Old-Time Makers of Medicine / The Story of The Students And Teachers of the Sciences Related to Medicine During the Middle Ages

by James J. Walsh

For most people who are not intimately familiar with monastic life, and, above all, with the story of the Benedictines, their prestige at Salerno might seem to be enough of itself to preclude all possibility of the education of women in medicine at Salerno. For those who know the Benedictines well, however, such a departure as the accordance of opportunities for women to study medicine would seem eminently in keeping with the practical wisdom of their rules and the development of their work. From the beginning the Benedictines recognized that a monastic career should be open to women as well as to men, and Benedict's sister, Scholastica, established convents for them, as her brother did the Benedictine monasteries, thus providing a vocation for women who did not feel called upon to marry. That the members of the order should recognize the advisability of affording women the opportunity to study medicine, and of handing over to them the department of women's diseases in a medical school in which they had a considerable amount of authority, seems, then, indeed, only what might have been expected of them.

We are prone in the modern time to think that our generation is the first to offer to women any facilities or opportunities for education in medicine. We are prone, however, just in the same way, to consider that a number of things that we are doing are now being done for the first time. As a matter of fact, it is extremely difficult to find any important movement or occupation that is not merely a repetition of a previous interest of mankind. The whole question of feminine education we are apt to think of as modern, forgetting that Plato insisted in his "Republic," as absolutely as any modern feminist, that women should have the same opportunities for education as men, and that at Rome, at the end of the Republic and the beginning of the Empire, the women occupied very much the same position in social life as our own at the present time. Their husbands supplied the funds, and they patronized the artists, gave receptions to the poets, lionized the musicians, and, in general, "went after culture" in a way that is a startling reminder of what we are familiar with in our own time. Just as soon as Christianity began to influence education, women were given abundant opportunities for higher education in all forms. In Ireland, the first nation completely converted to Christianity,—where, therefore, the national policy in education could be shaped by the Church without hindrance,—St. Brigid's school at Kildare was scarcely less famous than St. Patrick's at Armagh. It had several thousand students, and, to a certain extent at least, co-education existed. In Charlemagne's time, with the revival of education on the Continent, the women of the Imperial Court attended the Palace School, as well as the men. In the thirteenth century we find women professors in every branch at Italian universities. Some of them were at least assistants in anatomy. The Renaissance women were, of course, profoundly educated. In a word, we have many phases of feminine education, though with intervals of absolutely negative interest, down the centuries.

There had evidently been quite a considerable amount of opportunity, if not of actual encouragement, for women in medicine, both among the Greeks and the Romans, in the early centuries of the Christian era. Galen, for instance, quotes certain prescriptions from women physicians. One Cleopatra is said to have written a book on cosmetics. This name came afterwards to be confounded with that of Queen Cleopatra, giving new prestige to the book, but neither Galen nor Aëtius, the early Christian physician, both of whom quote from her work, speak of her as anything except a medical writer. Some monuments to women physicians from these old times have escaped the tooth of time. There was the tomb of one Basila, and also of a Thecla, both of whom are said to have been physicians. Two other names of Greek women physicians we have, Origenia and Aspasia, the former mentioned by Galen, the latter by Aëtius in his "Tetrabiblion." Daremberg, the medical historian, announced in 1851 that he had found a Greek manuscript with the title, "On Women's Diseases," written by one Metrodora, a woman physician. He promised to publish it. It was unpublished at the time of his death, but could not be found among his papers. There is a manuscript on medical subjects, bearing this name, mentioned in the catalogue of the Greek Codices of the Laurentian Library at Florence, but this is said to give no indication of the time when its author lived. We have evidence enough, however, to show that Greek women physicians were not very rare.

The Romans imitated the Greeks so faithfully—one might almost say copied them so closely—that it is not surprising to find a number of Roman women physicians. The first mention of them comes from Scribonius Largus, in the first century after Christ. Octavius Horatianus, whom most of us know better as Priscian, dedicated one of his books on medicine to a woman physician named Victoria. The dedication leaves no doubt that she was a woman in active practice, at least in women's diseases, and it is a book on this subject that Priscian dedicates to her. He mentions another woman physician, Leoparda. The word medica for a woman physician was very commonly used at Rome. Martial, whose epigrams have been a source of so much information in medical history, especially on subjects with regard to which information was scanty, mentions a medica in an epigram. Apuleius also uses the word. There are a number of inscriptions in which women physicians are mentioned. Among the Christians we find women physicians, and Theodosia, the mother of St. Procopius, the martyr, is said to have been very successful in the practice of both medicine and surgery. She is numbered among the martyrs, and occurs in the Roman Martyrology on the 29th of May. Father Bzowski, the Polish Jesuit, who compiled "Nomenclatura Sanctorum Professione Medicorum" (Rome, 1621; the book is usually catalogued under the Latin form of his name, Bzovius), has among his list of saints who were physicians by profession a woman, St. Nicerata, who lived at Constantinople in the reign of the Emperor Arcadius, and who is said to have cured St. John Chrysostom of a serious disease.

The organization of the department of women's diseases at Salerno, under the care of women professors, and the granting of licenses to women to practise medicine, is not so surprising in the light of this tradition among Greeks and Romans, taken up with some enthusiasm by the Christians. We are not sure just when this development took place. The first definite evidence with regard to it comes in the life of Trotula, who seems to have been the head of the department. Some of her books are well known, and often quoted from, and she contributed to a symposium on the treatment of disease, in which there are contributions, also, from men professors of Salerno at the time. She seems to have flourished about the middle of the eleventh century. Ordericus Vitalis, a monk of Utica, who wrote an ecclesiastical history, tells of one Rudolph Malcorona, who, in 1059, came to Utica and remained there for a long time with Father Robert, his nephew. "This Rudolph had been a student all his life, devoting himself with great zeal to letters, and had become famous for his visits to the schools of France and Italy, in order to gather there the secrets of learning. As a consequence he was well informed not only in grammar and dialectics, but also in astronomy and in music. He also possessed such an extensive knowledge of the natural sciences that in the town of Salerno, where, since ancient times, the best schools of medicine had existed, there was no one to equal him with the exception of a very wise matron."

This wise matron has been identified with Trotula, many of the details of whose life have been brought to light by De Renzi, in his "Story of the School of Salerno."[11] According to very old tradition, Trotula belonged to the family of Ruggiero. This was a noble family of Salerno, many of the members of which were distinguished in their native town at least, but the name is not unusual in Italy, as readers of Dante and Boccaccio are likely to know. It was, indeed, as common as our own Rogers, of which it is the Italian equivalent.

De Renzi has made out a rather good case for the tradition that Trotula was the wife of John Platearius I—so called because there were probably three professors of that name. Trotula was, according to this, the mother of the second Platearius, and the grandmother of the third, all of them distinguished members of the faculty at Salerno.

Her reputation extended far beyond her native town, and even Italy itself, and, in later centuries, her name was used to dignify any form of treatment for women's diseases that was being exploited. Rutebeuf, one of the trouvères, thirteenth-century French poets, has a description of the scene in which one of the old herbalist doctors who used to go round and collect a crowd by means of songs and music, and then talk medicine to them—just as is done even yet in many of the smaller towns of this country—is represented as saying to the crowd when he wants to make them realize that he is no ordinary quacksalver, that he is one of the disciples of the great Madame Trot of Salerno. The old-fashioned speech runs somewhat as follows: "Charming people: I am not one of these poor preachers, nor the poor herbalists, who carry little boxes and sachets, and who spread out before them a carpet. I am the disciple of a great lady, who bears the name of Madame Trot of Salerno. And I would have you know that she is the wisest woman in all the four quarters of the world."

Two books are attributed to Trotula; one bears the title, "De Passionibus Mulierum," and the other has been called "Trotula Minor," or "Summula Secundum Trotulam," and is a compendium of what she wrote. This is probably due to some disciple, but seems to have existed almost in her own time. Her most important work bears two sub-titles, "Trotula's Unique Book for the Curing of Diseases of Women, Before, During, and After Labor," and the other sub-title, "Trotula's Wonderful Book of Experience (experimentalis) in the Diseases of Women, Before, During, and After Labor, with Other Details Likewise Relating to Labor."

The book begins with a prologue on the nature of man and of woman, and an explanation of how the author, taking pity on the sufferings of women, came to devote herself to the study of their diseases. There are many interesting details in the book, all the more interesting because in many ways they anticipate modern solutions of difficult problems in women's diseases, and the care of the mother and child before, during, and after labor. For instance, there are a series of rules on the choice of the nurse, and on the diet and the régime which she should follow if the child is to be properly nourished without disturbance.