Acts of Care: Recovering Women in Late Medieval Health by Sara Ritchey (review)

Sara Ritchey's book Acts of Care explores women's everyday practices in the southern Low Countries during the thirteenth century. Ritchey argues that feminine caregiving was not just a manifestation of religious fervor, devotion, and piousness, as it has been commonly framed. Rather, these practices constituted an important yet understudied component of the broader field of medieval medicine. Exploring diverse practices such as healing prayers, birthing indulgences, medical blessings, liturgical images, and penitential observations reveals that women were highly knowledgeable about health and the body, and active participants in premodern European medicine.

Women's medical engagement is a history made of "fragile traces" excluded from university-trained medical treatises (4). Instead, we find traces in liturgy, miracles, poetry, meditations, sacred objects, and the testaments and endowments from hospitals and leprosaria populated by Cistercian nuns and beguines. Ritchey builds on the methodologies of performance studies, Native American and Indigenous studies, the history of enslaved communities in North America and the Caribbean, and from medical anthropology of sub-Saharan Africa in order to recover the therapeutic epistemologies of medieval European women. These methodologies offer new tools "for making visible voices and presences" silenced by technologies of power (28–29).

Acts of Care is divided into three sections that mirror Ritchey's research questions and sources. Part 1 presents hagiographic sources from the thirteenth-century liégeois corpus whose protagonists were "new" saints, that is, those saints still not officially canonized by the church. This body of saints' lives illuminates the ways in which holy people developed cults and attracted communities of faithful while they were still alive. Because miracle stories taking place at tombs, relics from women saints, and stories about miraculous posthumous healing were told and performed by women, these sources show how manifesting sanctity was gendered feminine. The liégeois corpus is also revealing about care and authority. Ritchey indicates that feminized forms of care were integral yet excluded from the European health care system. Women's affective labor performed through prayers and through the recitation of psalms and dramatic poetry for the sick was highly valued in the healing of wounds, performing obstetric services, and caring for people with diverse afflictions.

Part 2 turns to masculine constructions and conceptualizations of therapeutic discourse and knowledge by using a matrix of authoritative discourse, theological, medical, and hagiographic texts. Premodern medical theory conceived of the internal body as made of humors and qualities. The balance or imbalance of them determined a patient's sickness or health. Other elements corresponded to the comportment of the body—the so-called non-naturals. These elements referred to the six factors external to the body—air, food and drink, diet and rest, sleeping and waking, evacuation and retention, and the passions of the soul—and were understood to influence bodily health in humoral medicine. The presence of the non-naturals in medical terminology and texts indicates that emotional care was as vital as other therapeutic remedies to bodily health. Further, their presence reveals that there was a certain degree of anxiety among authoritative discourses, particularly in relation to the passions of the souls and to verbal forms of medicine—charms, incantations, and prayers. Instead of denying the efficacity of these widespread and popular remedies, university-trained male authorities sought to regulate the circumstances in which verbal medicine could work—only trained male physicians could properly use and harness these words. Theologians and hagiographers also expressed anxieties about the place of the soul in scientific medicine. Ritchey argues that religious authors challenged Scholastic medical authors' rationalization as it could erode the place of God in bodily health.

Part 3 interrogates women's actual knowledge of the body and its care. Ritchey explores modes of knowledge transmission in women's religious communities, such as beguinages and their affiliated hospitals. Prayers, liturgies, images, and poetry—interpreted through the lens of performative studies—reveal women's "therapeutic technology" made of psalters, charms, blessings, relics, meditations, and prayers in addition to...