"Here is a story. Once upon a time, there was a woman who lived on the edge of a village. She lived alone, in her own house surrounded by her garden, in which she grew all manner of herbs and other healing plants. Though she was alone, she was never lonely; she had her garden and her animals for company, she took lovers when she wished, and she was always busy. The woman was a healer and midwife; she had practical knowledge taught her by her mother, and mystical knowledge derived from her closeness to nature, or from a half-submerged pagan religion. She helped women give birth, and she had healing hands; she used her knowledge of herbs and her common sense to help the sick."Sounds like a great life, right? I'd sure jump at an existence like that.
"However, her peaceful existence was disrupted. Even though the woman was harmless, she posed a threat to the fearful. Her medical knowledge threatened the doctor. Her simple, true spiritual values threatened the superstitious nonsense of the Catholic church, as did her affirmation of the sensuous body. Her independence and freedom threatened men. So the Inquisition descended on her, and cruelly tortured her into confession to lies about the devil. She was burned alive by men who hated women, along with millions of others like her."Sounds familiar, doesn't it? That would be our prototypical fantasy healer/herbalist.
"Do you believe this story? Thousands of women do. It is still being retold, in full or in part, by women who are academics, but also by poets, novelists, popular historians, theologians, dramatists. It is compelling, even horrifying. However, in all essentials it is not true, or only partly true, as a history of what happened to the women called witches in the early modern period."It's when we begin to imagine the variety of the history obscured by this idea of the herbalist, of the healer, that we can see the diversity of fantastic possibilities which that history suggests.
“Therefore we can answer their first argument in this way: that if natural objects are used in a simple way to produce certain effects for which they are thought to have some natural virtue, this is not unlawful. But if there are joined to this certain characters and unknown signs and vain observations, which manifestly cannot have any natural efficacy, then it is superstitious and unlawful. Wherefore S. Thomas, II, q. 96, art. 2, speaking of this matter, says that when any object is used for the purpose of causing some bodily effect, such as curing the sick, notice must be taken whether such objects appear to have any natural quality which could cause such an effect; and if so, then it is not unlawful, since it is lawful to apply natural causes to their effects.”Also,
Again, there are some things in nature which have certain hidden powers, the reason for which man does not know; such, for example, is the lodestone, which attracts steel and many other such things, which S. Augustine mentions in the 20th book Of the City of God. And so women in order to bring about changes in the bodies of others sometimes make use of certain things, which exceed our knowledge, but this is without any aid from the devil. And because these remedies are mysterious we must not therefore ascribe them to the power of the devil as we should ascribe evil spells wrought by witches. (Part I, question 2)Again
But natural bodies may find the benefit of certain secret but good influences. Therefore artificial bodies may receive such influence. Hence it is plain that those who perform works of healing may well perform them by means of such good influences, and this has no connexion at all with any evil power.
And what, then, is to be thought of those witches who in this way sometimes collect male organs in great numbers, as many as twenty or thirty members together, and put them in a bird's nest, or shut them up in a box, where they move themselves like living members, and eat oats and corn, as has been seen by many and is a matter of common report? It is to be said that it is all done by devil's work and illusion, for the senses of those who see them are deluded in the way we have said. For a certain man tells that, when he had lost his member, he approached a known witch to ask her to restore it to him. She told the afflicted man to climb a certain tree, and that he might take which he liked out of the nest in which there were several members. And when he tried to take a big one, the witch said: You must not take that one; adding, because it belongs to a parish priest.
"Women as well as men practiced medicine and surgery; as with their predecessors in the Roman empire, women's practice was limited neither to obstetrical cases nor to female patients. For example, the names of 24 women described as surgeons in Naples between 1273 and 1410 are known, and references have been found to 15 women practitioners, most of them Jewish and none described as midwives, in Frankfurt between 1387 and 1497... Even in the twelfth century, however, the accomplishments of Trota and Abbess Hildegard were highly unusual. Once university faculties of medicine were established in the course of the thirteenth century, women were excluded from advanced medical education and, as a consequence, from the most prestigious and potentially lucrative variety of practice. Furthermore, it deserves to be emphasized that although women practitioners existed in many different regions of Europe between the thirteenth and the fifteenth centuries, they represent only a very small proportion of the total number of practitioners whose names are recorded-- according to one estimate, about 1.5 percent in France and 1.2 percent in England. It is probably that many more women may have engaged in midwifery and healing arts without leaving any trace of their activities in written records; but this in turn may imply that such women are likely to have clustered in the least prosperous sector of medical activity, or to have been part-time or intermittent practitioners." -- Siriasi, p. 27
Women surgeons often
specialized in the delicate work of cutting cataracts, since it required less
brute force. Women were allowed to practice as members of the apothecary guild
if they were widows of guild members. Herbalists-- that is, those who gathered
and sold herbs in the markets, to apothecaries and physicians-- could be of
Midwives were almost exclusively female, but their duties varied from the simple ones now associated with the doula to more complex situations. In a number of cities, the town took steps to regulate the practice of midwives directly, through panels of high-ranking or high-status women who would examine and certify midwives as competent. By the seventeenth century, a number of cities actually had guilds-- in London, apprentice midwives had to serve seven years with a senior midwife before being allowed to practice on their own.
Dame Trota, a possibly apocryphal figure, is the most famous of the women university physicians. It is said that she practiced at the University of Salerno, along with a number of other female medical scholars referred to as 'the Salernitarian Women'. A number of writings have been attributed to Trota, specifically those gathered together in the collections referred to as the _Trotula_.
Some historians claimed that all the texts in question were written by men and merely attributed to Trota; however, another extant general medical work by Trota was identified by John Benson. Monica Green advances a compelling argument that at least one of the Trotula texts was in fact written by a woman physician, though perhaps not Trota herself.
Some women were licensed as doctors or medical professionals in various states, and various writers have claimed that a few women attended medical school in period. In cases where women healers were licensed, the historians perceive a blurring between the status of physicians and licensed healers. For instance, in Naples, and in Florence, and even in Valencia (before 1329) women could be licensed as 'medica' during certain historical periods. Still, women almost never attended Universities to begin with.
It's certainly true that male physicians, University-trained, tried to get control over all other medical practitioners; but everything I've read of modern scholarship suggests the struggle was a labor issue rather than a religious one. As university-trained physicians became more common, Colleges of Physicans used their influence with their wealthy patrons and with town aldermen to get laws passed giving them supervision over what they called 'empirics,' non-scholarly medical practioners. Over time, they gained control and oversight over guilds of surgeons, apothecaries, and even midwives in cities, and tried legislate away those they couldn't control.
Curiously enough, physicians in those days used techniques we generally would see as holistic and/or unscientific: working from the theory of humors, they tended to prescribe diet and activity changes as well as bloodletting and purges; they also used astrology as a diagnostic and prescriptive tool. However, it's not a good idea to make too much of this, as some empirics used those techniques and theories as well, though treatment based directly on symptoms was also used. In fact, such theories were part of every person's medical knowledge. Everyone used herbs in their diet and for various home remedies, just as we use over the counter medicines today.
It's hard to tell how many empirics there were practicing at any given time, as most medical treatment was either given by relatives, employer's families, or other personal relations, and medical treatment was rarely a full-time job even for those who practiced outside their families. For women in particular, that obscures any records we may have of their practice, as they would appear as so and so's wife, daughter or widow in his tax assessments or legal papers, but their separate side businesses (spinster, brewster, webster, midwife) might not be mentioned in tax or legal papers.
This greater diversity of practitioners is reflected in children's books such as those by Karen Cushman (The Midwife's Apprentice and Matilda Bone).
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."
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
"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 at one point 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 been trained with 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 really survivable Cesarean section operation). Still, in rural areas, midwives practiced in concert with doctors into the early 20th century.
Of the three instruments of medicine, medication was the principal form of active intervention by which physicians sought to combat disease. The choice of appropriate medicinal substances and their compounding in proper proportions were central areas of medical knowledge. The foundation of medieval European pharmacy -- as of traditional herbal medicine in other societies-- was the attribution of medicinal powers to commonly available substances, usually plants and often those that might also be used in cooking. Sharp taste, pungent aroma, and unusual texture as well as readily perceptible action of some kind (for example, as a laxative or opiate) were all properties that might lead to the classification of a plant as medicinal. Unquestionably, consistent use of of certain common European plants as medicines began in antiquity and had a continuous history thereafter. But in western Europe, even in the early Middle Ages, this simple "kitchen-garden" medicine was never purely empirical, local, folkloric and handed down by oral tradition-- although these characteristics must surely have been present to some extent -- but seems always also to have contained elements derived from Greek medicine by way of written sources. From the early Middle Ages to the high Renaissance, medicinal recipes were the commonest form of medical writing.
"...you shall understand that since the preservation and care of the family, touching their health and soundness of body, consisteth most inher diligence, it is meet that she have a physical kind of knowledge, how to administer many wholesome receipts or medicines for the good of their healths, as well as to prevent the first occasion of sickness as to take away the effects and evil of the same when it hath made a seizure on the body,"
though he does say that he does not intend to make his reader a
practitioner, since knowledge of physic would be beyond her. We do have examples
of that in fantasy, though the path is somewhat complex: consider the main
character in Sharon Shinn's Summers at Castle Auburn.
But we are more likely to see the making of herbal remedies in fantasy as a side business for the fantasy healers. Sometimes that is perfectly in line with their roles as mythic characters -- see the Old Woman in the Swamp and the Young Sorcerer's Girl Student in Teresa Edgerton's Welsh/Arthurian Caelydonn series, or the education of Eilonwy in the Welsh-inspired Prydain Chronicles. The combination of great lady who through her holiness, some mystic power, or some other power, is shown in a lady of the manor in Edgerton's Grail and The Ring, and in history in the stories of St. Francesca Romana, a fifteenth-century wife and mother who set herself to minister to the ill through touch, prayer, ointments and liquids.
On the other hand, I sometimes wonder where the counterpart to Cadfael is in our fantasy world. Anyone familiar with the writings of Hildegard of Bingen on plants and medicines realizes that there would have been women infirmarers and abbesses who were interested in both herbal medicine and physic, as Cadfael is. The fact that Cadfael's type-- the healing monk-- is better documented and more described in history and of course in mythology is no excuse.
Often, we are told that only the use of herbs by
monks kept all knowledge from being swept away, which anti-Christian or
anti-Catholic writers take to mean that the monasteries or the church drove all
other herbal healing underground. There's no evidence of this, and contrary
evidence in the fact that Anglo-Saxon, formerly pagan, texts such as the Leech
book of Bald were written down at the end of the first millenium, and that their
writers struggled to reconcile their herbal and medical knowledge with that in
the Latin books they had access to. Admittedly, there was a great deal of
ancient medical knowledge that ended up in Arabic and/or Muslim hands and was
brought back to Christian Europe during the Crusades, often with added
information from Muslim practioners.
Another thing that seems to be missing in fantasy is the idea of woman gardeners or herbalists, who gathered and sold raw materials, which we can document to approximately 15th c. France, where the trade was followed by both men and women. Male gardeners, like male cooks, seem to have been the norm in noble houses, and the interest in creating one's own garden and having it laid out just so can be documented to both sexes. However, with the desire to have materials for medication and the still-room, the middle class and upper middle class women would have taken more interest in their gardens. Women were hired in gardens to do weeding, and surviving depictions of workers in the gardens show women doing difficult work. But they seem to have existed within the social structure, rather as proud and independent characters, and thus are not well-represented in fantasy so far. An unusual appearance is the green mages in Tamora Pierce's Circle of Magic series, where there are natural magic practitioners who work primarily with plants, and sometimes get pressed into service for healing, rather than the other way around.
The trope of the healer/witch/herbalist has been used, overused, abused, mythologized, and turned round and round to the point that it has migrated into and sometimes been relegated to Young Adult Literature and Romance Novels. But if we throw away the fantasy of the historical witch/healer/herbalist, we find that there are a diversity of types and ideas that inspire new thought and ideas.