Trotula;Europe’s first medical Women

Trotula.The woman who in the eleventh century was a pioneer in the field of prevention and hygiene, and of the relationship with patients.

Did you do not even know for sure the name: Trotula, perhaps Trout, or Trocta. Yet, despite the paucity of data, despite some saying that it never existed or, if it did exist, that it was a man, there are very few doubts about the historicity of this figure, very famous in the era in which he lived – around the anno Mille -, still known in the following centuries (it is also mentioned by Geoffrey Chaucer in one of the famous Canterbury Tales), then forgotten for many centuries, and finally recently re-studied.

Trotula De Ruggiero was the first doctor in Europe, or rather the first gynecologist: expert in the body and women’s things, from menstruation to pregnancy, from childbirth to beauty treatments. In an era in which the role of women, even with the due differences from place to place, was certainly not valued, she treated and taught: she was sanatrix and magistra , therapist and teacher, charged with the honor of transmitting knowledge (according to some was not actually magistra but almost magistra , not being able to receive the full title as a woman – in any case she was a “specialist” whose authority and wisdom was fully recognized in society and in the circumstances in which she lived).

The scientific journalist Pietro Greco has dedicated a biography to her this year ( Trotula , L’Asino d’oro Edizioni), and the publisher Manni has published the two main treatises attributed to her, one of a medical and clinical nature ( The symphony of the body ), and the other concerning cosmetics and body care ( Harmony of women ). Recently she was also the protagonist of two historical novels: Io, Trotula – Story of a legendary medieval scientist , by Dorotea Memoli Apicella, and Trotula , by Paola Presciuttini, a Florentine writer.

We know very little of his life, as Greco tells us, who in his book summarizes the various theories and presents the documentation on the historicity of medicine. The date of birth can be placed around 1030 in a noble family of Salerno, that of the De ‘Ruggiero, of Lombard or perhaps Norman origins. She married Giovanni Plateario, also a doctor, one of the most famous magistri of the equally famous school of Salerno, and had two sons, both doctors themselves. An anonymous person sums up his fame as follows: “I tell you about a philosopher named Trotula, who lived for a long time and who was very beautiful in her youth and from whom ignorant doctors draw great authority and useful teachings”.

At a time when the role of women, even with the necessary differences from place to place, was certainly not valued, she treated and taught: she was a sanatrix and magistra , therapist and teacher.

Orderico Vitale, an Anglo-Norman monk, writing in 1142, tells of a visit to Salerno by Rodolfo Malacorona, a noble expert in medicine who would not have found anyone in the city up to his medical knowledge, except for a very noble woman and very cultured. It would be Trotula. His death seems to have occurred in 1097, and the chronicles tell us that such was the fame and affection he enjoyed, that following the procession of his funeral a queue of several kilometers formed.

What was special about Trotula? His ability – continues the anonymous – was to reveal “a part of the nature of women”. In addition to being a woman, and therefore better able to understand herself, in her profession and in her studies she was facilitated by the fact that “all women more willingly revealed to her than to a man all their secret thoughts and opened their their nature “.

His abilities and personality were also able to be realized because he lived in a special environment. Trotula was very lucky to be born in Salerno, writes Eva Cantarella in an introductory speech to L’armonia delle donne . In an era when the role of women in society was very degraded, she managed – as far as we can know – to have her role and authority recognized, and perhaps – this is what we like to imagine – even to lead a life according to own wishes.

To understand Trotula you have to start from Salerno, which at that time was a special city , a crossroads of trade, and a meeting place for people and cultures. There the Greek tradition and the knowledge of the Arabs, the Byzantines and the Jews, the Normans and the Lombards are confronted. Translations from Arabic into Latin of the classics of Greek philosophy and Hellenistic science circulate in the environment.

When Trotula lived, the famous medical school had already established itself in Salerno, whose distinctive feature is the fusion of theory and practice. Legend has it that Salerno became the city of medicine for the meeting, in this locality, of four doctors from different origins: a Greek, a Latin, a Jew and an Arab. More than a legend, as Greco explains, this phantom encounter is the metaphor of the contamination between cultures that distinguishes the secular medicine that develops here to spread its fame throughout Europe. Great news, in the first decades after the year 1000, begins to assert itself through the transmission of knowledge no longer only by voice, but through written texts.

Illustration taken from the Trotula major

And it is a knowledge that is based on the principles of Greek medicine of Hippocrates and Galen, but confronts and updates itself with the new notions and knowledge of Islamic medicine, brought to Salerno by Costantino L’Africano, a doctor born in Carthage and who toured the world of those times – from Cairo to Persia, from Ethiopia to India, updating his knowledge. Constantine translates a series of books on Islamic medical science into Latin from Arabic. Thus the Greek and Hellenistic tradition re-emerges filtered by Arab culture, including that of the physician-philosopher Avicenna. In Salerno we study the theory and practice on anatomy with the dissection of corpses, even if of animals. It is no coincidence that a doctor of the School writes the Anatomy pigs .

The Campania medical school has another peculiarity: it is also open to women, as students and as teachers, the famous mulieres salernitanae . Although part of the tradition belittles their role as doctors, effectively reducing them to midwives, nurses, or experts in make-up and cosmetics, it is instead documented that in addition to following school courses, they became doctors and practiced the profession like their male colleagues. . It is in this climate that Trotula was born, and then practiced, who, in fact, founded European gynecology.

The two main works that are attributed to her, even though they were probably not materially written by her, are a treatise on female diseases, referred to as Trotula major , and one on cosmetics and body care, known in tradition as Trotula minor .

Not only does Trotula take care of healing, but he places his medical practice in a scientific theoretical framework, obviously in accordance with his time. Trotula refers to the vision of Hippocrates, with the body and health dominated by the balance between four elements: hot-moist blood, cold-wet phlegm, hot-dry yellow bile, cold-dry black bile. Here then is that diseases are explained within that theoretical context. Menstruation (which Trotula calls “flowers”, without adhering to the traditions that want them as a disgrace to women), for example, are the “specific purgation” arranged by Nature to compensate for excess moods. The disorders of that sphere, Trotula recognizes, affect many other areas of health, causing various ailments: inappetence, vomiting, pains, fever, dropsy, pangs in the heart … Menstruation can also fail due to “excessive pain, or anger, nervousness or fear”. The imbalance also causes other damage to health and disease in this case.

Trotula practices women’s medicine, treating issues and ailments that until then had little chance of being considered with feminine sensitivity.

The real novelty is that Trotula practices not a generic medicine, but a medicine for women, treating issues and disorders that until then had very little chance of being considered with female sensitivity. Immediately at the beginning of her major work, Trotula explains what pushes her to deal specifically with female medicine: women have the “miserable misfortune” of having to turn to male doctors with shame and embarrassment for the treatment of the diseases of their private parts. And so often they are neglected. You have chosen to deal with this sector precisely to meet women, who in this way can open themselves to confidences, show themselves shameless, and facilitate diagnosis and treatment.

The advice and therapies proposed by Trotula today can make you smile. “Take ginger, bay leaves and sabine”, writes for example Trotula about remedies to restore the missing menstrual cycle. “Chop them and put them in a pan over the hot coals, then have the woman sit on a perforated chair so as to receive the smoke through the lower parts”. Menstruation, she says, will resume. There is an explanation for this strange advice: in Galen’s tradition it was believed that the vagina and uterus smelled, and that they could therefore be treated with fumigations and applications of perfumed or smelly substances, as appropriate.

Some of the therapies have been present in popular culture for centuries, and sometimes border on magic. But one cannot help but notice the surprising elements of modernity. First of all, the concept of prevention. One of the cornerstones of Trotula’s practice is hygiene. She often recommends baths, ointments, massages, compresses, and then herbal teas or rubs as “gentle therapies” for many pregnancy ailments, or for complications of childbirth. He focuses on the importance of physical activity and balanced nutrition. On the regimen for the newborn he gives advice that sounds very modern: massages and hot baths to calm him, the vision of fabrics and marbles of different colors when he is older to stimulate him, address the baby with chants and simple words to start him with language …

Portrait of Trotula, from an engraving preserved at the Museum of Science and Technology in Milan.

Trotula also speaks of infertility. Challenging a popular conception for centuries, he attributes the difficulty in conceiving not only to women, but also to men. He dwells on remedies that seem very unlikely to us – powder based on the liver and testicles of an “only child” pig, or wool soaked in donkey milk to be applied on the navel – to promote conception. And he makes his proposals to assist men suffering from sterility: “substances capable of increasing and generating the seed, such as onions, parsnips and the like”. If, on the other hand, the man’s sexual desire is lacking, which prevents his erection, he proposes ointments to “generate spirits in quantity”. Entirely within his era in this, he proposes remedies proposes to increase the probability of conceiving a male child,

It is also modern because it tackles the question of sexuality and its importance for life and health without moralism and shame. It recognizes the existence of female desire and the importance of satisfying it. For example, he writes, “there are women who are not allowed sexual intercourse, either because they have taken a vow of chastity, either because they are linked by their religious condition, or because they have remained widows”. To these women, who desire sexual intercourse but cannot practice it, and are therefore subject to “serious illness”, she recommends compresses based on “calming” substances. It also proposes remedies for “women who do not want to conceive”, perhaps because they are terrified after having risked dying in a previous birth or because, it does not say so expressly but you can perhaps guess between the lines, they simply do not want more children.

The text dedicated to cosmetics, De ornatu mulierum, this too probably not written directly by Trotula but inspired by her, deals with beauty, dispensing tips and recipes. Also in this case, body care, prevention and hygiene are the basis of both health and pleasant appearance. Whiten the face, or make it more rosy, eliminate redness, remove hair, shave, lighten or darken the hair (after the success of blondes in Roman times, dark hair was also appreciated), thicken them, treat sunburn, pimples, chapped lips, whitening teeth, perfuming the breath…: Trotula does not neglect anything. And if some solutions – such as depilatory ointment based on boiling quicklime (with relative remedy to treat possible burns) – today seem to us just medieval barbarism,

In Trotula’s work there were surprising elements of modernity, such as the concepts of prevention and hygiene.

Almost hidden among the beauty tips – and before the final greeting “Trotula ends here, entrusting herself to the Lord” – there is also the recipe on “how to make a woman who has had sexual intercourse considered a virgin: a” shrinking “pack for the vagina based on natron powder, sodium carbonate, also used by the Egyptians for embalming. Still on the subject, but with the specific intent of simulating virginity on the wedding night, Trotula suggests the local application of leeches. Attentive doctor Trotula and – an appreciable quality even today – very complicit with her patients.


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