Handbook (Kent, Ohio: Kent State University Press, 1981), 36-37 and DavidHerlihy, Medieval Households (Cambridge: Harvard University Press, 1985), 148.

‘ Michel Mollat and Arthur Goldhammer, trans., The Poor in the Middle Ages:AnEssay in Social History (New Haven: Yale University Press, 1986), 27.

“ Ibid., a8.

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infants beginning in late Antiquity.’5 Even with such wards, abandonment often resulted in the infant’s death, and came under harshcriticism and contraindication from authorities like Burchard.’6

Seen in this light, pregnancy for the average woman seems arather terrible blessing. Certainly, a biological and Biblical imperative commanded people to perpetuate their kind, and in that highlyreligious society the very real threat of damnation loomed over anypotential decision to abort. Stories abounded like those found in thelives of Gertrude van Oosten (d. 1358) and Christina ofStommeln (d.1312), both unmarried and childless women, who found themselvestaunted and tormented by the Devil with images of a happy family.’7Women, especially poor women, faced a dreadful choice. Multiplepregnancies, necessary to overcome the odds social and medicalconditions set against their children’s survival, meant increasingrislcs to their own continued survival with every impregnation.Sexual denial, though an option, could simply lead to spousal rape’8in the worst cases, though more likely they would feel compelled tofold to intense pressure from the husband, from the Church, andfrom the community. Holding out too long might also drive achildless male to find another avenue for propagation.’9 A womanwho desired no children but needed the security and shelter thatmarriage provided certainly found herself caught in a bad romance.Prostitutes found themselves in an even worse situation, withunwanted pregnancy as an occupational hazard and daily threat,although perhaps a lucky one could use pregnancy to ensnare ahusband. Contraception and medically necessary abortion, thoughimperfect processes, allowed women an attempt at a compromiseand enhanced their agency, if they could access and use themproperly. Contraception in particular presented a tricky issue, for itseems unlikely the average woman kept a stock of ferula (a commoncontraceptive/abortive plant, whose efficacy has been backed bymodern science) by the bedside to take in quantity in case of

‘ Ibid., 28 and 288..6 Burchard, nos. 151 and 152, in Shinners, 468.‘ Herlihy, 125.

is a modern concept, certainly; none of the legal codes surveyed here containany such idea, and it seems doubtful that any man would have been prosecuted for it,but that makes the act itself and its physical and psychological impact on the victimsno less real.

W. Nelson francis, ed., The Book ofVices and Virtues (London: The Early EnglishText Society, 1942), 90. This worlc, intended for priestly use in instructing their flock,circulated in the vernacular in England and France from the 13’’ and Centuries. Itcalls sexual withholding a sin, condemns extramarital intercourse, and reaffirmspropagation as the central purpose of marriage.

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coitus.2° Considering the legal and moral restrictions on suchpractices, however, leads one to wonder where and how thesewomen learned of their reproductive options, and who (if anyone)assisted them in these procedures.

Propriety and affordability meant that midwives, or other unlearned women of varying knowledge, provided the majority ofmedical care for female patients. The unlearned women perhapsgained some expertise as a result of the omnipresence of midwiferyin a woman’s life, and could provide assistance, but undoubtedly,with more gynecological and obstetrical experience than anyone elsealive in medieval Europe, the burden fell largely on the midwife’sshoulders. Surgical descriptions of Caesarian sections even called forthe midwife to perform most of the grisly handiwork in the surgeon’sstead—strange, for a group of practitioners proud of their hands-onapproach to medicine.2’ They also lacked any centralization,professionalization, formal specialized training, or specific textualtransmission of knowledge of their craft. Universities had nomidwife degrees. In many ways they existed on the periphery ofmedieval European medicine, and the stock “wise woman” existedon the peripheries of society as well, especially if they were widowed.This put them in a prime position to offer illicit contraceptive andabortive remedies, especially in a poor rural area without any othertrained herbalists or physicians to tell any one particular smellymedical concoction from another. Classical, Arabic, and medievalEuropean medical texts all list a wide variety of contraceptives andabortifacients.22

It is worth noting that since obstetrical diagnostics of the timegenerally produced wildly inaccurate results until the second orthird trimester, the distinction between contraceptive and abortifadent in retrospect is hazy; inducing menstruation in a woman withan implanted embryo at any stage is today considered abortion butmedieval society considered amenorrhea a potential sign of pregnancy (and many other illnesses, though generally as a cause ratherthan a symptom).23 In a woman without any other detectable signsof parturiency, natural or induced menstruation would indicatesimple normalcy, even though modern tests might detect a first

John M. Riddle, “Oral Contraceptives and Early-Term Abortifacients duringClassical Antiquity and the Middle Ages,” Past & Present 132 (1991): 8.

“‘Rowland, 24.

““Riddle, 8-22.“ Trotula of Salerno, The Diseases of Women, Elizabeth Mason-Hohi, trans., in

Amt, 99.

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trimester pregnancy at the same stage the medieval “contraceptive”was administered. At any rate, the prescribed contraceptives andabortifacients largely effect the desired result 70% of the time or less,although a few (including rue and Queen Anne’s Lace, which looksremarkably similar to hemlock, especially to the unpracticed eye)seem totally effective with the proper dosage.24 In improper doses ormixture forms, the same plants, lilce pennyroyal, become deadly orotherwise harmful.25 While traditional knowledge about local plantsknown to reduce fertility might pass quietly from mother to daughter, obtaining proper dosages and mixtures from a local midwife orwise woman, the most accessible medical practitioners for anywoman, presented a much safer option.

Aside from the role of midwife, women could practice as nuns,abbesses, and even full-fledged medicae.26 In Boccaccio’s famedDeco meron, for example, a tale of the Third Day features a characternamed Giletta (referred to as “Donna Medico”) who cares for herfather’s patients after he passes away.27 Early hospitals and conventsprovided especially ample opportunities for women to participate inmedicine in a somewhat educated and organized manner, andBenedictine-style organizations featuring women spread quicklythroughout Europe during late Antiquity and the early medievalperiod.25 The institution at Salerno welcomed women openly earlyon, and they practiced relatively freely for a time as well in the Spainand England, but in France moreso than other nations aspiringfemale practitioners quickly ran afoul of the universities.29 In 1311 thefaculty at the University of Paris barred female practitioners andstudents, and proceeded to excommunicate and prohibit frompractice several learned women who refused to give up their profession.30 One such doctrix, Jacqueline Felice de Almania (sometimescalled Jacoba), wrote in her own defense in 1322:

And [I argue that] it is better and more suitable and proper that awoman wise and experienced in the art should visit sick women,and that she should examine them and inquire into the secrets ofnature and its hidden things, than that a man should do so, to

Riddle, 8-zz.51bid., 19.6 Rowland, 2-7.

Giovanni Boccaccio, Decameron, Third Day Novel IX, accessed from DecameronWeb, <http://www.brown.edu/Departments/ltalian_Studies/dweb/>.

s James Joseph Walsh, Medieval Medicine (London: A & C BlacIc, Ltd., 1920), 159.

Rowland, 6, 9-10.

30Jbid., 8.

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whom it is forbidden to see and inquire into the aforesaid things,nor to touch women’s hands, breasts, belly and feet, etc.; rather aman ought to avoid and shun the secrets of women and the intimate things associated with them as much as possible. And it usedto be that a woman allowed herself to die, rather than reveal hersecret illness to a man, because of the modesty ofthe female sex...3’

The faculty rejected her argument, despite support from the professional conduct standards of the day, and the fact that many medicalworks echoed such sentiments prior to laying out obstetrical orgynecological details. In addition to the pervasive Christian idealsof modesty and chastity, European medical literature prescribedespecial chastity and modesty for physicians.

St. Jerome, reared on Hippocrates and reflecting some of hisethical principles (though without full lcnowledge of his actualwork), advised clerical medics, “Never to discuss a woman’s looks,”and to follow the Hippocratic oath with regard to “Language, gait,dress, and manners,” though the oath only truly deals with the latter,prescribing chastity.33 In Visigothic Spain, law prohibited physiciansfrom bleeding women in private in order to avoid scandal.’ Cassiodorus encouraged personal purity, while a 9th century treatise fromParis says physicians ought not to be “lascivious” or “woman-lovers”,to avoid “acts of seduction”, and dedicates a nervous-soundingsection to a doctor’s proper etiquette when working on femalepatients.35 Some remedies for women required inserting mixturesinto a woman’s “privy member” and some even recommendedintercourse as a cure.6 In fact, many authors of works regardingwomen’s health admonish male readers only to read the work if heseeks to help women, not for titillating purposes.37 It seems disingenuous, then, for people so concerned with modesty, propriety, andavoiding undue contact with women to bar other women, especially

Jacqueline Felice de Almania, E. Chatelain and H. Denifle, eds., and Emilie Amt,trans., Chartularium universitatisparisiensis (Paris: Delalain, 1891), us.

Rowland, .St. Jerome, “Letter to Nepotian Priest” in Legacies in Ethics and Medicine, ed.

Chester R. Burns (New York: Science History Publications, 1977), 175. Circa 400 AD.Visigothic Code, Book Xl §i.

35Cassiodorus, “Letter to Supervising Physician of the Royal Household,” ed.Chester R. Burns (New York: Science History Publications, 1977), 176. Circa 530 ADand “Paris MSS BN u2lo,” Legacies in Ethics and Medicine, ed. Chester R. Burns (NewYork: Science History Publications, 1977), folios 12-15, pg. 183, 184, 191.36 “Sloane 2463 MSS,” in Rowland, 83 and 91. A fifteenth century copy of an olderworlc

Rowland, 15.

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willing, educated, and capable ones, from assuming that burden. Ofcourse, these strictures mostly impacted female academic medicalpractitioners. They did not leave women totally without healthcareoptions, but the loss of any measure of access to care affectedwomen as a whole. The regulations also removed a major potentialavenue for advancement of gynecological medical science, whichremained stagnant until well into the modern period.8

The three “Trotula” works attributed to a distorted imagining ofa real learned female physician known as Trota who attended andworked in the university at Salerno sometime around the twelfthcentury, remain the best-known and most-studied works onwomen’s health from the Middle Ages. They deal separately withcosmetics, diseases ofwomen, and treatments ofwomen, althoughthe work on diseases also deals with ailments suffered by both sexes.They circulated within academic circles, but vernacular copies andderivations also existed. The “English Trotula,” specifically theSloane 2463 manuscript, clearly derives from the Trotula work TheDiseases of Women (especially the gynecological portion), but withsome significant differences. In addition to amusing localizations,included either as true record or merely as a gambit of braggadocioto enhance authority and authenticity, the prefaces to the two worksdiffer significantly in their messages.39 Both mention “sicknessesmore often abound in [women],”4° and both delve into the dichotomies of heat, cold, dryness, and moisture as pertain to the composition of human bodies (men being warm and dry, women being coldand moist).4’

The Trotula document also sheds some light as to the physiological cause ofmedical ignorance, the “retired location” ofmost of awoman’s reproductive organs.”2 Maladies of the penis or testesmight be fairly simply assessed by medieval medicine, as they layoutside the body and so were easily observable to the unaided eye,but to most men a woman’s system seemed quite mysterious, andeven learned men understood painfully little about it, still believingthe womb might break free and wrealc havoc for a woman. Add to

38 Ibid., 24.

for example, the “52463” author points out that a certain (unoriginal) cure forexcessive menstruation was taught by “the Pryor of Bermondesey” to an ill woman(76), another “probatum est in Chepa, London,” and another “was provyd atSurcester” (8o).

° Trotula, in Amt, 99. “ S2463” states more gingerly that “women have variousmaladies and more terrible sicknesses than any man knows” in Rowland,

4’Trotula, in Amt, 98 and “Sz463,” in Rowland,“ Trotula, in Amt, 99.

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that the incredibly complex phenomenon ofmenstruation, woefullymisunderstood by everyone, and one finds a recipe for disaster.While basic first aid fell within the social expectations of femalework, and sex-mutual diseases like influenza and smallpox could bespotted and attended to in a basic fashion by men or women, theaverage man had little to no clue regarding female problems.43 Thelearned male practitioner knew only marginally more, leavingwomen in the lurch.

Aside from that, the two documents stand starkly apart. TheTrotula opens with a grand explanation of the complementarynature of man and woman, differentiated by God “so that the excessof each other’s embrace might be restrained by the mutual opposition of contrary qualities.”4 The author also distinguishes women asweaker than men by nature, and explains that he or she beganstudying women’s illnesses, “pitying their misfortunes and at theinstigation of a certain matron.”45 The Sloane author, by contrast,omits the strong/weak distinction and the discussion of the complementary nature of man and woman. This author opens byexplaining that women have more and additional diseases, comparedwith men, and therefore:

..because they are also ashamed to reveal and tell their distress toany man, I therefore shall write somewhat to cure their illnesses,praying to merciftil God to send me grace to write truly to His satisfaction and to the assistance of all women...[sick women] areashamed for fear of reproof in times to come and of exposure bydiscourteous men who love women only for physical pleasure andfor evil gratification...such men despise them and fail to realizehow much sickness women have...And so, to assist women, Tin-tend to write of how to help their secret maladies so that onewoman may aid another in her illness and not divulge her secretsto such discourteous men.6

The document goes on to say that anyone who “offends awoman because of the malady that she has by God’s command” sins,and offends both the woman and God.47 This specific manuscriptdates from the fifteenth century, although we know it was copiedfrom ones like it which circulated in the fourteenth century, due

‘ Monica H. Green, “Gendering the History of Women’s Healthcare,” Gender &History 20, nO. 3 (2008): 495.

Ibid., 98-99.45Ibid.,46 “S2463,” in Rowland, 59.

Ibid.

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largely to the massive amount of unlearned and unlicensed medicalpractitioners in England at the time.8 Where the Trotula takes acondescending, paternalistic, and somewhat scornful tone, S2463sounds sympathetic, and certainly aims at a specifically femaleaudience (indicated both by the author’s statements and the factthat the author wrote in vernacular Middle English). According toMonica Green and John Benton, The Diseases of Women almostcertainly came not from Trota (the historical person behind the“Trotula” character) but from a man’s pen, and the lacic of sympathyand the superior attitude seem congruent with that analysis.49While it feels poetic to ascribe the more sympathetic opening to afemale author, no evidence exists indicating the original author ofthe introduction to S2463, much less their sex. However, lest westray into misandry, the differences in audience may also account forthe differences in tone. An academic or clerical male audiencewould appreciate and expect the reliance upon the authority of Godand misogyny (not malicious, but an established and reasoned partof the culture, especially the learned medical culture). An appeal tosympathy and respect for patients likely would not only have seemedout of place but may have reduced the prestige and authority of theworic in the eyes of academic medical readers. for S2463, whilestatements about women’s inherent and God-given weaknesscompared to men certainly would have not been unexpected (andwould have been for the most part accepted), appealing to sympathyand showing respect for women and their plight endears the authorto the lay female reader. The fact that this author, perhaps not atrained physician, reaches out to their readers and empathizes musthave seemed fairly empowering to an average female audience, or atthe very least comforting.5° That the author considered this unusualapproach the proper one, and one which would help the success ofthe work, tells us that the text fulfilled a need for practical, usefulmedical knowledge amongst the unlearned lay female population.Whatever the personal beliefs of the true authors of these texts, theyknew their respective audiences well, and they stand out as a perfect

48 Rowland, 13.

Monica H. Green, “In Search of an Authentic’ Women’s Medicine: The StrangeFates of Trota of Salerno and Hildegard of Bingen,” Dynamis 19 (i): 50. Greenfurther asserts that the “Trotula” character is wholly a textual creation, and only oneofthe standard Trotula, On Treatmentsfor Women, actually comes to us from straightfrom Trota, and notes that she wrote On Treatments for learned female practitioners.

50 Rowland, 14. She bases this assumption on the fact that the manuscript oftenprefaces doctors’ opinions with “physicians say which would seem unnecessary ifthe author were a physician.

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example of the sharp dichotomy between the normal male attitudetowards women’s health and the everyday reality of health forwomen in Medieval Europe.

This reality seems grim. With laws restricting access tohealthcare on one side, social pressure to avoid intimate contactwith strange men on the other, and the Church looming over it all,medieval European women seem surrounded. Men still entered thescene in a positive and medical way; many women loved theirhusbands, and sermons admonished men to attend bedriddenchildbearing wives.5’ Nunneries and noblewomen sometimesemployed male physicians alongside traditional female healers, andurban women in dire emergencies sometimes called upon malepractitioners for assistance in childbirth.52 Green, normally quiteperspicacious, extends this idea even farther, conjecturing that menactually figured heavily in women’s healthcare and perhaps even asmuch as nonprofessional female practitioners, but the wide varietyof internal and external pressures to exclude and preclude men fromwomen’s health makes such a rosy conjecture untenable.53 In thehighly traditional, incredibly orthodox realm of medieval academicmedical practice, recommendations to avoid contact with femalepatients carried serious weight. For the common person, social andreligious pressures carried serious weight as well, evidenced by thepleas of the Sz463 author and the testimony of women like Jacoba,which indicate both male reluctance to assist in women’s healthcareand a genuine mutual desire between men and women to at leastattempt to maintain a segregation of healthcare. Though not totallyabandoned and alone, the suppressed, marginalized, and disdainedwomankind ofMedieval Europe needed to worlc amongst themselvesto take care of their unique problems, problems that mankind oftenavoided even acknowledging, and in this restored to themselves acertain measure of agency in an otherwise disempowering environment.

‘ St. Bernadino, Sermons XV!II-XXII, in Coulton, 224. From the fifteenth centuryAD. The same preacher (p. 226) also lambastes the ills of the single man’s lifestyle,being chiefly disorganization, lack of cleanliness, and lamentable bachelor remediesfor spills and ills which continue as proud traditions down to the modern day.

Green, “Gendering,” 495.Ibid., 495-496.

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Frankie graduated cum laude from the University of the PacfIc with adegree in Social Science. He will receive his M.A. in Early Modern Historyat San Francisco State this spring before beginning a PhD in the HistoryofHealth Sciences at UCSFthisfall. In thefuture, Frankie aspires to be aprofessor at a prestigious/hiring university, grinding out tiresome surveytextbooks in order to fund lavish research trips to Europe. He hopes toone day be an Old Professor, delighting in students’ passing around ofwild rumors about his early life and trophy wall ofcomplaints regardingharsh grading practices. If all else fails, he plans to sell his soul on the“History” Channel.

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