History of Herbal Medicines for Women

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CHAPTER 2 History of Herbal Medicines for Women

WOMEN, HERBS, AND HEALTH REFORM: A HISTORICAL SUMMARY

Aviva Romm

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:

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.

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