By Kate Manns
Pre-medieval texts and ancient manuscripts provided reference for early physicians and therapists, detailing discoveries from anatomy to diagnosis and treatment. For nearly five hundred years, The Trotulawas the only truly comprehensive compendium of female and paediatric medicine in this genre. Believed to be written in the early twelfth century; mystery and controversy have shrouded its origin. It was not until the sixteenth century that the true female co-authorship of The Trotula was realised and Trota di Ruggiero (‘Trotula’ literally translating to ‘little Trota’) was given credit for her work. Research by Dr. Monica Green in 2001 uncovered that the compendium should be recognised not as one book by a single author, but as three distinct texts: On the Conditions of Women, On Treatments for Women and On Women’s Cosmetics, each with a unique author. The second of the three texts is now accredited to the Salernitan woman healer and teacher, Trota, now considered the first true gynaecologist and obstetrician.
Despite the existence of her texts throughout Europe, Trota’s name and credit for her contributions to medicine and surgery have been obscured throughout history. It was after 1566 (almost five hundred years after her death), that a newly published copy of ‘The Trotula’ was ascribed incorrect authorship. The new author, Eros Juliae, may have been accredited as a result of a transcriptional error, or it may have been a convenient alteration in a society increasingly unsupportive of female accomplishment. Other ‘authors’, including Trottus, who otherwise is never mentioned in reference to medicine or science, deprived the ‘first woman professor of medicine of more than her chair’. We can now rest assured that, despite ongoing research; ‘Trotula of Salerno’ occupied a unique and powerful seat in the development of medieval female medical treatment.
Trota di Ruggiero was born into a wealthy Salernitan family in the eleventh century. Sometimes referred to as the ‘magistra mulier sapiens’ (wise woman teacher) she studied and practised medicine in Salerno, the first medical school of the western world, where students of all religions and language were united under Latin teaching. Trota studied, taught and practised with both male and female physicians as one of the most distinguished medical teachers, a true ‘muliere saleritana’ (lady of Salerno). An integral part of the medical community in Salerno, it is thought that Trota contributed not only to ‘The Trotula’, but collaborated with her husband Joannes Platearius I to write the great encyclopaedia Regimen Sanitatis, also writing ‘Trotula’s Curing of Sick Women Before and After Childbirth’ and Practica Secundum Trotam containing health advice of a more general nature. Trota pioneered the study of paediatric medicine, promoting the field’s importance, resulting in its occupation of a unique branch of medicine.
Trota’s work characterized medieval medicine, shaping Salerno’s ‘twelfth century Renaissance’ and, importantly, modernising female medical practice. Its controversial theories included contraception, the male contribution to infertility (and the use of animal hormones for conception) and menstruation regulation (including early abortion). Trota openly defied church rule with her scandalous administration of opiates for pain relief during childbirth, awarding her fame and contributing to her legacy of innovation. Sophisticated surgical technique not only modernized pre-medieval women’s health, but also contributed to a marked decrease in post partum death from infection. Trota demonstrated revolutionising techniques (Constantinus Africanus, a student at Salerno, describes a caesarean performed by Trota) and expounded new ideas addressing the inferiority of women and their resulting medical sufferance.
Though challenging the status quo, Trota also represents a woman of her time as she advocates the use of female physicians for greater female focus, arguing women’s susceptibility to ailment as a result of Eve’s sin. In the prologue to a large portfolio containing The Trotula, it is stated that ‘when the Creator of the universe made men and women, He endowed both with reason, intellect, and freedom, but to women he gave weaker bodies than to men’. These transient boundaries define Trota’s work, educating her peers and advancing progressive ideas about women’s health care in a society dominated by male physicians with little or no practical female medical experience.
Trota’s On The Treatment of Women provides medical advice concerning menstruation, conception, pregnancy, childbirth and other more general diseases with little theoretical speculation, instead incorporating humoral therapeutics. Indeed the ‘elemental’ and ‘humoral’ theory of sickness formed the basis of medical investigation, with illness resulting from systemic imbalances of hot or cold, wet or dry. Trota states the need to determine ‘which women are hot and which are cold’ in order to allow ‘a succinct exposition on the treatment’. Her work became a textbook for female medicine and was used by medics and midwives alike throughout Europe for nearly four centuries. She speaks of the use of herbs, spices, oils, animal products, long convalescences and a positive mental attitude, as well as thorough examination and consultation. An expert in cases of difficult labour, Trota dictated efficient procedures for handling breech, posterior and otherwise abnormal presentations during birth. Revolutionizing care during childbirth, including the turning of an infant in the uterus during labour, she advocated the repair of tears using silk thread. It was through teachings such as Trota’s, that holistic treatment and educated analysis emerged in medical practice. The book also, however, gives us an interesting insight into the perceived importance of femininity. Several of its chapters are dedicated to more familiar concerns of the wealthy woman; providing treatments for frizzy hair, freckle removal, bad breath and chapped lips. It thus functioned as a truly practical reference book for all elements of medieval female care.
As research grows, so too does our confidence in the story of Trota di Ruggiero and our satisfaction with the appropriate accreditation of her authorship. The importance of ‘The Trotula’ as a reference for female treatment and care is un-mirrored by any other text of the medieval period, successfully arguing for a unique female focus in a world where women were previously viewed with a medical contempt, or at the very least, ignorance. The text provides a wealth of historical and sociological insight and is considered by some scholars as evidence of an earlier golden age for female medicine and education. Trota di Ruggiero was a woman of talent and compassion, revolutionizing female and paediatric health care and contributing to the progression of pre-modern medicine as a whole.
Green, M. H. (ed and trans) The Trotula, A Medieval Compendium of Women’s Medicine (Philadelphia, 2001)
Bois. D, Distinguished Women of Past and Present: Trotula of Salerno, see http://www.distinguishedwomen.com/biographies/trotula.html
McNeil. R, Trotula of Salerno, see http://www.malaspina.org/home.asp?topic=./search/details&lastpage=./search/results&ID=340
Hurd-Mead. K.C ,‘Trotula’, Isis Vol. 14, Issue 2 (Chicago, 1930)
E. Mason-Hohl, The Diseases of Women; A Translation of Passionibus mulierum curandorum (Los Angeles, 1940)
Hamilton. G. L, ‘Trotula’ Modern Philology, Vol. 4, Issue. 2 (Chicago, 1906)
For information on medieval medical practice and gynaecology:http://www.gallowglass.org/jadwiga/herbs/WomenMed.html