The Trotula, the most popular textbook on women's medicine in medieval Europe, will be known to most medievalists only by name--through the Wife of Bath's allusion to Dame Trot. This is through no fault of their own; until now, it has been impossible to seriously study the text, which was last edited in 1544. With the publication of Monica Green's The Trotula, this has changed--we now have a beautiful book, the outcome of fifteen years of research, which includes an introduction to the period, a scholarly edition of the three texts that make up the traditional compendium, a facing English translation, copious notes for the scholar, a useful bibliography for the student, and an index and attempt at identification of much of the pharmacopoeia. Moreover, we have an aesthetic and pleasant book to hold and to own, of note in today's electronic world. Its paper is thick and well- margined, its type spacious and easy-to-read; the reproductions, which include maps and manuscript pages, are outstanding. In short, this is the definitive Trotula, a new edition of which will not be necessary, probably, for another five hundred years.
The sixty-seven page introduction is rich in information. It begins by situating the texts within the thriving medical metropolis of medieval Salerno. Green demonstrates that the traditional "text" of the Trotula was actually made up of three distinct texts: the Conditions of Women (Liber de Sinthomatibus Mulierum), the Treatments for Women (De Curis Mulierum), and Women's Cosmetics (De Ornatu Mulierum); each of which derived from and represented a different kind of source. Conditions relies mainly on the Latin translation of Ibn al-Jazzar's Viaticum. Green argues that it is, therefore, primarily a learned and literate text, written by a male author, and based on the two medical traditions of antiquity, Galen and Soranus. By contrast, Treatments demonstrates minimal Arabic or Galenic influence and little concern with theory; it is pragmatic, advising on a broad spectrum of women's medical concerns such as incontinence, dry lips, and breast pain. It reflects, therefore, the "real life concerns of local women" (43) and was probably based on oral traditions (45). The third text, Cosmetics is completely empirical, with no medical theory at all; instead it supplies detailed prescriptions for the dyeing of hair, the removal of blemishes, and the artificial restoration of virginity, among others. It is mainly a "witness to the contemporary hygienic needs of women in southern Italy". (46)
Of course, the claim to fame of the Trotula was its authorship by a woman, with her presumed feminine insights into women's bodies. But Green is convincing in her argument that only Treatments reflects the real medical practitioner, Trota's, practice; the earliest versions of Conditions and Cosmetics were authored by men. Trota's original text, a Practica, was early excerpted into Treatments, and combined with Conditions and Cosmetics to create the Trotula in the thirteenth century. When it was finally published in 1544, its editor, Georg Kraut, artificially shaped it into the "smoothly organized summa" (59), he thought it should be, suppressing its magical elements, and altering its prologue to reflect its presumed feminine authorship.
Green's edition and translation derives from nine manuscripts, ranging from the mid-thirteenth to the late fourteenth century; the Latin totals only sixty-two pages. The facing English translation is excellent and commensurate with the Latin, making it easy to refer from one to the other. Although Green opposes the theoretical emphasis of Conditions to the empiricism of Treatments and Cosmetics, this reader was more struck by the folkloric feel of Conditions with its wealth of precise prescriptions for such empirical problems as scanty menses, uterine suffocation, itching of the vagina, infertility and contraception, among others. Almost all of the recipes are simple and pragmatic; for example, mint tea with honey (75) or mugwort in wine (77) for amenorrhea. Some of its methods of application, while traditional, will leave the modern student puzzled; for example, a wandering uterus can be encouraged to reassume its rightful place by applying pleasant things to the nose (balsam, musk) and malodorous things to the vagina (burnt linen, p. 87). Indeed, what I found most remarkable about this text was neither its emphasis on theory, which seemed minor, nor its quaintness, but its medical optimism. Most women's problems were treatable, it implies, with easily available herbal ingredients, and without recourse to religion or magic.
These implicit themes--pragmatism, optimism, and secularism-- are also found in Treatments. For instance, scanty menses will respond to wafers made of flour, eggs, madder and marshmallow; hypermenorrhea to a drink of plantain mixed with ashes of nettle. Obesity can be treated with steambaths; a swollen penis (sic) alleviated by a marshmallow compress. Treatments clearly belongs to a familiar genre, the practical folk herbal still in use today. What may be most interesting to the medievalist are the symptoms that were to be treated--a swollen face, a chronic cough, a lax vagina, foul- smelling sweat--a list not so far from that hocked everyday in advertisements for hygiene products and over-the-counter medicines. A composite of the healthy medieval woman can, therefore, be put together from this text; she will be neither too fat nor too thin; her skin will be free of blemishes, of freckles and wrinkles, her complexion, pale but rosy. She will have white teeth, sweet breath, and smooth hands, regular periods with moderate flow; and she will be fertile.
In Cosmetics this picture gains detail. Thus its recipes for haircare imply that a medieval woman's hair was to be clean and shiny (171), sweet-smelling, soft, smooth and fine (171), and either a rich black or blond (173). Her face was to be clean and clear (as the numerous recipes for steambaths and facials on p. 177 demonstrate); pale, as the recipes for whitening the face prove; fine and clear, without rashes or sunburn. Lips were to be soft and red, and not too thick (there is a recipe for slimming thick lips on p. 187); the breath was to be sweet, the teeth, white. The variety of depilatories meant that the ideal medieval woman was not to be hirsute. In short, what Cosmetics sold, in the twelfth century, was the look of a well-protected, upper-class woman-- not so very different from that sold today.
This book will be useful to historians of medicine, of women's studies, of medieval culture, and of Southern Italy, and to graduate, and even undergraduate students interested in grappling with the actual practice of medieval medicine. Except for its use of endnotes instead of footnotes, the organization of the book is very user-friendly. I suppose my one bone to pick with Professor Green might be the coolness of her prose, which avoids stances of any kind, whether of feminism, positivism, modernity, or medievalism. She seems to have drawn surprisingly few conclusions from these texts about women's practice, about the pragmatism of medieval medicine or its relation to folk medicine, or even about Salerno. Perhaps these will appear in her next book, or perhaps she has left them to be teased out of her fine work by other scholars and students.