Читать книгу The Greatest Benefit to Mankind: A Medical History of Humanity - Roy Porter - Страница 43

Margery Kempe’s difficulties derived in part from perceptions of her gender; certain disorders were associated with women and their reproductive systems. Giving birth is depicted in medieval texts as an all-female business, the mother being supported by relatives, neighbours and a midwife. Midwives rose in status, as some town councils paid them to act in an official capacity in cases involving female illness, obstetrics and infant care. They were called upon to test for virginity or sterility, and to certify infant deaths.

A few obstetrical texts were directed to female readers, and male writers discussed gynaecological problems and prescribed remedies for female sexual disorders, advising not least on contraception. The Treasury of the Poor, ascribed to Peter of Spain (later Pope John XXI), gave over a hundred prescriptions concerning fertility, aphrodisiacs and contraceptives, presumably derived from popular tradition. Medical attitudes towards sex were far from puritanical, for sexual release was regarded as requisite for humoral balance, and female orgasm was widely believed essential for conception.

Female healers abounded, sometimes learning their craft from a male member of the family, and a few women wrote medical texts. Hildegard of Bingen (1098–1179), who had been put in a convent at the age of eight and began having religious visions soon after, practised medicine in her role as abbess of Rupertsberg. Her main work was the Liber simplicis medicinae (c. 1150–60) [Book of Simple Medicine], on the curative powers of herbs, stones and animals; she also wrote on the natural causes of diseases. These texts summarize traditional lore concerning the medical uses of animals, vegetables and minerals, advising treatments on the principle of opposites, while for terrible diseases like leprosy she commended exotic remedies involving unicorn liver and lion heart. Herbs were God’s gifts; either they would cure or the patients ‘will die for God did not will that they should be healed’.

Another acclaimed woman healer is more enigmatic. Obstetrical writings and other treatises of women’s disorders are attributed to a certain Trotula, said to be a female member of the medical school of Salerno during the twelfth century; but ‘Trotula’, anglicized as ‘Dame Trot’, was more likely a male writing in drag. Texts called The English Trotula long circulated, containing advice on conception, pregnancy and childbirth and motherhood (nursing mothers should avoid highly salted or spiced food).

A few female healers were accepted into the Florentine practitioners’ guild, and English records show women called ‘leech’ or ‘medica’; at St Leonard’s Hospital, York, a Sister Ann was described in 1276 as a medica. But women were excluded in the later Middle Ages, marginalized by professional conflicts and guild restrictive practices. In 1421, the English physician Gilbert Kymer and his cronies petitioned Parliament to ban women from practising. The limitation of medical and surgical practice to those who had received a university training or were enrolled in a guild tended to confine women to nursing, midwifery and home physic.

Control of midwifery became more common from the fifteenth century. The Papal Bull of 1484 denouncing witchcraft drew attention to alleged attacks by sorceresses on virility and fertility; in their viciously misogynistic Malleus maleficarum (1486) [Hammer of Witches], the Dominicans Henricus Institoris (Heinrich Kramer, fl. 1470–1501) and Jacob Sprenger (fl. 1468–94) accused midwives of murdering babies in the womb, roasting them at sabbaths or offering them to the Devil. There is little evidence, however, that female healers were charged with witchcraft.

Medieval authors on sex and childbirth (or ‘generation’ as the subject was known) drew on a variety of traditions: Aristotle, Galen, Soranus and the Bible. The standard view was that men and women shared a common physiology, but in perfect and flawed versions. Female generative organs were like those of men, but inverted and inferior – the vagina was an inverted penis which had never fully developed. Thus, the female form was a faulty version of the male, weaker, because menstruation and tearfulness displayed a watery, oozing physicality; female flesh was moister and flabbier, men were more muscular. A woman’s body was deficient in the vital heat which allowed the male to refine into semen the surplus blood which women shed in menstruation; likewise, women produced milk instead of semen. Women were leaky vessels (menstruating, crying, lactating), and menstruation was polluting.

De secretis mulierum [On Women’s Secrets] spelt out the harmful effects of menstruation:

women are so full of venom in their time of menstruation that they poison animals by their glance; they infect children in the cradle; they spot the cleanest mirror; and whenever men have sexual intercourse with them, they are made leprous and sometimes cancerous.

The womb was an unstable organ, making women less balanced than men. Social consequences followed from these physiological teachings. According to the instigator of the Reformation, Martin Luther (1483–1546),

Men have broad and large chests, and small narrow hips, and more understanding than women, who have but small and narrow breasts, and broad hips, to the end they should remain at home, sit still, keep house, and bear and bring up children.

Controversies flared among doctors, philosophers and theologians over the gendering and engendering of the body. The roles of the male and female in fecundation were disputed, as Aristotle’s distinction between superior male ‘form’ and inferior female ‘matter’ (seed and seedbed), clashed with the Galenic theory of the confluence of male and female semen to make a baby. Such niceties could have weighty implications: how, for example, had the Virgin Mary conceived Christ – was it from menstrual blood, or was such blood a waste product? Contrasting explanations could also be given regarding the means and the moment of the soul’s entering the foetus.

In the later Middle Ages, medical and Christian views cross-fertilized at many points as the body assumed heightened significance in the humanistic theology of the times. While some, like the early Church Fathers, still viewed it as the prison of the spirit, new emphasis came to be placed on the soul’s incarnation in the flesh, the doctrine of immanentism. In the consecration of the host in the eucharist, the bread was transubstantiated into Christ’s body, turning miraculously to flesh. There was similar stress on bodily resurrection at the Last Judgment. In Catholic rituals, a saint’s power was associated with relics of the body: a hallowed bone, tooth or toenail protecting against evil; hence the booming relics business.