Medieval Women Physicians

Very probably the most interesting chapter for us of the modern time in

the history of the medical school at Salerno is to be found in the

opportunities provided for the medical education of women and the

surrender to them of a whole department in the medical school, that of

Women's Diseases. While it is probable that Salerno did not owe its

origin to the Benedictines, and it is even possible that there was some

medica teaching there for all the centuries of the Middle Ages from the

Greek times, for it must not be forgotten that this part of Italy was

settled by Greeks, and was often called Magna Graecia, there is no doubt

at all that the Benedictines exercised great influence in the counsels

of the school, and that many of the teachers were Benedictines, as were

also the Archbishops, who were its best patrons, and the great Pope

Victor III, who did much for it. For several centuries the Benedictines

represented the most potent influence at Salerno.



For most people who are not intimately familiar with monastic life, and,

above all, with the story of the Benedictines, their prestige at Salerno

might seem to be enough of itself to preclude all possibility of the

education of women in medicine at Salerno. For those who know the

Benedictines well, however, such a departure as the accordance of

opportunities for women to study medicine would seem eminently in

keeping with the practical wisdom of their rules and the development of

their work. From the beginning the Benedictines recognized that a

monastic career should be open to women as well as to men, and

Benedict's sister, Scholastica, established convents for them, as her

brother did the Benedictine monasteries, thus providing a vocation for

women who did not feel called upon to marry. That the members of the

order should recognize the advisability of affording women the

opportunity to study medicine, and of handing over to them the

department of women's diseases in a medical school in which they had a

considerable amount of authority, seems, then, indeed, only what might

have been expected of them.



We are prone in the modern time to think that our generation is the

first to offer to women any facilities or opportunities for education in

medicine. We are prone, however, just in the same way, to consider that

a number of things that we are doing are now being done for the first

time. As a matter of fact, it is extremely difficult to find any

important movement or occupation that is not merely a repetition of a

previous interest of mankind. The whole question of feminine education

we are apt to think of as modern, forgetting that Plato insisted in his

Republic, as absolutely as any modern feminist, that women should have

the same opportunities for education as men, and that at Rome, at the

end of the Republic and the beginning of the Empire, the women occupied

very much the same position in social life as our own at the present

time. Their husbands supplied the funds, and they patronized the

artists, gave receptions to the poets, lionized the musicians, and, in

general, went after culture in a way that is a startling reminder of

what we are familiar with in our own time. Just as soon as Christianity

began to influence education, women were given abundant opportunities

for higher education in all forms. In Ireland, the first nation

completely converted to Christianity,--where, therefore, the national

policy in education could be shaped by the Church without

hindrance,--St. Brigid's school at Kildare was scarcely less famous than

St. Patrick's at Armagh. It had several thousand students, and, to a

certain extent at least, co-education existed. In Charlemagne's time,

with the revival of education on the Continent, the women of the

Imperial Court attended the Palace School, as well as the men. In the

thirteenth century we find women professors in every branch at Italian

universities. Some of them were at least assistants in anatomy. The

Renaissance women were, of course, profoundly educated. In a word, we

have many phases of feminine education, though with intervals of

absolutely negative interest, down the centuries.



There had evidently been quite a considerable amount of opportunity, if

not of actual encouragement, for women in medicine, both among the

Greeks and the Romans, in the early centuries of the Christian era.

Galen, for instance, quotes certain prescriptions from women physicians.

One Cleopatra is said to have written a book on cosmetics. This name

came afterwards to be confounded with that of Queen Cleopatra, giving

new prestige to the book, but neither Galen nor Aetius, the early

Christian physician, both of whom quote from her work, speak of her as

anything except a medical writer. Some monuments to women physicians

from these old times have escaped the tooth of time. There was the tomb

of one Basila, and also of a Thecla, both of whom are said to have been

physicians. Two other names of Greek women physicians we have, Origenia

and Aspasia, the former mentioned by Galen, the latter by Aetius in his

Tetrabiblion. Daremberg, the medical historian, announced in 1851 that

he had found a Greek manuscript with the title, On Women's Diseases,

written by one Metrodora, a woman physician. He promised to publish it.

It was unpublished at the time of his death, but could not be found

among his papers. There is a manuscript on medical subjects, bearing

this name, mentioned in the catalogue of the Greek Codices of the

Laurentian Library at Florence, but this is said to give no indication

of the time when its author lived. We have evidence enough, however, to

show that Greek women physicians were not very rare.



The Romans imitated the Greeks so faithfully--one might almost say

copied them so closely--that it is not surprising to find a number of

Roman women physicians. The first mention of them comes from Scribonius

Largus, in the first century after Christ. Octavius Horatianus, whom

most of us know better as Priscian, dedicated one of his books on

medicine to a woman physician named Victoria. The dedication leaves no

doubt that she was a woman in active practice, at least in women's

diseases, and it is a book on this subject that Priscian dedicates to

her. He mentions another woman physician, Leoparda. The word medica

for a woman physician was very commonly used at Rome. Martial, whose

epigrams have been a source of so much information in medical history,

especially on subjects with regard to which information was scanty,

mentions a medica in an epigram. Apuleius also uses the word. There

are a number of inscriptions in which women physicians are mentioned.

Among the Christians we find women physicians, and Theodosia, the mother

of St. Procopius, the martyr, is said to have been very successful in

the practice of both medicine and surgery. She is numbered among the

martyrs, and occurs in the Roman Martyrology on the 29th of May. Father

Bzowski, the Polish Jesuit, who compiled Nomenclatura Sanctorum

Professione Medicorum (Rome, 1621; the book is usually catalogued under

the Latin form of his name, Bzovius), has among his list of saints who

were physicians by profession a woman, St. Nicerata, who lived at

Constantinople in the reign of the Emperor Arcadius, and who is said to

have cured St. John Chrysostom of a serious disease.



The organization of the department of women's diseases at Salerno, under

the care of women professors, and the granting of licenses to women to

practise medicine, is not so surprising in the light of this tradition

among Greeks and Romans, taken up with some enthusiasm by the

Christians. We are not sure just when this development took place. The

first definite evidence with regard to it comes in the life of Trotula,

who seems to have been the head of the department. Some of her books are

well known, and often quoted from, and she contributed to a symposium on

the treatment of disease, in which there are contributions, also, from

men professors of Salerno at the time. She seems to have flourished

about the middle of the eleventh century. Ordericus Vitalis, a monk of

Utica, who wrote an ecclesiastical history, tells of one Rudolph

Malcorona, who, in 1059, came to Utica and remained there for a long

time with Father Robert, his nephew. This Rudolph had been a student

all his life, devoting himself with great zeal to letters, and had

become famous for his visits to the schools of France and Italy, in

order to gather there the secrets of learning. As a consequence he was

well informed not only in grammar and dialectics, but also in astronomy

and in music. He also possessed such an extensive knowledge of the

natural sciences that in the town of Salerno, where, since ancient

times, the best schools of medicine had existed, there was no one to

equal him with the exception of a very wise matron.



This wise matron has been identified with Trotula, many of the details

of whose life have been brought to light by De Renzi, in his Story of

the School of Salerno.[11] According to very old tradition, Trotula

belonged to the family of Ruggiero. This was a noble family of Salerno,

many of the members of which were distinguished in their native town at

least, but the name is not unusual in Italy, as readers of Dante and

Boccaccio are likely to know. It was, indeed, as common as our own

Rogers, of which it is the Italian equivalent.



De Renzi has made out a rather good case for the tradition that Trotula

was the wife of John Platearius I--so called because there were probably

three professors of that name. Trotula was, according to this, the

mother of the second Platearius, and the grandmother of the third, all

of them distinguished members of the faculty at Salerno.



Her reputation extended far beyond her native town, and even Italy

itself, and, in later centuries, her name was used to dignify any form

of treatment for women's diseases that was being exploited. Rutebeuf,

one of the trouveres, thirteenth-century French poets, has a

description of the scene in which one of the old herbalist doctors who

used to go round and collect a crowd by means of songs and music, and

then talk medicine to them--just as is done even yet in many of the

smaller towns of this country--is represented as saying to the crowd

when he wants to make them realize that he is no ordinary quacksalver,

that he is one of the disciples of the great Madame Trot of Salerno. The

old-fashioned speech runs somewhat as follows: Charming people: I am

not one of these poor preachers, nor the poor herbalists, who carry

little boxes and sachets, and who spread out before them a carpet. I am

the disciple of a great lady, who bears the name of Madame Trot of

Salerno. And I would have you know that she is the wisest woman in all

the four quarters of the world.



Two books are attributed to Trotula; one bears the title, De

Passionibus Mulierum, and the other has been called Trotula Minor, or

Summula Secundum Trotulam, and is a compendium of what she wrote. This

is probably due to some disciple, but seems to have existed almost in

her own time. Her most important work bears two sub-titles, Trotula's

Unique Book for the Curing of Diseases of Women, Before, During, and

After Labor, and the other sub-title, Trotula's Wonderful Book of

Experience (experimentalis) in the Diseases of Women, Before, During,

and After Labor, with Other Details Likewise Relating to Labor.



The book begins with a prologue on the nature of man and of woman, and

an explanation of how the author, taking pity on the sufferings of

women, came to devote herself to the study of their diseases. There are

many interesting details in the book, all the more interesting because

in many ways they anticipate modern solutions of difficult problems in

women's diseases, and the care of the mother and child before, during,

and after labor. For instance, there are a series of rules on the choice

of the nurse, and on the diet and the regime which she should follow if

the child is to be properly nourished without disturbance.



Probably the most striking passage in her book is that with regard to a

torn perineum and its repair. This passage may be found in De Renzi or

in Gurlt. It runs as follows: Certain patients, from the severity of

the labor, run into a rupture of the genitalia. In some even the vulva

and anus become one foramen, having the same course. As a consequence,

prolapse of the uterus occurs, and it becomes indurated. In order to

relieve this condition, we apply to the uterus warm wine in which butter

has been boiled, and these fomentations are continued until the uterus

becomes soft, and then it is gently replaced. After this the tear

between the anus and vulva we sew in three or four places with silk

thread. The woman should then be placed in bed, with the feet elevated,

and must retain that position, even for eating and drinking, and all the

necessities of life, for eight or nine days. During this time, also,

there must be no bathing, and care must be taken to avoid everything

that might cause coughing, and all indigestible materials.



There is a passage, also, almost more interesting with regard to

prophylaxis of rupture of the perineum. She says, In order to avoid the

aforesaid danger, careful provision should be made, and precautions

should be taken during labor somewhat as follows: A cloth should be

folded in somewhat oblong shape, and placed on the anus, so that, during

every effort for the expulsion of the child, that should be pressed

firmly, in order that there may not be any solution of the continuity of

tissue.



Her book contains, also, some directions for various cosmetics. How many

of these are original, however, is difficult to say. Trotula's name had

become a word to conjure with, and many a quack in the after time tried

to make capital for his remedies in this line by attributing them to

Trotula. As a consequence, many of these remedies gradually found their

way into the manuscript copies of her book, and subsequent copyists

incorporated them into the text, until it became practically impossible

to determine which were original. There are manuscripts of Trotula's

work in Florence, Vienna, and Breslau. Some of these contain chapters

not in the others, undoubtedly added by subsequent hands. In one of

these, that at Florence, from which the edition of Strasburg was printed

in 1544, and of Venice, 1547, one of the Aldine issues, there is a

mention in the last chapter of spectacles. We have no record of these

until the end of the thirteenth century, when this passage was probably

added. It was also printed at Basle, 1566, and at Leipzig as late as

1778, which would serve to show how much attention it has attracted even

in comparatively recent times.



After Trotula we have a number of women physicians of Salerno whose

names have come down to us. The best known of these bear the names

Constanza, Calendula, Abella, Mercuriade, Rebecca Guarna, who belonged

to the old Salernitan family of that name, a member of which, in the

twelfth century, was Romuald, priest, physician, and historian, Louise

Trencapilli, and others. The titles of some of their books, as those of

Mercuriade, who occupied herself with surgery as well as medicine, and

who is said to have written on Crises, on Pestilent Fever, on The

Cure of Wounds, and of Abella, who acquired a great reputation with her

work on Black Bile, and on the Nature of Seminal Fluid, have come

down to us. Rebecca Guarna wrote on Fevers, on the Urine, and on the

Embryo. The school of Salernitan women came to have a definite place

in medical literature.



While, as teachers, they had charge of the department of women's

diseases, their writings would seem to indicate that they studied all

branches of medicine. Besides, there are a number of licenses preserved

in the archives of Naples in which women are accorded the privilege of

practising medicine. Apparently these licenses were without limitation.

In many of these mention is made of the fact that it seems especially

fitting that women should be allowed to practise in women's diseases,

since they are by constitution likely to know more and to have more

sympathy with feminine ills. The formula employed as the preamble of

this license ran as follows: Since, then, the law permits women to

exercise the profession of physicians, and since, besides, due regard

being had to purity of morals, women are better suited for the treatment

of women's diseases, after having received the oath of fidelity, we

permit, etc.



Salerno continued to enjoy a reputation for training women physicians

thoroughly, until well on in the fifteenth century, for we have the

record of Constance Calenda, the daughter of Salvator Calenda, who had

been dean of the faculty of medicine at Salerno about 1415, and

afterwards dean of the faculty at Naples. His daughter, under the

diligent instruction of her father, seems to have obtained special

honors for her medical examination. Not long after this, Salerno itself

lost all the prestige that it had. The Kings of Naples endeavored to

create a great university in their city in the thirteenth century. They

did not succeed to the extent that they hoped, but the neighboring rival

institution hurt Salerno very much, and its downfall may be traced from

this time. Gradually its reputation waned, and we have practically no

medical writer of distinction there at the end of the fourteenth

century, though the old custom of opportunities for women students of

medicine was maintained.



This custom seems also to have been transferred to Naples, and licenses

to practise were issued to woman graduates of Naples. This never

achieved anything like the reputation in this department that had been

attained at Salerno. Salerno influenced Bologna and the north Italian

universities profoundly in all branches of medicine and medical

education, particularly in surgery, as can be seen in the chapter on

Great Surgeons of the Medieval Universities, and the practice of

allowing such women as wished to study medicine to enter the university

medical schools is exemplified in the case of Mondino's assistant in

anatomy, Alessandra Giliani, though there are also others whose names

have come down to us.



The University of Salerno had developed round a medical school. It was

the first of the universities, and, in connection with its medical

school, feminine education obtained a strong foothold. It is not

surprising, then, that with the further development of universities in

Italy, feminine education came to be the rule. This rule has maintained

itself all down the centuries in Italy, so that there has not been a

single century since the twelfth in which there have not been one or

more distinguished women teachers at the Italian universities.

University life gradually spread westward, and Paris came into existence

as an organized institution of learning after Bologna, and, doubtless,

with some of the traditions of Salerno in the minds of its founders.

Feminine education, however, did not spread to the West. This is a

little bit difficult to understand, considering the reverence that the

Teutonic peoples have always had for their women folk and the privileges

accorded them. A single unfortunate incident, that of Abelard and

Heloise, seems to have been sufficient to discourage efforts in the

direction of opportunities for feminine education in connection with the

Western universities. Perhaps, in the less sophisticated countries of

the North and West of Europe, women did not so ardently desire

educational opportunities as in Italy, for whenever they have really

wanted them, as, indeed, anything else, they have always obtained them.



In spite of the absence of formal opportunities for feminine education

in medicine at the Western universities, a certain amount of scientific

knowledge of diseases, as well as valuable practical training in the

care of the ailing, was not wanting for women outside of Italy. The

medical knowledge of the women of northern France and Germany and

England, however, though it did not receive the stamp of a formal degree

from the university and the distinction of a license to practise, was

none the less thorough and extensive. It came in connection with certain

offices in their own communities, held by members of religious orders.

Genuine information with regard to what the religious were doing during

the Middle Ages was so much obscured by the tradition of laziness and

immorality, created at the time of the so-called reformation in order

to justify the confiscation of their property by those whose one object

was to enrich themselves, that we have only come to know the reality of

their life and accomplishments in comparatively recent years. We now

know that, besides being the home of most of the book knowledge of the

earlier Middle Ages, the monasteries were the constant patrons of such

practical subjects as architecture, agriculture in all its phases,

especially irrigation, draining, and the improvement of land and crops;

of art, and even what we now know as physical science. Above all, they

preserved for us the old medical books and carried on medical traditions

of practice. The greatest surprise has been to find that this was true

not only for the monks, but also for the nuns.



One of the most important books on medicine that has come to us from the

twelfth century is that of a Benedictine abbess, since known as St.

Hildegarde, whose life was spent in the Rhineland. Her works serve to

show very well that in the convents of the tenth, eleventh, and twelfth

centuries there was much more of interest in things intellectual than we

have had any idea of until recent years, and that, indeed, one of the

important occupations of convent life was the serious study of books of

all kinds, some of them even scientific, as well as the writing of works

in all departments. The century before St. Hildegarde there is the

record of Hroswitha, who wrote a series of dramas in imitation of

Terence, that were meant to replace, for the monks and nuns of that

period, the reading of that rather too human author. Hroswitha, like

Hildegarde, was a German, and we have the record, also, of another

religious writer, abbess of the Odilian Cloister, at Hohenberg, who

wrote a book called Hortus Deliciarum, the Garden of Delights, a book

of information on many subjects not unlike our popular encyclopedias of

the modern time, the title of which shows that the place of information

in life was considered to be the giving of pleasure. While this work

deals mainly with Biblical and theological and mystical questions, there

are many purely scientific passages and many subjects of strictly

medical interest treated.



The life of the Abbess Hildegarde is worthy of consideration, because it

illustrates the period and makes it very clear that, in spite of the

grievous misunderstanding of their life and work, so common in the

modern time, these old-time religious had most of the interests of the

modern time, and pursued them with even more than modern zeal and

success, very often. Her career illustrates very well what the

foundation of the Benedictines had done for women. When St. Benedict

founded his order for men, his sister, Scholastica, wanted to do a

similar work for women. We know that the Benedictine monks saved the old

classics for us, kept burning the light of the intellectual life, and

gave a refuge to men who wanted to devote themselves in leisure and

peace to the things of the spirit, whether of this world or the other.

We have known much less of the Benedictine nuns until now the study of

their books shows that they provided exactly the same opportunities for

women and furnished a vocation, a home, an occupation of mind, and a

satisfaction of spirit for the women who, in every generation, do not

feel themselves called to be wives and mothers, but who want to live

their lives for others rather than for themselves and their kin, seeking

such development of mind and of spirit as may come with the leisure and

peace of celibacy.



Hildegarde was born of noble parents at Boeckelheim, in the county of

Sponheim, about the end of the eleventh century (probably 1098). In her

eighth year she went for her education to the Benedictine cloister of

Disibodenberg. When her education was finished, she entered the

cloister, of which, at the age of about fifty, she became abbess. Her

writings, reputation for sanctity, and her wise saintly rule attracted

so many new members to the community that the convent became

overcrowded. Accordingly, with eighteen of her nuns, Hildegarde withdrew

to a new convent at Rupertsberg, which English and American travellers

will remember because it is not far from Bingen on the Rhine. Here she

came to be a centre of attraction for most of the world of her time. She

was in active correspondence with nearly every important man of her

generation. She was an intimate friend of Bernard of Clairvaux, who was

himself, perhaps, the most influential man in Europe in this century.

She was in correspondence with four Popes, and with the Emperors Conrad

and Frederick I, and with many distinguished archbishops, abbots, and

abbesses, and teachers and teaching bodies of various kinds. These

correspondences were usually begun by her correspondents, who consulted

her because her advice in difficult problems was considered so valuable.



In spite of all this time-taking correspondence, she found leisure to

write a series of books, most of them on mystical subjects, but two of

them on medical subjects. The first is called Liber Simplicis

Medicinae, and the second Liber Compositae Medicinae. These books were

written in order to provide information mainly for the nuns who had

charge of the infirmaries of the monasteries of the Benedictines. Almost

constantly someone in the large communities, which always contained aged

religious, was ailing, and then, besides, there were other calls on the

time and the skill of the sister infirmarians. There were no hotels at

that time, and no hospitals, except in the large cities. There were

always guest houses in connection with monasteries and convents, in

which travellers were permitted to pass the night, and given what they

needed to eat. There are many people who have had experiences of

monastic hospitality even in our own time. Sometimes travellers fell

ill. Not infrequently the reason for travelling was to find health in

some distant and fabulously health-giving resort, or at the hands of

some wonder-working physician. Such high hopes are nearly always set at

a distance. This of itself must have given not a little additional need

for knowledge of medicine to the infirmarians of convents and

monasteries. There were around many of the monasteries, moreover, large

estates; often they had been cleared and made valuable by the work of

preceding generations of monks, and on these estates peasants came to

live. Workingmen and workingwomen from neighboring districts came to

help at harvest time, and, after a chance meeting, were married and

settled down on a little plot of ground provided for them near the

monastery. As these communities grew up, they looked to the monasteries

and convents for aid of all kinds, and turned to them particularly in

times of illness. The need for definite instruction in medicine on the

part of a great many of the monks and nuns can be readily understood,

and it was this need that Hildegarde tried to meet in her books. The

first of her books that we have mentioned, the Liber Simplicis

Medicinae, attracted attention rather early in the Renaissance, and was

deemed worthy of print. It was edited at the beginning of the sixteenth

century by Dr. Schott at Strasburg, under the title, Physica S.

Hildegardis. Another manuscript of this part was found in the library

of Wolfenbuttel, in 1858, by Dr. Jessen. This gave him an interest in

Hildegarde's contributions to medicine, and, in 1859, he noted in the

library at Copenhagen a manuscript with the title Hildegardi Curae et

Causae. On examination, he was sure that it was the Liber Compositae

Medicinae of the saint. The first work consists of nine books, treating

of plants, elements, trees, stones, fishes, birds, quadrupeds, reptiles,

and metals, and is printed in Migne's Patrologia, under the title

Subtilitatum Diversarum Naturarum Libri Novem. The second, in five

books, treats of the general diseases of created things, of the human

body and its ailments, of the causes, symptoms, and treatment of

diseases.



It would be very easy to think that these are small volumes and that

they contain very little. We are so apt to think of old-fashioned

so-called books as scarcely more than chapters, that it may be

interesting to give some idea of the contents and extent of the first of

these works. The first book on Plants has 230 chapters, the second on

the Elements has 13 chapters, the third on Trees has 36 chapters, the

fourth on various kinds of Minerals, including precious stones, has 226

chapters, the fifth on Fishes has 36 chapters, the sixth on Birds has 68

chapters, the seventh on Quadrupeds has 43 chapters, the eighth on

Reptiles has 18 chapters, the ninth on Metals has 8 chapters. Each

chapter begins with a description of the species in question, and then

defines its value for man and its therapeutic significance. Modern

scientists have not hesitated to declare that the descriptions abound in

observations worthy of a scientific inquiring spirit. We are, of course,

not absolutely sure that all the contents of the books come from

Hildegarde. Subsequent students often made notes in these manuscript

books, and then other copyists copied these into the texts.

Unfortunately we have not a number of codices to collate and correct

such errors. Most of what Hildegarde wrote comes to us in a single copy,

of none are there more than four copies, showing how near we came to

missing all knowledge of her entirely.



Dr. Melanie Lipinska, in her Histoire des Femmes Medecins, a thesis

presented for the doctorate in medicine at the University of Paris in

1900, subsequently awarded a special prize by the French Academy,

reviews Hildegarde's work critically from the medical standpoint. She

says that the saint distinguishes a double mode of action of different

substances, one chemical, the other physical, or what we would very

probably call magnetic. She discusses all the ailments of the various

organs, the brain, the eyes, the teeth, the heart, the spleen, the

stomach, the liver. She has special chapters on redness and paleness of

the face, on asthma, on cough, on fetid breath, on bilious indigestion,

on gout. Besides, she has other chapters on nervous affections, on

icterus, on fevers, on intestinal worms, on infections due to swamp

exhalations, on dysentery, and a number of forms of pulmonary diseases.

Nearly all of our methods of diagnosis are to be found, hinted at at

least, in her book. She discusses the redness of the blood as a sign of

health, the characteristics of various excrementitious material as signs

of disease, the degrees of fever, and the changes in the pulse. Of

course, it was changes in the humors of the body that constituted the

main causes for disease in her opinion, but it is well to remind

ourselves that our frequent discussion of auto-intoxication in recent

years is a distinct return to this.



Some of Hildegarde's anticipations of modern ideas are, indeed,

surprising enough. For instance, in talking about the stars and

describing their course through the firmament, she makes use of a

comparison that is rather startling. She says: Just as the blood moves

in the veins which causes them to vibrate and pulsate, so the stars

move in the firmament and send out sparks as it were of light like the

vibrations of the veins. This is, of course, not an anticipation of the

discovery of the circulation of the blood, but it shows how close were

men's ideas to some such thought five centuries before Harvey's

discovery. For Hildegarde the brain was the regulator of all the vital

qualities, the centre of life. She connects the nerves in their passage

from the brain and the spinal cord through the body with manifestations

of life. She has a series of chapters with regard to psychology normal

and morbid. She talks about frenzy, insanity, despair, dread, obsession,

anger, idiocy, and innocency. She says very strongly in one place that

when headache and migraine and vertigo attack a patient simultaneously

they render a man foolish and upset his reason. This makes many people

think that he is possessed of a demon, but that is not true. These are

the exact words of the saint as quoted in Mlle. Lipinska's thesis.



It is no wonder that Mlle. Lipinska thinks St. Hildegarde the most

important medical writer of her time. Reuss, the editor of the edition

of Hildegarde published in Migne's Patrology, says: Among all the

saintly religious who have practised medicine or written about it in the

Middle Ages, the most important is without any doubt St. Hildegarde....

With regard to her book he says: All those who wish to write the

history of the medical and natural sciences must read this work in which

this religious woman, evidently well grounded in all that was known at

that time in the secrets of nature, discusses and examines carefully

all the knowledge of the time. He adds, It is certain that St.

Hildegarde knew many things that were unknown to the physicians of her

time.



When such books were read and widely copied, it shows that there was an

interest in practical and scientific medicine among women in Germany

much greater than is usually thought to have existed at this time. Such

writers, though geniuses, and standing above their contemporaries,

usually represent the spirit of their times and make it clear that

definite knowledge of things medical was considered of value. The

convents and monasteries of this time are often thought of by those who

know least about them as little interested in anything except their own

ease and certain superstitious practices. As a matter of fact, they

cared for their estates, and especially for the peasantry on them, they

provided lodging and food for travellers, they took care of the ailing

of their neighborhood, and, besides, occupied themselves with many

phases of the intellectual life. It was a well-known tradition that

country people who lived in the neighborhood of convents and

monasteries, and especially those who had monks and nuns for their

landlords, were much happier and were much better taken care of than the

tenantry of other estates. For this a cultivation of medical knowledge

was necessary in certain, at least, of the members of the religious

orders, and such books as Hildegarde's are the evidence that not only

the knowledge existed, but that it was collected and written down, and

widely disseminated.



Nicaise, in the introduction to his edition of Guy de Chauliac's

Grande Chirurgie, reviews briefly the history of women in medicine,

and concludes:



Women continued to practise medicine in Italy for centuries,

and the names of some who attained great renown have been

preserved for us. Their works are still quoted from in the

fifteenth century.



There was none of them in France who became distinguished,

but women could practise medicine in certain towns at least on

condition of passing an examination before regularly appointed

masters. An edict of 1311, at the same time that it interdicts

unauthorized women from practising surgery, recognizes their

right to practise the art if they have undergone an

examination before the regularly appointed master surgeons of

the corporation of Paris. An edict of King John, April, 1352,

contains the same expressions as the previous edict. Du

Bouley, in his 'History of the University of Paris,' gives

another edict by the same King, also published in the year

1352, as a result of the complaints of the faculties at Paris,

in which there is also question of women physicians. This

responded to the petition: 'Having heard the petition of the

Dean and the Masters of the Faculty of Medicine at the

University of Paris, who declare that there are very many of

both sexes, some of the women with legal title to practise and

some of them merely old pretenders to a knowledge of medicine,

who come to Paris in order to practise, be it enacted,' etc.

(The edict then proceeds to repeat the terms of previous

legislation in this matter.)



Guy de Chauliac speaks also of women who practised surgery.

They formed the fifth and last class of operators in his time.

He complains that they are accustomed to too great an extent

to give over patients suffering from all kinds of maladies to

the will of Heaven, founding their practice on the maxim 'The

Lord has given as he has pleased; the Lord will take away when

he pleases; may the name of the Lord be blessed.'



In the sixteenth century, according to Pasquier, the practice

of medicine by women almost entirely disappeared. The number

of women physicians becomes more and more rare in the

following centuries just in proportion as we approach our own

time. Pasquier says that we find a certain number of them

anxious for knowledge and with a special penchant for the

study of the natural sciences and even of medicine, but very

few of them take up practice.



Just how the lack of interest in medical education for women gradually

deepened, until there was almost a negative phase of it, only a few

women in Italy devoting themselves to medicine, is hard to say. It is

one of the mysteries of the vicissitudes of human affairs that ups and

downs of interest in things practical as well as intellectual keep

constantly occurring. The number of discoveries and inventions in

medicine and surgery that we have neglected until they were forgotten,

and then had to make again, is so well illustrated in chapters of this

book, that I need only recall them here in general. It may seem a little

harder to understand that so important a manifestation of interest in

human affairs as the education and licensure of women physicians should

not only cease, but pass entirely out of men's memory, yet such

apparently was the case. It would not be hard to illustrate, as I have

shown in Cycles of Feminine Education and Influence in Education, How

Old the New (Fordham University Press, 1910), that corresponding ups

and downs of interest may be traced in the history of feminine education

of every kind. In that chapter I have discussed the possible reasons for

these vicissitudes, which have no place here, but I may refer those who

are interested in the subject to that treatment of it.