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

The role of women healers was well established in ancient Greece, whereas in Egypt priestesses were often physicians and keepers of healing traditions. Their practices represented a synthesis of the physical and spiritual aspects of healing. One of the most revered deities of healing in ancient Egypt was the goddess Isis, to whom supplicants directed their prayers for healing. The medical practices of ancient Greece led to the development of later Western medical healing practices, including surgery. It has been suggested by scholars that women may have been largely responsible for the initial development of surgical techniques and therapeutics. Leto was the goddess of surgery.

Hygiea, an important goddess in the Greek pantheon and daughter of Asclepias, the legendary father of medicine (circa 900 bce), is still a part of medicine today. Her statue is found on the fronts of hospitals and her name is invoked daily in our word hygiene, as is her sister’s—Panacea—often mentioned in medicine. Both sisters were invoked for the restoration of good health—the practice of hygiene now considered central to preventive medicine. Hundreds of shrines dedicated to this family were erected in ancient Greece. Each woman in the family of Asclepias had her own staff, much like Asclepias’, with a snake winding around it—a symbol that has persisted for thousands of years as emblematic of healers—and that is still used today as the symbol of Western medicine.

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

A famed ancient Athenian woman healer, Agnodice, left an extraordinary legacy. At the time of her birth in Greece, women were forbidden to study medicine; the penalty for doing so was death. Women throughout the entire Greek empire recognized her as having started a female medical revolution in Athens, which eventually influenced the practice of medicine. It is said that Agnodice felt so called to practice medicine as a response to the number of women dying as a result of refusal by medical doctors to treat them that she dressed as a man and enrolled at the medical school in Alexandria. Upon graduating, she established her practice, still disguised as a man, but upon being discovered to be a woman, local women flooded to her practice. When authorities discovered her proper identity, she was arrested and put on trial. It is purported that when her patients discovered her plight they threatened to rebuke their husbands by withholding “marital favors” if they did not support Agnodice’s liberation. Congregating at the courthouse, they threatened to commit suicide en masse if she was not released. Successful in their efforts, Agnodice was freed and permitted to practice—in any manner of clothing she pleased. More significantly, women, with the exception of slaves, were permitted to openly study and practice medicine, treating only the diseases of women and children. This led to a new avenue of social and economic freedom for women in Greece. Numerous famed female physicians followed in Agnodice’s footsteps: Theano, Aspsasia, Antiochis, and Cleopatra, a physician practicing at the time of Galen (second century ce). These women specialized in gynecologic and obstetric complaints, wrote extensively, and were renowned for their work.

At the University of Athens there is a fresco of the famed woman physician Aspasia in the company of such leaders as Socrates, Plato, and Sophocles. Her writings remained the standard textbook of gynecology until the time of Trotula. Aspasia employed treatments for problems as diverse as difficult labor, retained placenta, uterine tumors, and peritonitis, for which she performed successful surgeries. Cleopatra also wrote an extensive gynecology text that was distributed throughout Greece and Rome, and used as a standard treatise by doctors and midwives well into the sixteenth century. However, her work had been falsely attributed to a male writer of the sixth century ce. Soranus is later thought to have plagiarized her work extensively in his famed text, Gynaecology. This was not uncommon: What is believed to be the oldest medical treatise, written by a woman named Metrodora, was attributed to a man named Metrodorus. The original manuscript written by Metrodora still survives in Italy.

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

Overall, midwives tended to be well respected in their communities; however, their skills and expertise varied tremendously. Because there were neither formal education programs for midwives, nor standards of practice, the quality of care and skill a midwife possessed was largely individual. Nonetheless, there are impressive, if few, records of women from both the Middle Ages who dedicated themselves to healing and medicine. Empress Eudoxia (420 ce) is attributed with the founding of two medical schools and a hospital in Syria, Jerusalem, and the land that eventually became Mesopotamia. Princess Radegonde of Burgundy studied medicine and opened a hospital for lepers, and Hilda of Whitley was an Anlgo-Saxon princess who became a physician and in 657 ce built an abbey where she practiced medicine and taught many classical academic subjects.

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

When the Moors conquered Spain, Spanish women trained in the healing arts of midwifery and alchemy alongside men, with an emphasis on the treatment of gynecologic and obstetric conditions. The renowned Arabic physician Rhazes is said to have learned many new remedies from women, and to have admitted jealousy of women healers, whom he said were often able to find cures where he had failed to successfully treat a patient.

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:

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

Another of her collections, Physica, is comprised of nine books containing treatises on plants and trees, minerals and metals, and animals, including their medicinal and “energetic” qualities, and again drawing upon Greek medical descriptions. As is the case with most healers, Hildegard of Bingen’s medical protocol reflected the cultural and religious context in which she lived; thus, Christian mysticism pervades her writing. Yet, her role as a woman healer also ran contrary to the common trends of the society in which she lived. Unlike some of the healers already mentioned who made deliberate political choices to develop their arts contrary to popular opinion on the role of women in medicine, Hildegard’s calling came to her unbidden, as did her dedication to monastic life. Nonetheless, she represents a high level of intellectual achievement, forwardness in her discussion of women’s gynecologic and sexual concerns, and an exemplary level of dedication to social service.

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.

Women, considered the weaker gender, were seen to be in need of protection from the rigors of intellectual exercise, which might “damage their delicate constitutions.” In the Victorian era, a sharp distinction was made between science and superstition. A line was drawn between the intuitive, folkloric, and nonacademic approaches of traditional healers and the linear, academic approaches of medical doctors and scientists. It is ironic, however, that the cures of early doctors were largely unsuccessful, and with the use of heroic treatments such as purges, bleedings, and mercury-based drugs, often led to more harm than good. In direct contrast, although herbal cures were not always successful, they often were, and they rarely caused anything near the magnitude of adverse physical problems caused by the cures of the regular doctors.

By necessity, women resumed their roles as active community healers during the settlement of the United States, delivering babies and tending to the health care needs of families from the east to the west coasts during westward expansion. Some women brought healing remedies with them from Europe, eventually planting gardens with herbs that have now become naturalized throughout much of the United States. Many learned to replace their traditional remedies with indigenous plant species, not infrequently learned about from their native neighbors.

As in Europe, the politics of medicine, which in the United States ultimately gave rise to the American Medical Association, once again eventually usurped the role of the community-wise woman. From witchcraft accusations of seventeenth-century New England to the systematic discrediting of midwives and women doctors through the early 1900s, the history of medicine in the United States tells a story of competing political interests, smear campaigns against “irregular” doctors and women, and the development of a medical monopoly by regular physicians.

Until the early 1900s, medical schools for women, blacks, and Native Americans coexisted with medical schools that allowed only males. In 1912, the Flexner report commissioned by the Carnegie Foundation, effectively led to the closure of the former schools, and only those schools sanctioned by the report remained operational.* Although many of the criticisms made in the Flexner report may have accurately portrayed the dismal state of numerous medical programs, there appears to have been no effort made after the report to ensure access to medical education for those whom these schools served.

The Popular Health Movement

The Popular Health Movement is one of the under-acknowledged examples of a major women’s health reform movement in the United States.¹¹ Taking place between the 1830s and 1840s, it was a broad-based social movement focused on educating individuals about their bodies, their health, and disease prevention. It was a strategic reaction against the status of the elitist, formally trained physicians who promoted heroic, dangerous treatments that were frequently as incapacitating or deadly as they might have been life saving.¹¹ Popular health movement educators instead emphasized healthy lifestyles, proper diet, exercise, eliminating corsets, and advocated the use of birth control as well as abstinence in marriage to limit family size.

An emphasis was placed on lay practitioners, including midwives, as it was perceived that gentler treatments were to be found in the hands of women and domestic healers.¹¹ Alternative health establishments, such as water cure centers, were popularly frequented and physiologic societies were founded that provided women opportunities to learn about and discuss their health concerns. Women were strongly encouraged to go to medical school and liberate information for others. It was firmly believed that medical information should be accessible to all and that the specialized language of doctors, medical journals, and textbooks prevented nonmedical practitioners from understanding what should rightfully be common knowledge.¹¹

Although this movement eventually ceded to the times, the post–Civil War period marked the beginning of widening opportunities for women to access greater education. There was a significant increase in the number of women attending medical schools, with women comprising up to 6% of all physicians in the United States. This is a remarkable statistic, since as recently as 1973 in the United States, only 9% of all physicians were female.*

The Women’s Medical Movement

Women physicians, continuing the philosophic tradition of the popular health movement, established the women’s medical movement as a way to publicly challenge the popular medical philosophies regarding women’s health championed by conventional physicians. These theories included the belief that women were fragile and that education damaged the female reproductive organs. Limited by constraints that prevented them from working in male-run hospitals, they founded exemplary and successful women’s hospitals, employing doctors and nurses of both genders. Boston Women’s Medical College became the first contemporary medical school established for the training of female physicians. Eventually merging with Boston University because of financial troubles, the school still exists as the prestigious Boston University College of Medicine.

The Progressive Era

In the early 1900s, referred to as the progressive era, the women’s health movement largely wrestled with the issues of legalization of contraception, led by activist Margaret Sanger, which eventually led to the legalization of birth control and the maternal and child health movement, which was trying to increase the safety of motherhood through the establishment of prenatal care and maternal health clinics.¹² New York City was the center of activity for both efforts.

The Women’s Health/Self-Help Movement

The 1960s and 1970s saw the rebirth of the women’s health movement, once again arising to challenge a male-dominated medical system. The women’s self-help movement has continued to tackle such difficult issues as abortion rights, rape, women’s cancers, childbirth reform, and the excessive use of surgeries such as hysterectomies, mastectomies, and cesarean sections.

The return to natural medicines and “lay” healers that occurred in the post–Civil War era resurfaced in the mid-1960s along with the women’s self-help movement. Herbalists—both women and men—began to reclaim the use of herbal medicines again in response to perceptions of over control by the medical system, as well as overuse of medications and invasive treatments. Back-to-nature philosophies consistent with using gentler and more natural remedies, and the desire to be independent of conventional institutions (i.e., the medical establishment), created the modern-day role of herbalists whom, trained by studying the plants themselves, apprenticing themselves to indigenous healers, and studying old texts such as the eclectic medical books, began to quietly practice their art. Similarly, women found themselves training as midwives to meet the needs of increasing numbers of women seeking home births in order to birth without intervention and outside the confines of medical establishments and protocol. Some women learned the arts of midwifery and herbal medicine simultaneously, serving their communities much as the wise women of more ancient times. Many of the most well-known and respected herbalists and midwives of today’s herbal movement are those who began in the 1960s and 1970s.

Rebirth of Alternative and Traditional Healing in the Contemporary United States

In recent decades, increasing numbers of women have become disenchanted with the interventionist and impersonal nature of obstetrics and gynecology, as well as other specialties, such as oncology, and have turned to alternative healers for care. Articles on the large number of iatrogenic diseases caused by mis-medication and unnecessary use of procedures in hospitals and doctors’ offices has fueled the desire of many to seek more natural medical approaches. This strong public interest in herbal medicine has fed a large economic boon in the natural products industry. Scientific evaluation of herbal medicines has begun, frequently looking to the traditional use of the herbs to direct researchers toward possible medical applications.

Both midwifery and herbal medicine are experiencing resurgence, largely as a result of demand by women patients. Women are making connections between their health and their environments—whether their personal lives, work lives, or physical, ecologic environment. Stress, past abuses, and environmental health risks are increasingly recognized as important factors influencing health. It is fascinating to appreciate that the transformations currently taking place in health care are not sudden or new, but the result of centuries of effort for health care reform by women healers and those unique men practicing alongside these remarkable women, who together continue to shape the history of health care.

Aphrodisiacs

The use of aphrodisiacs to increase libido is documented in most cultures throughout history, even as far back as ancient Assyria (Table 2-1).⁵ Herbal sexual stimulants remain popular products and are commonly available over the counter. Women today are most likely to seek aphrodisiac herbs for the treatment of sexual debility, such as in the perimenopausal years, rather than simply to increase an otherwise healthy sex drive.

TABLE 2-1 Herbs Used as Aphrodisiacs