This much-needed monograph by Sara Ritchey makes a major contribution to the overlapping subjects of the history of medicine, medieval women’s and gender history, as well as the study of women religious, history from below, and social and cultural history. Ritchey’s volume speaks to all of these historiographical themes, asking new and perceptive questions about often familiar sources. It blends these approaches in an innovative analysis of the gendered dynamics of healing within the local and religiously distinctive communities of the thirteenth-century Low Countries.
Two related concerns animate the methodological and theoretical approaches adopted in the book. First, Ritchey seeks to address some of the problems that feminist historians face with the erasure of women’s medical expertise from most late medieval records on healthcare. A clerical monopoly over textual production worked to mute the daily experiences of lower-status medieval women, an often-intractable problem that Ritchey references in the book’s subtitle. The domestic environment in which most women’s healthcare took place gave it an oral and vernacular tone. Learned male practitioners interpreted these markers as a lack of expertise, contrasting domestically-based female care negatively with written and sometimes Latin male-authored texts aimed largely at literate men. Men and women outside the schools and monasteries interpreted care in “far more fluid and unbounded ways,” but medical treatment associated with women was often denigrated to such an extent that it became devalued and aligned with a lack of knowledge and skill (8). Ritchey thus seeks to refocus attention on women’s medical expertise to circumvent some of these problems.
Second, the study takes a broader view of healthcare in this period. By using the concept of “therapeutic treatments,” it better acknowledges and unifies the “physical, social, emotional, and spiritual” facets of women’s care in particular (5). This type of approach also allows a much more expansive analysis of themulieres religiosae in the Low Countries, ensuring a holistic and detailed account of the networks that emerged around their caregiving activities. As Ritchey demonstrates, treatment of the body and the cura animarum formed a nexus of care for these pious women, who were themselves responding to overlapping religious impulses. Some had taken holy vows as Cistercian nuns, although female religious had a troubled relationship with the Cistercian order in the thirteenth century especially, while others were beguines, anchoresses, tertiaries, or lived as holy laywomen unattached to any specific order. These women often practiced their piety and caregiving beyond both cloister and the conjugal household, but faced clerical attempts to categorise and control their activities along normative channels (17). Ritchey admirably traces the myriad ways that these pious women exercised agency in delivering care, accruing charismatic reputations for healing the sick and reviving the dead.
Several historiographical traditions inform Acts of Care, which crafts a distinctive approach to healthcare among religious women by attending to the feminine and spiritual tone of caregiving. Since Caroline Walker Bynum foregrounded the visceral and embodied tone of holy women’s piety, feminist scholars of the Middle Ages have been attuned to the profound ways that gendered embodiment inflected holiness and vice versa. [1] By analysing how religious women’s bodies were transformed into miraculous sites of spiritual and physical healing, Acts of Care sits within this tradition and addresses implicitly many of the questions that Bynum’s work raised. Much of the scholarship on late medieval health and natural philosophy focuses on intellectual traditions and their application. Monica Green has produced seminal studies on the secreta mulierum discourse, the medical women of Salerno and the gendered interplay of oral and literate knowledge. [2] Scholarship on disability in the high and late Middle Ages has begun to centre both the treatment and experience of physical and mental impairment. [3] Ritchey’s focus on how holy women developed and used technologies of healthcare thus contributes to debates about disability, agency and gendered marginality in everyday life. [4]
Most significantly, Acts of Care poses new questions about familiar records. Ritchey emphasises that “the sources for religious caregiving exist. Their recovery simply demands a shift in our thinking about how gendered interactions shape the documentary record” (4). She makes the perceptive observation that “[t]hese treatments, and the communities in which they were embedded and in which they gained meaning, have remained historically invisible as healthcare practices in part because they often appear as indistinguishable from the expected behaviours of “religious women” (32). This method also bridges the divide often separating so-called “learned” and “popular” texts, instead considering women’s healthcare practices more organically. From this perspective, Acts of Care offers novel ways of thinking about and understanding religious practices and the milieux in which beliefs about religion and healthcare circulated during this period.
Ritchey’s sharp focus on power relations and their implications draws on feminist and postcolonial theories from the field of anthropology, the history of enslaved peoples, performance studies and Native American and Indigenous Studies (NAIS). This work, argues Ritchey, helps to counter some of the “technologies of power maintained by white, elite, colonial, and settler archives and historical narratives” (28-29). Ritchey explores the categories that the study embraces, using theories of “marginalized epistemologies and...performative modes of care-giving” (31). A central influence upon her approach is the work of Patricia Hill Collins on recovering Black women’s epistemologies and experiences (that racist, patriarchal systems otherwise side-line) from situations and discourses less affected by racially-charged patterns of surveillance and suppression. This offers a subtle tool for glossing the power dynamics operating between the learned men recording the lives of mulieres religiosae and the holy women themselves.
The book is structured well and opens with a rewarding introductory chapter on the evidence for and categories of care in the late medieval Low Countries. The main body of the study is divided into three sections that, respectively, deal with narratives, knowledge, and practices of care. The first section is comprised of two chapters, the first entitled “Translating Care: The Circulation of Healing Stories.” Ritchey identifies two analytical concerns that provide the foundations for this chapter: first, how women’s “therapeutic authority” was crafted and presented in miracle tales, and second, how accounts of healing were transmitted, received and interpreted in “healing communities” (39-40). Stories of their divine aid spread by word of mouth as the healed, their families and communities shared news of their cure, acting as a source of knowledge to people seeking treatment for themselves or others (e.g., 67). Here too, Ritchey interprets saints’ relics as a “therapeutic technology” that worked in tandem with hagiographical stories to provide the foundations for their curative powers. Chapter 2 is entitled “Bedside Comforts: The Social Organization of Care.” Ritchey explores beyond the liègeois corpus to trace wider “care-giving practices” among less prominent and often anonymous pious women in the region (78). Turning to the evidence base for religious women’s involvement in institutional healing, Ritchey observes that “the ad hoc and ephemeral nature of feminine circuits of care” makes their work less visible in larger foundations, but glimpses can be seen in records for hospices and less formal settings (83-84).
Section Two centres on “Therapeutic Knowledge,” exploring the gendered construction and maintenance of authority around healing. The main chapter, “Empirical Bodies,” considers how male religious and physicians understood and presented curative practices in a range of texts during this period. Learned traditions about healing and embodiment were not opposed to more vernacular beliefs and these perspectives often coalesced in intellectual circles. While misogynist discourse increasingly cast women’s bodies as dangerous and faulty, and women practitioners were usually excluded from learned medicine, female saintly bodies also held the power to cure and to convey divine signs through their embodied grace (165-68). The third and final section turns to “Therapeutic Practice” in two connected chapters that examine how holy women incorporated religious texts—psalters and saints’ lives in particular—into their healthcare routines. Here, Ritchey offers a more sustained treatment of the sensorial tone of holy women’s prayer in healthcare as well as in devotional settings. Chapter 4—“Rhythmic Medicine: The Psalter as a Therapeutic Technology in Beguine Communities”—shows how embodied, performative prayer and meditation were central to the treatment of body and soul. It considers how texts associated with holy women reflected both their healthcare practices and their perceptions of how prayer and health were deeply connected. The final chapter, “Salutary Words: Saints’ Lives as Efficacious Texts in Cistercian Women’s Abbeys,” turns to the corpus of holy women’s lives as spiritual objects that performed similar functions to the women’s holy bodies. Ritchey emphasises the “multimediality” evident in some of these vitae, where prayers, images and other inscriptions worked together to absolve sin and heal the body (250).
In the epilogue, Ritchey draws together thematic strands in a moving treatment of the invisibility that could envelop many aspects of women’s care. In written accounts of miracles, the aura of the divine could “make transcendent the skill and body knowledge that caregivers produced and shared” ensuring textual neglect of the women’s cura animarum along with their practical abilities (260-61). These types of often domestic and familial care were “naturalized as compassionate, maternal or servile” in the medieval through to the modern era (260). This attention to the entangled nature of physical and spiritual care unifies Ritchey’s core arguments about the gendered assumptions that contributed to the construction of religious and medical authority. Yet it also emphasises the pastoral role that many of these women assumed in their local communities, prompting new questions about how and when beguines could address shortcomings in spiritual provision.
Aside from its thematic treatment outlined above, Acts of Care contributes brilliantly to many other strands of scholarship on medieval religion and gender. Perhaps most significantly, it speaks to the ways that holy women lived full and highly respected lives of devotion and service, independently of patriarchal restrictions that sought to regulate their religious beliefs and practices. These miracle stories and their transmission underscore the mobility of holy women in Liège as their influence and curative power was not geographically bounded by the local community. Attending to the composition and function of these “healing communities,” as Ritchey designates them, carries implications for how historians can gain a deeper understanding of the everyday agency of holy women. The physical performance of prayer and meditation was not an inferior replacement for lower levels of literacy. Many of these beguines could read vernacular religious texts, such as psalters and books of hours, which in turn inspired or strengthened the divine force behind their curative actions. Learned men writing about health and healing viewed their spiritual abilities as deeply feminine, and also valuable and curative to the sick. Their work was appreciated in their local communities and their powers were acknowledged and admired in learned circles. Acts of Care renders visible and restores life to these and other aspects of holy women’s experiences.
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Notes:
1. C. Walker Bynum, Jesus as Mother: Studies in the Spirituality of the High Middle Ages (Berkeley, 1984); Holy Feast and Holy Fast: The Religious Significance of Food to Medieval Women (Berkeley, 1988); Fragmentation and Redemption: Essays on Gender and the Human Body in Medieval Religion (New York, 1990).
2. See, for instance, M. Green, Making Women’s Medicine Masculine: The Rise of Male Authority in Pre-Modern Gynaecology (Oxford, 2008); The Trotula: An English Translation of the Medieval Compendium of Women’s Medicine, ed. M. Green (Philadelphia, 2001).
3. I. Metzler, Disability in Medieval Europe: Thinking about Physical Impairment During the High Middle Ages, c.1100-1400 (London, 2006); I. Metzler, A Social History of Disability in the Middle Ages: Cultural Considerations of Physical Impairment (London, 2013).
4. See especially J.M. Bennett, “Married and Not: Weston’s Grown Children in 1268-1269,” Continuity and Change, 34:2 (2019), 151-82; J.M. Bennett, “Wretched Girls, Wretched Boys and the European Marriage Pattern in England (c. 1250-1350,” Continuity and Change, 34:3 (2019), 315-47; S. Farmer, Surviving Poverty in Medieval Paris: Gender, Ideology. and the Daily Lives of the Poor (Ithaca and London, 2001).