The Trotula AMedievalCompendium of Women s Medicine Edited and Translated by Monica H. Green PENN University of Pennsylvania Philadelphia
Preface IN HISTORIESOFWOMENas in histories of medicine, readers often find a passing reference to a mysterious person called Trotula of Salerno. Trotula, for whom no substantive historical evidence has ever been brought forth, is said by some to have lived in the eleventh or twelfth century and is alleged to have written the most important book on women s medicine in medieval Europe, On the Diseases of Women (De passionibus mulierum). She is also alleged to have been the first female professor of medicine, teaching in the southern Italian town of Salerno, which was at that time the most important center of medical learning in Europe. Other sources, however, assert that Trotula did not exist and that the work attributed to her was written by a man. Any figure who could generate such diametrically opposed opinions about her work and her very existence must surely be a mystery. Yet the mystery of Trotula is inevitably bound up with the text she is alleged to have written. The Trotula (for the word was originally a title, not an author s name) was indeed the most popular assembly of materials on women s medicine from the late twelfth through the fifteenth centuries.written in Latin and so able to circulate throughout western Europe where Latin served as the lingua franca of the educated elites, the Trotula had also by the fifteenth century been translated into most of the western European vernacular languages, in which form it reached an even wider audience. 1 Surprisingly, for all its historical importance this work exists in no printed form that can reliably be used by students and scholars. The Latin Trotula was edited for publication only once, in the sixteenth century, under the title The Unique Book of Trotula on the Treatment of the Diseases of Women Before, During, and After Birth, 2 and the only modern translations available are based on this same Renaissance edition. 3 While these modern translations have had some utility in keeping alive the Trotula question, they have in another sense perpetuated the confusion, since they have passed on to new generations of readers the historical distortions of the Renaissance edition, a work which is in fundamental respects a humanist fabrication. The Renaissance editor, undoubtedly with the best of intentions, added what was to be the last of many layers of editorial improvements. These
xii Preface intrusions had, over the course of the four-hundred-year life of the Trotula, almost thoroughly obliterated all indications that this was not one text but three. True, they were all probably of twelfth-century Salernitan origin, but they reflected the work of at least three authors with distinct perspectives on women s diseases and cosmetic concerns. The first and third of these texts, On the Conditions of Women and On Women s Cosmetics, were anonymous. The second, On Treatments for Women,wasattributedevenintheearliestmanuscripts to a Salernitan woman healer named Trota (or Trocta). Each of the texts went through several stages of revision and each circulated independently throughout Europe through the end of the fifteenth century, when manuscript culture began to give way to the printed book. But the texts also had a second, parallel fate. By the end of the twelfth century, an anonymous compiler had brought the three texts together into a single ensemble, slightly revising the wording, adding new material, and rearranging a few chapters. This ensemble was called the Summa que dicitur Trotula (The Compendium Which Is Called the Trotula ), forming the title Trotula (literally little Trota or perhaps the abbreviated Trota ) out of the name associated with the middle text, On Treatments for Women.Theappellationwasperhapsintendedtodistinguishtheensemble from a general, much longer medical compilation, Practical Medicine, composed by the historical woman Trota. The Trotula ensemble soon became the leading work on women s medicine, and it continued to be the object of manipulation by subsequent medieval editors and scribes, most of whom understood Trotula not as a title but as an author s name. 4 By 1544, when the ensemble came into the hands of the Renaissance editor, Georg Kraut, generations of scribes and readers had come to believe that they were dealing with a single text or, at most, two texts on the same subject by a single author. 5 It is, then, quite understandable that Kraut saw his task as merely to clean up a messy, badly organized text. He rewrote certain passages, suppressed some material and, in his most thorough editorial act, reorganized all the chapters so as to eliminate the text s many redundancies and inconsistencies (due, we know now, to the fact that several authors were addressing the same topics differently). There is no way that a reader of this emended printed text could, without reference to the manuscripts, discern the presence of the three discrete component parts. Hence when some twenty years later a debate over the author s gender and identity was initiated (and it has continued to the present day), it was assumed that there was only one author involved. 6 Medieval readers were coming to the Trotula texts with urgent questions about how to treat women s diseases or address cosmetic concerns, or perhaps with more speculative questions about the workings of the female body
Preface xiii or the processes of generation. For them, the texts were a vital fund of information. Questions of authorship or textual development were of minimal importance. 7 For modern students of medical history or the history of women, however, it is imperative to understand the processes by which the Trotula ensemble was compiled if we are to answer such questions as: What do these texts show us about the development of medieval medical theories concerning the workings of the female body? What can they reveal about the impact of the new Arabic medicine that began to infiltrate Europe in the late eleventh century? Is there, in fact, a female author behind any of the texts and, if so, what can she tell us about medieval women s own views of their bodies and the social circumstances of women s healthcare either in Salerno or elsewhere in Europe? Answering these questions calls for close textual analysis that pulls apart, layer by layer, decades of accretion and alteration. Such analysis shows us not simply that there are three core texts at the heart of the Trotula but also that the ensemble became a magnet for bits and pieces of material from entirely unrelated sources. We cannot, for example, attribute the neonatal procedures described in 124 27 to local southern Italian medical practices but must recognize them instead as the work of a ninth-century Persian physician named Rhazes. Such analysis shows us, in other words, that the Trotula ensemble is a patchwork of sources. There is no single author and no single text. There is, consequently, no single (or simple) story to be told of Trotula or women s medicine at Salerno. Knowledge of the multiplicity of the Trotula may resolve certain questions (about the redundancies and inconsistencies that so troubled the Renaissance editor Georg Kraut, for example), but it raises others. Particularly, if the texts are so protean (a total of fifteen different versions of the independent texts and the ensemble can be identified in the medieval manuscripts), 8 how do we choose any single version to study? Obviously, the authors of the three original, independent works had their own unique conceptions of the content and intended uses of their texts. On the basis of my reconstructions of these original forms of the texts, I describe in the Introduction their more distinctive medical theories and practices; I also summarize what is now known about the medical practices of the women of Salerno including, most important, Trota. Nevertheless, the three original twelfth-century works often bore only an oblique resemblance to the text(s) that later medieval readers would have had in front of them. The Trotula ensemble, ragged patchwork though it is, has a historical importance in its own right, since it was this version of the texts that the largest proportion of medieval readers would have seen, and it was this assembly of theories and remedies (whatever their sources or however incon-
xiv Preface gruous the combination originally may have been) that would have been most commonly understood throughout later medieval Europe as the authoritative Salernitan teachings on women and their diseases. One of the several versions of the ensemble was particularly stable in form and widespread in circulation: this is what I have called the standardized ensemble, which, with twenty-nine extant copies, ranks as the most popular version of the Salernitan texts in any form, circulating either independently or as a group. The standardized ensemble is a product of the mid-thirteenth century (whether it was produced at Salerno itself I cannot say) and it reflects the endpoint of what had been an active first century of development for the three texts. 9 Since it was also the version most closely associated with university circles (and so the version most likely known to medieval commentators, both medical and lay), I felt that this was the version best suited for use by modern scholars and students who are interested in medieval medical and intellectual history and the history of women. I have based the present edition on the earliest known complete copy of the standardized ensemble, an Italian manuscript from the second half of the thirteenth century, and I have collated it in full with eight other manuscripts coming from various parts of Europe and dating from the later thirteenth century through the turn of the fourteenth century. The edition and translation presented here, then, reflect the standardized Trotula ensemble text as it was known and used up through about 1300. To facilitate a historically nuanced understanding of the ensemble, I have annotated the edition to highlight its major points of divergence from the three original Salernitan texts on women s medicine. 10 The translation, like all such endeavors, is merely an attempt to recapture a physical world and a conceptual world-view in many ways foreign to modern readers, especially those who function within the western biomedical paradigm. Inevitably, many nuances anatomical, nosological, and botanical can never be adequately recaptured. 11 As translator, therefore, I in no sense wish to authorize the efficacy of any of the following remedies. Many more questions remain regarding Trota and the Trotula, but it is my hope that this first edition of these important and influential texts will offer a foundation for future debates and, in the process, enhance our understanding of women s healthcare in medieval Europe. Note on Abbreviations and Pronouns For reasons of space, when quoting in the Notes from the original Trotula treatises I refer to them by abbreviations of their Latin titles:
Preface xv TEM = Tractatus de egritudinibus mulierum (Treatise on the Diseases of Women, the rough draft of the LSM) LSM = Liber de sinthomatibus mulierum (Book on the Conditions of Women) DCM = De curis mulierum (On Treatments for Women) DOM = De ornatu mulierum (On Women s Cosmetics) All quotations come from working drafts of my editions of the independent texts. For complete descriptions of the manuscripts, please see my published handlists. 12 I have employed the same system of enumeration for component paragraphs of all the different versions of the Trotula,whetherintheiroriginalindependent form or when combined into the ensemble, as laid out in my essay The Development of the Trotula. 13 Paragraphs identified with a simple arabic numeral will refer to material that is found in the standardized ensemble (the version of the text edited here) as well as in earlier versions. Hence, for example, when I refer to 45 in the first version of Conditions of Women (LSM 1), this refers to the same section on uterine suffocation, mutatis mutandis, as 45 in the present edition. Since many passages from the original texts were moved or deleted during the first century of the texts development, however, I have also employed subordinate alphanumerics so that readers may understand where these now-lost sections were located. So, for example, 305f, a detailed procedure for vaginal hygiene, had appeared in early versions of Women s Cosmetics in the position after 305 as found in this edition. Readers may refer to the concordances of the Trotula texts in my above-mentioned essay for full comparisons of all the different versions of the texts. Finally, my employment of pronouns should be explained. As noted earlier, the gender of the author(s) of the Trotula has been a central concern in scholarship to date and will, no doubt, be of prime interest to many readers of the present edition precisely because gender whether of the authors, scribes, practitioners, or patients is central to larger historical questions surrounding women s healthcare and roles in medical practice. Although it is not my objective to settle all these questions here, I have employed gendered pronouns to indicate where I think the gender of the author (or, for that matter, the patient) is clear and where it is not. Thus, I believe the authors of Conditions of Women and Women s Cosmetics to be male and so use the masculine pronoun. Treatments for Women, however, represents what I believe to be a palimpsest, with afemaleauthor svoiceoverwrittenbyanother(orothers)ofuncertaingender. 14 For that text and for other situations where there is still ambiguity or doubt about a historical actor s gender, I have employed the inclusive forms s/he, her/his, her/him.