Meanings of Sex Difference in the Middle Ages: Medicine, Science, and Culture (review)

Making use of a double entendre, one might say that this book is truly seminal. It extends the study of this topic beyond the simplicities of medieval discussions about whether females have semen (seed) to a level of scholarship that interweaves medical and natural philosophic sources and the social history of a gothic society into a brilliant contribution to knowledge. Michel Foucault and Caroline Bynum unveiled hidden but complex issues of sexuality and sex differences from their mysterious shrouds, and now Joan Cadden uncovers how late-medieval people confronted life’s meaning through shifting attitudes about sex differences.

The first of two parts provides the classical and medieval background for the exploration and reformulation of issues in the second part. The classical sources (Hippocratic Corpus, Aristotle, Soranus, Galen, Nemesius) gave a variety of explanations for sex differences and reproduction that were practical, although theoretically based on the male perspective. They provided the format for the discussion of numerous issues, ranging from clinical usage to human social behavior, but, Cadden notes, they carried with them sufficient disagreements and ambiguities that were “invitations to debate” (p. 37)—and medieval thinkers creatively did debate them. The choices of sources and models were handled differently by Constantine the African (especially in On Coitus), Hildegard of Bingen (especially in her Book of Compound Medicine), and William of Conches. These authors provide no monolithic explanations, no more than did their sources, but they begin steps toward a more coherent medical and philosophical approach to sex differences. Constantine argued that women derive more pleasure from men, despite their sex’s relative lack of heat (or, simpler, their “cooler” nature): while a man’s enjoyment comes with the expulsion of his fluid, a woman has the double pleasure of expelling hers while, at the same time, receiving his. Virtually uniquely, Hildegard conveys a woman’s viewpoint, which, while accepting the culture’s views, nonetheless placed women as more than passive providers for fetal gestation and growth: she gave more symmetry to the two parents’ formulation of their progeny’s complexion and disposition (which roughly includes our concept of character).

Cadden sees no convergence of opinion, but instead a convergence of concern that, undoubtedly, gave more importance to women’s role. While most writers rejected the classical proposition that, through fetal arrested development, women were “failed” men, they assigned greater importance to the female as an only slightly less-than-equal partner. In debating such questions as whether women’s coital pleasure is greater than men’s and whether women can conceive without pleasure, they publicized to a wider audience, who heard the questiones and disputations, an openness about matters of sexuality, albeit more from a male viewpoint.

Cadden commands the sources and links them with modern sources that amplify her thesis. Her ability to connect scholastic and medical discussions with social history is a great achievement in scholarship. It is no wonder, then, that this book won the 1994 Pfizer Award for best book in the history of science.