Medicine and the Making of Roman Women: Gender, Nature and Authority from Celsus to Galen (review)

This book provides a sophisticated analysis of medical approaches to women during the Roman imperial period. It begins with an attempt to situate medical practitioners, both male and female, in the context of Roman social practices and attitudes toward women, and then provides a discussion of the conceptual framework of Roman medicine; here, Flemming discusses the history of medical ideas stemming from the Greek Classical and Hellenistic periods that became the basis of many medical beliefs and practices in the Roman imperial period. Flemming then analyzes a number of individual authors of medical texts who preceded Galen. First, she treats a group of Latin writers (such as Celsus, Pliny the Elder, Scribonius, and Thessalus, in addition to Dioscorides), who combine traditional Roman ideas about the nature of women’s bodies with Greek medical influences; she then provides an excellent overview of the history of medical sects as she turns to examine such Greek writers as Rufus of Ephesus, Aretaeus the Cappadocian, and Soranus. Finally, she provides a thoughtful and wide-ranging analysis of Galen on women.

The book’s strengths are many: Flemming has chosen apposite passages from a huge amount of material in her efforts to show the various constructions of women in these disparate texts and authors. Her central thesis, that medicine reflected preexisting and contemporary Greek and Roman ideas about women, that it made no radical attempts to revise these ideas and assumptions, that it in fact aimed in different ways to support these assumptions even as it forcefully challenged opponents in the medical marketplace, is amply demonstrated. The most successful portion of the book is the material on Galen, where the author seems most at home. In the earlier sections of the book, the clarity of her arguments is occasionally dimmed as she moves back and forth between authors; the work on Galen, however, is well focused and its conclusions compelling.

For Galen, she first analyses his general orientation toward medicine, or rather, toward his own idea of medicine, “a great epistemic edifice” as she rightly calls it (p. 255). She shows how Galen asserts his authority not only through his all-encompassing range of knowledge, but also through his own biography, a life, according to Galen himself, lived closely along the lines of the “iatric” ideal. She discusses his encounters with elite Roman women and how his attitude toward women and the doctor’s role shaped his interpretation of these encounters. She then explores Galen’s medical methodology and his determination to establish its rational base, but distinguishes between men’s place of control and assent in this rational system and women’s place merely as subject. Finally, she turns to a detailed analysis of female physiology, nosology and therapeutics, as Galen saw them. She notes some important differences between the inherited Hippocratic ideas about women, in which sexual intercourse and pregnancy are healthy and even therapeutic, and Galen’s contrary stand, in which pregnancy, parturition and related events are dangerous. She argues that, for Galen, the womb itself is not the key source of women’s diseases, but rather the imperfect nature of the female body as a whole. She shows how Galen’s women are understood consistently in accordance with his teleological principles: women are the way they are (farther from perfection than men) because this is for the best. She argues that Galen’s teleological view of nature reinforces preexisting cultural and political assumptions about the role of women.

This impressive book also opens up lines for further inquiry. Careful as Flemming is in her assessments, she rarely addresses the question of cultural differences between Greece and Rome. Thus, because her work is focused on the medical constructions of Roman women, it would have...