Making Women’s Medicine Masculine: The Rise of Male Authority in Pre-Modern Gynaecology (review)

Monica Green has produced another spectacular history of women’s medieval medicine. She is well known among medieval historians of medicine and society as the translator and editor of The ‘Trotula’: A Medical Compendium of Women’s Medicine (Philadelphia: University of Pennsylvania Press, 2001) and for her articles on female healthcare in medieval Europe. Not surprisingly, the Trotula figures prominently in her latest work on Making Women’s Medicine Masculine. Green examines how women were excised from their own healthcare, both physically and theoretically. The goal of her book is to “explore the cultural situation and strategic functions of the Trotula texts” (12), which Green accomplishes with exacting skill and acumen. She explains that the texts making up the collection contained in the volume often called the Trotula were not all written by women. Instead, though Trota or another woman wrote at least one of these texts, learned men authored the majority of these texts on theoretical female obstetrics or gynecology for male audiences.

Much of Green’s argument lays not on the gendered intent of medical authorities to dominate over women’s medicine, but rather on women’s education and, in particular, on their literacy in Latin. Green makes a persuasive argument that women were locked out of medical practice, and likewise medical theory and understanding of female physiology, because of the few numbers of women allowed into the literate community of Latin readers and the lack of avenues for women to a Latin education. Women’s participation in healthcare depended greatly on their participation in the “culture of literate medicine: whether as literate or semi-literate authors, as literate or quasi-literate readers and listeners and practitioners, or, even more distantly, as recipients (as patients) of a form of medicine whose theoretical structures they did not help create and whose precepts they were, perhaps, never expected to understand” (21).

Green addresses the complex social difficulty of cross-sex healthcare in the Middle Ages. (See especially chapter 4.) Medieval social conventions frowned on men looking at, much less touching women to whom they were not married, which both prevented physicians from examining or treating their female patients directly and caused women to be reluctant to turn to male physicians with medical issues pertaining to their “private parts.” Green writes that physicians and surgeons were “inhibited to a significant degree by concerns that cross-sex practice will bring not only shame to the female patient, but dishonour to the male practitioner” (23). Midwives (obstetrices) and other female attendants or assistants became the eyes, nose, and hands of the twelfth-century physician since he could not or would not touch his female patients. Some twelfth-century male authors wrote or implied that “knowledge of women’s diseases [e.g. menstruation disorders, breast cancers, etc.] should be in ‘women’s own hands,’” though they were few (51).

Green makes a strong case that most medical texts about women were written by men for men. Given Green’s evidence, clearly the section of the Trotula called On Women’s Cosmetics was written by a male author to inform other men, and The Book on the Conditions of Women was almost certainly the same, while On Treatments for Women was the only segment written by a woman, most likely Trota. By the fourteenth century, the Salernitan texts on women’s medicine were bound together into a compendium called the Trotula, later sometimes called The Secrets of Women and credited to a male author (214). The Trotula became the most widely circulated work that included a female author of any medieval genre, and though it was included in the libraries of many colleges and masters at universities, it was never a “school” text (68).

There were women practicing medicine in the fourteenth and fifteenth centuries who gathered knowledge by reading medical texts in vernacular translations, mostly medical recipe books rather than theory, knowing what...