Trotula

Italian physician and writer

• Born: Eleventh century
• Birthplace: Unknown
• Died: c. 1097
• Place of death: Salerno (now in Italy)

Author of a respected treatise on women’s disease and childbirth, Trotula was influential in the field of women’s medicine for nearly five hundred years.

Early Life

For most of the twentieth century, the facts of the life of Trotula (TROT-yew-luh) seemed clear enough. Many scholars believed that Trotula lived in Salerno, Italy, in the eleventh century. Her full name was Trotula di Ruggiero, and her family was wealthy, but no other information was known about her birth and childhood. Salerno, the center of medical knowledge in medieval Europe, was the site of several world-famous hospitals and spas. The city also had the Western world’s first medical school, which welcomed women as students and instructors. Trota, known as magistra mulier sapiens (wise woman teacher), was a physician and teacher there, specializing in women’s health and childbirth. Her husband, John Platearius, was another physician at the school. They were the parents of two sons, Matteo or Mattias, who also studied medicine, and Johannes the Younger. Trotula was the author of several medical textbooks, alone and in collaboration with her husband.

Tracing the life history of medieval figures is always difficult, because few records were kept and fewer have survived to the present. Scholars have concluded that there was no factual evidence for what they thought they knew about Trotula, and the most significant details of her life came into question. There was a historical figure named Trotula di Ruggiero, but she may not have been the same Trotula or Trota who interests scholars of the history of medicine. Trota the medical practitioner may have been an illiterate though knowledgeable midwife, or a practicing physician and teacher. She may have been the first female professor of medicine, or one of many mulieres saleritanae (ladies of Salerno) teaching in the same period. There may not have been women studying and practicing in Salerno at all. Although many sources give 1097 as the year of Trotula’s death, others say she was born in that year, and still others find no record. Most intriguingly, Trotula may have been a man or may not have existed at all.

Life’s Work

Interest in the historical figure of Trotula stems from several Italian manuscripts about medicine, gynecology, and obstetrics, attributed variously to Trotula, or Trocta, or Trota. The two most important of these manuscripts are De passionibus mulierum ante, in, et post partum (on the diseases of women before, during, and after childbirth), a compendium in sixty brief chapters of medical information pertaining to the special health issues of women, and Practica secundum Trotam (practical medicine according to Trotula), a larger work of a more general nature. Both appear to have been written during the late twelfth century or perhaps as late as the middle of the thirteenth. At this time, medicine in Italy flourished, in part because of an influx of learning from the Arab world, but was still greatly influenced by Christian conceptions of woman as the embodiment of Eve, and therefore fallen, weak, and shameful.

The manuscripts attributed to Trotula are collections of treatments for menstruation, conception, pregnancy, and childbirth in addition to medical advice of a more general kind, such as remedies to lighten freckles, treat snakebite, or cure bad breath. The author of De passionibus mulierum gathered much information that was commonly known at the time and also proposed some revolutionary ideas. For example, Trotula was unusual in claiming that some failures to conceive were caused by physical problems in men. Further, she advocated for the use of drugs to make labor less painful, in opposition to religious teaching that women were ordained to suffer through childbirth.

The manuscripts reveal that medieval medical knowledge contained a great deal of what would today be considered mere quackery, as well as advice that strikes people in the twenty-first century as sensible and modern. Typical of the first type is a treatment for a woman who is too fat to conceive: She should be anointed with cow dung mixed with wine and placed in a steam bath a few times a week. A powder made from the testicles of a pig, mixed with wine and drunk, will also guarantee conception. Midwives are instructed to say a specific prayer as they cut an umbilical cord and tie it off with a string from a stringed instrument. They must also take note that the length of a grown man’s penis is directly proportional to the length of umbilical cord that was left attached when he was born. Worms may be lured out of a person’s ears with a cored apple. Interestingly, Trotula explains month by month how a fetus develops and states that life begins during the eighth month.

Some of Trotula’s advice is similar to that of the holistic healers practicing almost a thousand years later. She urges physicians to examine their patients thoroughly and to be good listeners. She recommends various herbs to calm nerves and ease pain, as well as exercise, a balanced diet, good hygiene, avoidance of stress, aromatic massage, and a cheerful outlook.

Instructions for a normal delivery are given, as well as contingency plans for breech birth and stillbirth. Trotula appears to be unique in explaining how to sew up perineal tears suffered in childbirth and also offers advice about avoiding the tearing. Several of the chapters discuss ways to bring on menstruation when it has stopped; presumably these are instructions for abortion. There is also advice for a woman who is no longer a virgin but who would like to appear as one, including various ways to tighten the vaginal muscles. She warns against the practice of rubbing ground glass on the vagina to produce a simulation of the blood of first intercourse.

The Trotula manuscripts were written in Latin, the language of science and learning in Europe in the eleventh and twelfth centuries. At that time, manuscripts were copied out by hand and translated and revised freely. Because the information in the manuscripts attributed to Trotula was considered complete and reliable, it was distributed widely. A collection called the {I}Trotula{/I} became the standard work on medieval women’s medicine; it consisted of three short works on conditions and treatments of women and on cosmetics. Dozens of medieval copies of these works are located today in libraries and special collections throughout Europe, some in Latin, and others in Dutch, French, Irish, English, and other languages. Many of these manuscripts give credit to Trota, or Trocta, as the source of the information; others have the title Trotula (Little Trota), from which an author’s name is inferred.

The work is mentioned in many other writings from the late twelfth through the fifteenth centuries, and gradually the name Trota or Trotula entered the public consciousness as the most important source of information about women’s medicine. One indication of Trotula’s fame is found in Geoffrey Chaucer’s The Canterbury Tales (1387-1400), in which a passing mention of medical advice from “Dame Trot” demonstrates that his audience could be expected to know the reference.

As the manuscript was copied and revised through the centuries, editors tended to make small notes explaining the source of the material. Gradually, a biography for the author evolved, based on imperfect knowledge and memory, and more works were attributed to her. Through the fourteenth, fifteenth, and most of the sixteenth centuries, Trotula’s identity as a female medical specialist in Salerno was accepted without question. By the mid-1500’, however, it was no longer the case that women were allowed to study at universities or to practice medicine, and Trotula’s identity came under question. With no biographical evidence beyond the fact that the author must have been a man, a parallel tradition grew up claiming that Trotula was the pseudonym of a male writer. At the end of the sixteenth century, editions of the Trotula gave the author’s name as Eros, attributing the work to a man.

This compendium was thought for almost four hundred years to be the work of a single author the woman Trotula or perhaps the man Eros but is now acknowledged as three independent works by three authors. As demonstrated in 1985, only the middle section is in fact by Trotula, and this author may or may not be the same Trotula to whom other manuscripts are attributed.

Significance

For four hundred or more years, the manuscripts attributed to Trotula represented the state of the art in gynecology and obstetrics in Europe. Copied in Latin and the common languages of several countries, these manuscripts were the standard reference works for midwives and physicians. Although the original manuscripts no longer exist, and their author or authors cannot be verified, and although much of the medicine described in the manuscripts has been supplanted with new knowledge and practice, the Trotula was the single most important collection of information about women’s medicine in medieval Europe and provides a wealth of historical and sociological information. In addition, many (though not all) of the treatments recommended in the Trotula manuscripts were genuinely new and appropriate, making it possible for physicians to enhance and save lives.

The question as to whether Trotula was indeed a woman is probably not ultimately solvable. For some scholars, a female Trotula is evidence of an earlier golden age of women’s education and medicine, and the claims that the author could not have been a woman are evidence of masculine denial of women’s accomplishments. To others, attribution to a female author points to political, rather than scholarly, motivation. It remains for philologists to examine the surviving manuscripts and attempt to unravel the truth not only about Trotula but also about the sexual politics that have shaped theories about her over the centuries.

Bibliography

Benton, John F. “Trotula, Women’s Problems, and the Professionalization of Medicine in the Middle Ages.” Bulletin of the History of Medicine 59 (1985): 30-53. An important study, the first to use evidence in the manuscripts themselves to demonstrate that the pieces collected in the Trotula were written by three different authors and that much of what was believed about Trotula’s biography could not be substantiated.

Green, Monica H. “In Search of an ’Authentic’ Women’s Medicine: The Strange Fates of Trota of Salerno and Hildegard of Bingen.” Dynamis 19 (1999): 25-54. Green is the foremost scholar of medieval gynecology and the Trotula. Here she sorts through the sources of information and misinformation published about Trotula’s life and clarifies what can and cannot be verified.

Green, Monica H., ed. and trans. The Trotula: A Medieval Compendium of Women’s Medicine. Philadelphia: University of Pennsylvania Press, 2001. Green’s lengthy introduction to this edition presents the most complete discussion of the work and of Trotula and the other authors available.

Hughes, Muriel Joy. Women Healers in Medieval Life and Literature. 1943. Reprint. Freeport, N.Y.: Books for Libraries Press, 1968. Devotes much of the chapter “Medieval Midwives” to Trotula, making the case that she was a knowledgeable and successful midwife in Salerno.

Riddle, John M. Contraception and Abortion from the Ancient World to the Renaissance. Cambridge, Mass.: Harvard University Press, 1992. Brief discussion of the Trotula’s advice about birth control, and a portrait of Trotula from a medieval manuscript.