More on midwives

The preceding information on women physicians, midwives and empirics in general, shouldn't be taken to say that the Colleges of Physicians were not trying to get women out of the medical profession. They were, though not steadily. But I would still characterize the problem as a trade dispute first, and misogynistic second.

There is, for instance, the singular case of Jacoba Felice, brought to court in Paris on charges of practicing, successfully, as a physician. The argument of the Faculty of Medicine of Paris was that she could not practice not because she was a quack, or untrained, but because she was a woman. However, the charges brought against her were specifically on the grounds of not being licensed, not of being a woman:

"That, in these actions, she has often exercised and continues to exercise a medical practice in Paris and its suburbs, that she has practiced and practices it from day to day, although she has not been approved in any official school in Paris or elsewhere, and that she does this without the license of the chancellor of the church of Paris and of the said dean and masters."

(However, I have found no credible evidence that Felice was burned for practicing medicine, as one Canadian journal author claims.)

Even in places where the Colleges of Physicians regulated the activities of 'empirics,' women empirics were often allowed to practice on women, due to the argument that many women would be embarrassed to talk about their illnesses or be examined by a male medical professional. Also as a result, midwifery flourished well into and through the 18th century, since male professionals were generally banished from the birthing-room until the advent of special birthing equipment.

"A memorial of Eleanor Willughby, a seventeenth century midwife," Adrian Wilsong, in Women, science and medicine 1500-1700: mothers and sisters of the Royal Society , describes a country midwife who practiced in concert with her physician father, and sometimes smuggled him into her cases to examine the patient. Laurel Thatcher Ulrich's A midwife's tale : the life of Martha Ballard, based on her diary, 1785-1812 speaks of the process by which physicians began to take over the midwives' practice in the early 19th century.

Even when medicine began to be more scientific and less literary/philosophical -- so that a physician's education didn't have to discuss whether the human female had a single or double-horned uterus -- male physicians usually had little practical experience in birthing. What they did have was metal implements, specifically forceps, which were used to assist in difficult births. (In the hands of a rough or inexperienced professional, however, those forceps could do great damage to mother and baby alike.) In fact, 17th and 18th century physicians could, and did, do something similar to partial-birth abortions to save women's lives when the child could not be extracted (since there was no reliable or actually survivable Cesarean section operation). Still, in rural areas, midwives practiced in concert with doctors into the early 20th century.

Holistic Herbalism?

People often backwards-generalize the division between a symptomatic or disease-focused 'scientific' medicine and an alternative 'holistic' or 'whole person medicine' seen in today's culture to the middle ages. To be completely blunt, this is bunk.

Even a little study of the methods and studies of physicans in the medieval and early modern period (pre-Vesalius, for instance), shows that they used holistic, whole-body, mind/body theories such as the theory of humors, astrology, and Galen's writings about the bowels (what foods and activities were contrictive, and what laxative) and strove for moderation in their patients' lives. Such theories let to activities such as bloodletting, cupping (applying hot cups to the skin to bring blood and lymph toward the surface), sweating, and emetic, purgative and/or laxative treatments to expel contents of the stomach and bowel from one end of the digestive tract or the other.

Medieval and early modern empirics, or folk medicine practitioners, used combinations of holistic, symptomatic, and symbolic medicine-- but their medicine was almost never *more* holistic than that of the physicians. Even the simplest scan through the recorded documents shows this. Though Culpeper's English Physician is in places 'holistic' by modern medical standards, it was the document of an empiric-- a non-guild-recognized apothecary -- writing based on the usual treatments described by the physicians of his day. But other authors, such as Gerard, who writes of what the common folk do with this herb and that, or even, to reach back to ancient history, Pliny, don't describe holistic medicine. Pliny, in fact, is famous for having written down any superstition or folk belief that people would describe to him, and one sometimes wonders whether his informants for the Natural History succumbed to the temptation to pull his leg about certain beliefs.

There was, it is true, a 17th and 18th century fad for belief in the Doctrine of Signatures, which holds that substances display their medicinal uses by some distinguishing feature. However, the first appearance of the Doctrine of Signatures is in Pliny, and it was taught and discussed in universities as a way of organizing knowledge, so many educated men, philosophers, and physicians of the middle ages and Renaissance knew of and subscribed to it. The last hurrah of the theory was probably in William Coles' Art of Simpling, whose use of the theory was hotly contested.

I am often told that we can have no idea how medieval women, or in fact any peasant empirics, used herbs, since they practiced only in secret, and never wrote anything down. (Thus, of course, the Lore mentioned by Diana Wynne Jones.) This is convenient, as one can thus make any claim one desires and it cannot be refuted by the documentary evidence.

However, it seems unlikely to be true, as references to home-made remedies appear in documents relating to the less prosperous, and we also see references in botanical and medical writings of the period to things the authors learned from peasants, old women, folklore, and etc. Furthermore, there is a certain intersection between those uses for herbs recorded on the extant herbals and texts, and uses recorded by ethnographers in the 19th and 20th centuries, and claimed now as the rightful herbal lore. To me, at least, it seems plausible that the ancient crafts of the herbalists (to blatantly twist poor Budge to my uses) as used in the middle ages do not remain entirely undocumented.

One curious exception is that of Willow bark, a source of salicylic acid. One can hardly turn around or stub one's toe in a fantasy novel without being offered willow-bark tea. (For reasons unknown, fantasy willow-bark tea, unlike its modern NSAID equivalents in real life, can be drunk as much as needed without stomach effects or increasing bleeding in wounds.) While the Egyptians and Hippocrates appear to have suggested willow bark for pain, it drops out of the written medicinal record after that, until 1763, when Reverend Edmund Stone tried powdered willow bark for fevers and arthritis. Allegedly, it was the theory of humors that led him to do so, since willows grow in the same damp low-lying places that are associated with fevers and arthritis. Oddly enough, however, meadowsweet, another source of salicin, is mentioned by medieval and early modern herbalists for fevers, though other herbs of varying usefulness such as camomile and mints were prescribed for fevers and agues in written works.