CHAPTER 2 History of Herbal Medicines for Women
WOMEN, HERBS, AND HEALTH REFORM: A HISTORICAL SUMMARY
Such “fathers of herbal medicine” as Dioscorides did not simply pull their therapeutic theories out of the air. His herbal was the human, largely female heritage finally recorded by a man interested enough in the subject and literate enough to be able to write it down. Ironically, the early records of women’s knowledge could be read by very few women.2
—Jennifer Bennett, Lilies of the Hearth: The Historical Relationship between Women and Plants
Women’s history has always been woven with plants and the healing arts, particularly botanical medicine and midwifery. 1 2 3 4 In virtually every culture, without exception, women maintained knowledge of herbal healing for the prevention and treatment of common maladies that afflicted their communities, including herbal treatments for women’s complaints. A textbook on botanical medicine for women would not be complete without recognition of the historical role of women healers.
Few records exist to tell us the stories of ancient women healers: their training, their successes, the clinical challenges they faced, or their experiences as women with medical careers.1 The limited historical records that do exist, however, give us a glimpse of some of the remarkable women healers in ancient times. Given the pharmacy of their day, it is clear that many of these women were highly skilled herbalists.3,5 Modern history leaves no doubt as to the important role women have played in the resurgence of herbal medicine and traditional healing practices in present-day medicine.
WOMEN HEALERS THROUGHOUT HISTORY
There is a remarkable absence of women healers in the archives of medicine. Information on the practices of women healers must be “carefully teased out of a few surviving works written by women healers, from relics and artifacts, from myth and song, and from what was written about women.”1 Although women have long handed herbal knowledge down to their daughters, both orally and in the form of “stillroom” books—the herbal equivalent of family recipe books—only a minority of women from the most privileged, educated backgrounds managed to keep comprehensive records or documentation of herbal “recipes.” Negligibly few women published serious medical works. On the rare occasion one did, it was frequently under a male pseudonym. Jeanne Achterberg states:
The experience of women healers, like the experience of women in general, is a shadow throughout the record of the world that must be sought at the interface of many disciplines: history, anthropology, botany, archaeology, and the behavioral sciences. … The available information on woman as healer in the western tradition spans several thousand years, stretching far back into prehistory when conditions were likely to support women as independent and honored healers. During and following those very early years, the role of women healers has been inexorably married to shifts in the ecology, the economy, and the politics in the area in which they lived.1
Women Healers of Ancient Egypt and Ancient Greece
The oldest report of a woman physician dates to circa 3000 bce. Records from this time indicate that a well-known practicing female physician lived in the city of Sais, where later there was a medical school. One of the earliest known medical documents, the Kahun papyrus (circa 1900 bce) from Egypt, addresses the diseases of women and children. It has been suggested that this papyrus was written for women practitioners, as in ancient Egypt only women treated women’s diseases.3 Egyptian queens, including Queen Hatshepsut (who reigned from 1503–1482 bce), encouraged women to become physicians. Hatshepsut herself set up three medical schools as well as botanical gardens. Women healers were responsible for planting medicinal herb gardens and maintaining pharmacies.
Egyptian belief in the afterlife led to the practice of burying with the dead those things that were important to them in life and that would be needed in their next existence. At least one Egyptian Queen, Mentuhetep, is purported to have been found buried with alabaster ointment jars, vessels for tinctured herbs, dried herbs, and spoons for measurement. Polydamna, also a queen and physician of Egypt, was reputed to have given knowledge of the healing properties of the opium poppy, one of the possible ingredients in the famous sedative nepenthe. She was also alleged to have trained Helen of Troy (circa 2000 bce), who is thought to have brought herbal knowledge from ancient Egypt to ancient Greece.3
By the time of Hippocrates (400 bce), women’s role in society had been minimized to that of servants; their role in the healing arts was likewise marginalized. Nonetheless, the contributions of several women healers were recorded. Aristotle’s wife Pythias was known to “assist” Aristotle in his work; together they wrote a text of their observations of the flora and fauna of one of the Greek islands. She was also involved in the study of anatomy and left detailed illustrations of chick and human embryologic studies. Queen Artemisia of Caria (350 bce) has been praised by Pliny the Elder and Theophrastus for her healing abilities, and is credited by them for introducing wormwood (Artemisia spp.) as a cure for numerous ailments, although there is some debate over the attribution of the botanical name for the Artemisia species to Queen Artemisia as opposed to the goddess Artemis. Pliny (c. 50 ce) wrote of several women who authored medical books, including Elephantis and Lais.3
Women Healers in Ancient Rome
Prior to Greek influence in Rome, physicians were disparaged. Families were expected to tend to their own health needs. The spiritual attributions of health and disease received more recognition than the physical, with goddesses such as Diana, Minerva, and Mater Matuta presiding over women’s reproductive concerns. Women had better social status in ancient Rome than in ancient Greece, and Roman women met the arrival of female physicians from Greece with great receptivity. It may be that Roman male rulers were less pleased. Pliny the Elder is quoted as having said that women healers should practice inconspicuously “so that after they were dead, no one would know that they have lived.”1 Nonetheless, women healers, mostly from aristocratic families, were busily practicing by the first century ce, being greatly sought after and handsomely paid for their work.
Two successful practitioners were Leoporda and Victoria, both of whom are mentioned in medical writings of the day, with Victoria receiving the dedication to a medical book. In the preface of the book, Rerum Medicarum, she is recognized as being a knowledgeable and experienced physician. Inscriptions of tombstones of women physicians from Rome include such accolades as “mistress of medical sciences” and “excellent physician.”3 Several celebrated women physicians include Olympias, Octavia, Origenia, Margareta (an army surgeon), and Fabiola. The former two wrote books of prescriptions, and the latter was considered to possess remarkable intellectual ability as well as unusual charity. Fabiola opened a hospital for the poor in Rome—the first civil hospital ever founded and thought to be one of the best in Europe at the time. It is said that when she died thousands attended her funeral procession.
Western Europe: The Middle Ages
The Middle Ages were an ambivalent time for women healers. Emerging from the early Middle Ages, during which women healers were considered to be diabolic, little respect was left for ancient traditions deifying women, their bodies, and their connection to nature. St. Jerome, ironically a dear friend and supporter of the healer Fabiola, is quoted as having said that “woman is the gate of the devil, the path of wickedness, the sting of the serpent, in a word, a perilous object.”1
By the Middle Ages, women healers appeared to take two divergent paths: Although midwives were well respected as skilled practitioners within their communities, many so-called cunning women, who were often poor and illiterate, were accused of and tried for witchcraft. Cunning women were thought to be dabbling in sorcery and bewitchment; midwives were often called as witnesses to testify against them at witchcraft trials.6 Midwives were seen as protectors of the expectant mother; a midwife was “the key figure in preventing harm…who guaranteed and subtended the order threatened by the witch.”7
Midwives were not impervious to accusations of witchcraft. There are notable cases, such as Walpurga Haussman of Dillenge, who was tried as a witch and executed.6 However, they are mainly notable because they are anomalous cases; some prosecutions were a result of political positioning, whereas others were of previously respectable midwives who slipped into “irregular healing methods.”6
Jacoba Felicie is an example of one tried for the practicing medicine without a license. Brought to trial in 1322 by the Faculty of Medicine at the University of Paris, she was a literate woman from an affluent family. Jacoba, with unspecified medical training, had successfully treated numerous patients who testified at her trial. Yet, the testimonies were used against her as proof that she had committed the cardinal crime, not of healing, but of attempting to cure. In fourteenth-century England, educated women practitioners were likewise the target of campaigns by English physicians seeking to rid themselves of “worthless and presumptuous women who usurped the profession” seeking fines and long imprisonment for women who attempted the “practyse of Fisyk.”4 Women practitioners who spared their lives had enough fear instilled in them to practice their crafts extremely covertly, if at all.
Although volumes of women’s herbal healing traditions were lost during this time, Europeans still depended on plants for medicine, so common household cures persisted. Numerous lay books on herbal medicinal cures were sold for the “gentlewoman” to use for keeping her family well, and ironically these books offered much of the same materia medica in use by physicians during that time. However, the revered place of women healers in their communities had been dramatically altered. Attitudes about nature, women, and their bodies also changed considerably, with the Baconian belief that all three were conquerable by medicine and technology.8
Trotula of Salerno is a legendary female healer of the Middle Ages. It is alleged that Trotula was considered the most distinguished teacher at the medical college in Salerno, Italy, a gathering place for men and women of Greek, Arab, Latin, and Jewish backgrounds studying medicine. She is said to have been the first female professional of medicine at Salerno, in the eleventh or twelfth century, and was called to medicine because she saw women suffering from obstetric and gynecologic complaints that they were too embarrassed to discuss with male doctors. Trotula was an early advocate of healthy diet, regular exercise, hygiene, and reduced stress. Although her history is not known with certainty, one of the most significant historical discourses on obstetrics and gynecology, referred to as The Trotula, actually a compendium of three texts, was either written in part by her, named after her, or is based on her teachings.9 The Trotula remained an authoritative text for several centuries. It is predicated on religious and philosophical notions of the period (i.e., the curse of Eve and women’s fall from grace), but the author(s) do not pathologize the normal processes of a woman’s body and assert that women have particular needs that should only be evaluated and treated by other women. The clinical portions of the book refer to the menses as “flowers,” describing menstruation as a process necessary for fertility, much as trees need flowers to produce fruits. Diagnoses are based on keen observation and include assessment of physical findings from pulse and urine, as well as the patient’s features and speech patterns. The text advanced theories and procedures, and was the first to define the diagnosis of syphilis based on its dermatologic manifestations. Trotula appears to have treated all manner of conditions with a variety of practices ranging from medicated oils to cesarean section, if necessary, with awareness of the need for antisepsis in surgery, prescribing topical and internal herbal treatments that may have been efficacious, based on what is known today about their actions. Sensitivity to the intimate needs of women is expressed, for example, by publishing the prescription of a procedure that will allow a woman who has previously lost her virginity to appear a virgin upon first intercourse after marriage, lest she face difficult political, legal, and social consequences. Jeanne Achterberg in Woman as Healer describes Trotula of Salerno:
She personified the balance that is so critical to the advancement of woman as a health care professional; a knowledge of science, attention to the magic that is embedded in the mind, a mission of service, awareness of suffering and the gift of compassion. She also had the courage to speak, write, and teach with conviction.1
The place of women healers continued to decline dramatically, but another woman healer of the Middle Ages, Hildegard of Bingen, achieved such significant fame that her story bears telling. Hildegard, like many of the other famed women healers, was born of a noble family. She lived between 1098 and 1179 ce in Germany. At 3 years of age, she began receiving visions* and she began religious education at age 8. Her gift of prophecy gave her the uncanny ability to understand religious scriptures immediately, and from an early age she drew the attention of nobles and religious leaders. She also received visions of how life at her abbey was to be lived, ranging from ornate clothing to the development of a language used in the convent—of which nearly a thousand words survive today. Hildegard was known as a gifted intellectual, skilled in both academia and the arts—the latter as a musician and composer. One of her many books, Cause et Curae, a collection of five tomes, is a comprehensive medical work in which she describes diagnosis based on four humoral types (sanguine, phlegmatic, melancholic, and choleric), reminiscent of ancient Greek medical descriptions; appropriate behaviors for lifestyle, including recommendations for diet, stress reduction, and moral behaviors; and astrological predictions, for example, for conception. She provides an extensive discourse on gynecology, with recipes for external and internal preparations, as well as applications for over 200 medicinal plants. Her recommendations also included the use of gemstones, incantations, as well as hydrotherapy.3
Women Herbalists in the Eighteenth and Nineteenth Centuries
“In the year 1775 my opinion was asked concerning a family recipe for the cure of dropsy. I was told that it had long been kept a secret by an old woman in Shropshire who had sometimes made cures after the more regular practitioners had failed.”10 This statement was made by the illustrious Dr. William Withering, discussing his discovery of the use of foxglove. He is purported to have paid the woman, a Mrs. Hutton, an undisclosed sum of gold coins for sharing the family “recipe,” consisting of 20 herbs for the treatment of what was then considered a virtually incurable condition. Little mention of Mrs. Hutton or her herbal practice, if indeed that is what it was, is otherwise made, but the story of the development of the still-used drug digitalis for the treatment of congestive heart failure is medical legend.
Samuel Thomson, the founder of Thomsonian Herbalism, which for a time was rival to the “regular” doctors, wrote in 1834, “We cannot deny that women possess superior capacities for the science of medicine.”4 Thomson, like Withering, learned herbal medicine from a countrywoman well versed in the subject, although Thomson studied botanical medicines extensively, whereas Withering learned the secret of only one formula. Yet, in the Victorian era, women interested in the healing arts and plants were relegated to the study of botany, which was considered to provide good gentle exercise for the mind and body. Women were discouraged and prevented from the practice of medicine, and eventually even midwifery, the latter of which was taken over, initially by an untrained class of physicians referred to as barber surgeons, which was an accurate name as they were literally both barbers and surgeons.