Introduction: Women, Health, and Healing in Early Modern Europe

Mary E. Fissell

Bulletin of the History of Medicine, Volume 82, Number 1, Spring

2008, pp. 1-17 (Article)

Published by The Johns Hopkins University Press

DOI: 10.1353/bhm.2008.0024

For additional information about this article

http://muse.jhu.edu/journals/bhm/summary/v082/82.1fissell.html

Access Provided by Johns Hopkins University at 07/09/10 1:35PM GMT

 Introduction: Women, Health, and
Healing in Early Modern Europe
mary e . fissell

summary: Women played substantial roles in health and healing in medieval

and early-modern Europe. They have been undercounted in studies that rely
upon occupational labels, but when we look at caregiving and bodywork, we can
see women providing a broad range of services. Although women often healed in
domestic settings, neither female patients nor practitioners should be considered
in isolation from larger market forces that shaped men’s healing work.

keywords: gender, patients, women, healers, bodywork, caregiving, medieval,

early modern

Almost everyone in early modern Europe was brought into the world by
women and ushered out of it by women. Women’s hands birthed babies,
cut umbilical cords, and swaddled newborns. Women’s hands treated the
sick, comforted the dying, and laid out bodies, readying them for burial.
Women, in other words, were central to health and healing before 1800.
This special issue includes a variety of articles, most of which were first
presented at a conference in April 2006, that bring fresh perspectives to
the histories of women as healers and women as patients in early modern
Europe.1 By putting women in the center, and by starting our inquiry with
healing, at the bedside of the sick, we can rethink some of the categories
of analysis we have been using for the past few decades of the social history
of medicine. Further, when we re-embed healing within more general care
of the body, we abolish hierarchies of value created by learned physicians
and reproduced by later generations seeking to create or endorse tradi-
tions within medicine—seeking professional ancestors as object lessons.

It is a great pleasure to thank Sandra Cavallo, Amy Froide, and Katharine Park for their
helpful comments on an earlier version of this essay, and to thank Olivia Weisser for timely
and skilled research assistance.
1. For details, see www.hopkinsmedicine.org/histmed.

   Bull. Hist. Med., 2008, 82  : 1–17

  mary e. fissell

Interest in the history of women healers goes back to at least the early
modern period. In their introductions, seventeenth-century writers of
midwifery books liked to nod to the biblical mentions of midwifery in
order to justify their writing on the topic, or sometimes to underline the
worth of midwives. Seventeenth- and eighteenth-century Italian medical
historians created traditions about medieval female physicians of Salerno.2
Midwives, of course, featured as the bad girls in late nineteenth-century
narratives about the rise of obstetrics.3 In the twentieth century, a few
pioneer women physicians explored what we might consider their own
prehistory—that is, the longue durée of female healers.4 In North America,
the women’s movement of the 1970s prompted questions about women’s
participation in (or exclusion from) medicine and its historical roots,
notably in Mary Roth Walsh’s pioneering “No Women Need Apply,” which
spawned a rich scholarship on women physicians, followed about a decade
later by significant attention to the history of nursing.5
Feminists asked about women patients as well as women doctors. Schol-
ars such as Ann Douglas Wood, Carroll Smith-Rosenberg, and Charles
Rosenberg put Victorian women patients at the center of the story—and
it is not a happy tale. In less-skilled hands than these, such narratives
reduced female patients to victims of patriarchal male physicians.6 Early

2. Monica H. Green, “In Search of an ‘Authentic’ Women’s Medicine: The Strange Fates
of Trota of Salerno and Hildegard of Bingen,” Dynamis, 1999, 19  : 25–54.
3. E.g., J. H. Aveling, The Chamberlens and the Midwifery Forceps: Memorials of the Family and
an Essay on the Invention of the Instrument (London: Churchill, 1882).
4. Kate Hurd-Mead, A History of Women in Medicine (Haddam, Conn.: Haddam Press,
1938).
5. Mary Roth Walsh, “Doctors Wanted, No Women Need Apply”: Sexual Barriers in the Medical
Profession, 1835–1975 (New Haven: Yale University Press, 1977). On women doctors see,
e.g., Regina Morantz-Sanchez, Sympathy and Science: Women Physicians in American Medicine
(New York: Oxford University Press, 1985); Virginia Drachman, Hospital with a Heart: Women
Doctors and the Paradox of Separatism at the New England Hospital, 1862–1969 (Ithaca: Cornell
University Press, 1984). On nursing, see Susan M. Reverby, Ordered to Care: The Dilemma of
American Nursing, 1850–1945 (Cambridge: Cambridge University Press, 1987); Darlene Clark
Hine, Black Women in White: Racial Conflict and Cooperation in the Nursing Profession, 1890–1950
(Bloomington: Indiana University Press, 1989). Judith Leavitt’s collection of articles was
very influential in making women and medicine a successful topic for undergraduate teach-
ing: Judith Walzer Leavitt, ed., Women and Health in America: Historical Readings (Madison:
University of Wisconsin Press, 1984).
6. Carroll Smith-Rosenberg, “The Hysterical Woman: Sex Roles and Role Conflict in
Nineteenth-Century America,” Soc. Res., 1972, 39  : 652–72; Carroll Smith-Rosenberg and
Charles Rosenberg, “The Female Animal: Medical and Biological Views of Woman and Her
Role in Nineteenth-Century America,” J. Amer. Hist., 1973, 60  : 332–56; Ann Douglas Wood,
“‘The Fashionable Diseases’: Women’s Complaints and Their Treatment in Nineteenth-
Century America,” J. Interdiscip. Hist., 1973, 4  : 25–52; or, at a more popular level, Barbara
 Introduction  

modern patients did not get their due until Roy Porter almost single-hand-
edly put patients onto the agenda of the history of medicine—and then
the focus was squarely on early modern men.7 It is only very recently that
scholars have begun to think about the early modern patient in gender
terms, some while after that same lens was turned upon practitioners.8
For the early modern period, the impetus to look at women and healing
has been a little different from that of Walsh or Wood. The scholarship on
the nineteenth century discussed above often had specific political goals:
the indictment of sexism embedded in medical ideas and practices, and
the expanded inclusion of women in the medical profession. No such
straightforward lessons for today structure scholarship on medieval and
early modern women and healing. Instead, women’s and then gender
history came to explore early modern female healers by three related
pathways: the recuperation of midwives, the history of women’s work,
and the recovery and analysis of medical texts related to women. The first
accomplished almost a complete reversal of accepted wisdom: from super-
stitious, ignorant, and dangerous women, midwives have been recuper-
ated as competent practitioners with their own unwritten knowledge and
practices transmitted orally from teacher to student. For a brief moment,
the hero/villain roles were reversed: the ignorant midwife swapped places
with an inexperienced, instrument-wielding man-midwife, cast as a villain.9

Ehrenreich and Deirdre English, Complaints and Disorders: The Sexual Politics of Sickness (Old
Westbury, N.Y.: Feminist Press, 1973).
7. Roy Porter, ed., Patients and Practitioners: Lay Perceptions of Medicine in Pre-Industrial
Society (Cambridge: Cambridge University Press, 1985).
8. Barbara Duden, The Woman beneath the Skin (Cambridge: Harvard University Press,
1991); Lauren Kassell, “How to Read Simon Forman’s Case Books: Medicine, Astrology,
and Gender in Seventeenth-Century London,” Soc. Hist. Med., 1999, 12  : 3–18. I draw a
distinction here between those few studies that explore how gender shapes or constructs
the experiences of being sick or being a patient, and the much larger and richer literature
on gender and the body, such as Laura Gowing, Common Bodies: Women, Touch, and Power in
Seventeenth-Century England (New Haven: Yale University Press, 2003); or Gianna Pomata,
“Menstruating Men: Similarity and Difference of the Sexes in Early Modern Medicine,”
in Generation and Degeneration: Tropes of Reproduction in Literature and History from Antiquity
through Early Modern Europe, ed. Valeria Finucci and Kevin Brownlee (Durham, N.C.: Duke
University Press, 2001), pp. 109–52.
9. Crucial to the recuperation was Hilary Marland, ed., The Art of Midwifery (London:
Routledge, 1993). Subsequent examples include Doreen Evenden, The Midwives of Seven-
teenth-Century London (Cambridge: Cambridge University Press, 2000); Nina Gelbart, The
King’s Midwife: A History and Mystery of Madame du Coudray (Berkeley: University of California
Press, 1998). There has also been a range of cultural studies of childbirth and midwifery,
such as Lianne McTavish, Childbirth and the Display of Authority in Early Modern France (Alder-
shot: Ashgate, 2005); Caroline Bicks, Midwiving Subjects in Shakespeare’s England (Aldershot:
Ashgate, 2003).
  mary e. fissell

Now we are at a moment of greater balance and careful evaluation, with

few heroines and fewer villains, and many new questions. For example, we
need to ask: when do “midwives” become an occupational group?10 There
is little evidence for medieval midwives (versus experienced local women)
before the thirteenth century, and we still have very little understanding
of midwifery outside of cities—when did midwives begin to practice in
rural areas? How did communities come to validate a particular woman’s
claim to skill in birthing babies?
On the second pathway, an interest in women’s work has begun to
broaden the picture of women healers beyond midwives, an emphasis
underlined in this issue. Crucial to a reunderstanding of women and medi-
eval medical work was Monica Green’s 1989 essay in Signs, read profitably
by many an early-modernist, that showed that women’s health was the
concern of both men and women in the Middle Ages, not just limited to
midwives.11 The two paths intersect, of course, in studies that explore how
midwives were regulated, as in the early essay by Merry Wiesner-Hanks on
patterns of midwife regulation in German cities that showed us how well-
respected and civically significant some early modern midwives were.12
Third, a substantial body of work began by exploring medieval and
Renaissance texts that had something to do with women and medicine.
For example, Monica Green has painstakingly unpacked the complex
history of the so-called Trotula texts dealing with women’s health. Helen
King has traced the profound impact that the translation of Hippocratic
writings on gynecology had upon learned Renaissance medicine. Joan
Cadden has provided us with a rich analysis of the complex ways that
scholars in the Middle Ages thought about sex difference. In works such
as these, feminist scholars are deploying sophisticated textual skills in
combination with attention to the social and cultural contexts in which
such texts were written, translated, reproduced, and read.13 Similarly, a

10. Monica H. Green, “Bodies, Gender, Health, Disease: Recent Work on Medieval
Women’s Medicine,” Stud. Mediev. & Renaiss. Hist., 3rd ser, 2005, 2  : 1–46, esp. p. 15; Green,
Making Women’s Medicine Masculine: The Rise of Male Authority in Pre-Modern Gynaecology
(Oxford: Oxford University Press, forthcoming).
11. Monica H. Green, “Women’s Medical Practice and Health Care in Medieval Europe,”
Signs, 1989, 14  : 434 –73.
12. Merry Wiesner, “Early Modern Midwifery: A Case Study,” in Women and Work in Pre-
Industrial Europe, ed. Barbara Hanawalt (Bloomington: Indiana University Press, 1986), 
pp. 94 –113.
13. For a sample of such work, see Monica H. Green, The Trotula: A Medieval Compendium
of Women’s Medicine (Philadelphia: University of Pennsylvania Press, 2001); “The Possibilities
of Literacy and the Limits of Reading: Women and the Gendering of Medical Literacy,” in
Monica Green, Women’s Healthcare in the Medieval West: Texts and Contexts (Aldershot: Ashgate,
 Introduction  

group of scholars has begun to tackle one of the forms of writing often
(but not exclusively) associated with women: the recipe book. These texts,
which exist in relatively large numbers for the early modern period, do not
lend themselves to easy analysis—they are often just series of recipes, with-
out much (or sometimes any) paratextual apparatus that would provide
insights into composition and use. Nevertheless, scholars such as Elaine
Leong and Alisha Rankin (both included in this issue), Jennifer Stine,
and Catherine Field have begun sophisticated analyses of these texts by
attending to the contexts of both composition and use.14
Two interconnected problems continue to shape our attempts to write
histories of women and healing before 1800. First, for structural reasons,
women’s health-care work is underdocumented compared to that of many
men. Second, we are working in a scholarship that continues to value, and
perhaps even reify, boundaries between types of healers, between men’s
work and women’s work, and between healing and caregiving. At the risk
of throwing out several babies with the bathwater, I am going to suggest
that we loosen the grip that these boundaries have upon our historical
imaginations.
In medieval and early modern sources, men are identified by occu-
pational labels much more frequently than are women. Quite simply,
there were legal and administrative reasons for recording men’s work-
titles—but also, the structures of men’s work often differed from those of
women. Women, for example, rarely enjoyed the semimonopolistic kinds
of employment protection and relative career stability provided by guilds
or city companies. An older literature put women healers at the margins:

2000), pp. 1–76; Green, “From ‘Diseases of Women’ to ‘Secrets of Women’: The Transfor-
mation of Gynecological Literature,” J. Mediev. & Early Mod. Stud., 2000, 30  : 5–39; Mont-
serrat Cabré, “From a Master to a Laywoman: A Feminine Manual of Self-Help,” Dynamis,
2000, 20  : 371–93; Helen King, Midwifery, Obstetrics and the Rise of Gynaecology: The Uses of a
Sixteenth-Century Compendium (Aldershot: Ashgate, 2007); King, The Disease of Virgins: Green
Sickness, Chlorosis, and the Problems of Puberty (London: Routledge, 2004); Joan Cadden, The
Meanings of Sex Difference in the Middle Ages: Medicine, Science, and Culture (Cambridge: Cam-
bridge University Press, 1993).
14. Jennifer K. Stine, “Opening Closets: The Discovery of Household Medicine in Early
Modern England” (Ph.D. diss., Stanford University, 1996); Elaine Leong, “Medical Recipe
Collections in Seventeenth-Century England: Knowledge, Gender, and Text” (D.Phil. diss.,
Oxford University, 2005); Alisha Rankin, “Medicine for the Uncommon Woman: Experience,
Experiment, and Exchange in Early Modern Germany” (Ph.D. diss., Harvard University,
2005); Catherine Field, “‘Many Hands Hands’: Writing the Self in Early Modern Women’s
Recipe Books,” in Genre and Women’s Life Writing in Early Modern England, ed. Michelle Dowd
and Julie Eckerle (Aldershot: Ashgate, 2007), pp. 49–63. On printed recipe collections, see
Lisa K. Meloncon, “Rhetoric, Remedies, Regimens: Popular Science in Early Modern Eng-
land” (Ph.D. diss., University of South Carolina, 2005); and see n. 24 below.
  mary e. fissell

excluded from guild-based work, and from learned medicine taught at

universities, they were seen as outside the central tripartite structure of
early modern medicine. In the 1980s and 1990s social historians of medi-
cine, myself included, focused our attention on ordinary practitioners
rather than the top of the hierarchy, but that quantitative work often
failed to uncover the female healers who we suspected were there. In her
essay in this issue, Montserrat Cabré highlights the ways in which medi-
eval women healers have been almost invisible in the historical records
used to reconstruct populations of healers. There are men aplenty with
occupational titles like surgeon or tooth-drawer, but women are usually
fewer than 3 percent of the total population of healers. Cabré suggests
that women performed healing roles along a continuum from domestic
caring (by definition, not listed as an occupation) through more formal
labor such as midwifery that might be recompensed.
Recent women’s history underlines the importance of moving beyond
occupational titles, in part because of these problems of documentation.
For example, in her fine-grained study of Exeter in the late fourteenth
century, Maryanne Kowaleski found no mention of midwives in town
records that pertained to work, although we might infer that a number
of midwives delivered the hundreds of babies who grew up to make late
medieval Exeter’s population; however, five women were called midwives
in court records when they examined women to determine if they were
truly pregnant as they claimed.15 Years ago, Olwen Hufton memorably
described early modern women’s work as an economy of expedients and
makeshifts.16 More recently, Pam Sharpe reminds us that women’s “occu-
pations” varied by the day, the week, and especially the season—not to
mention stages of the life cycle, perhaps the single most significant vari-
able shaping women’s work.17 Women were very active players in early
modern economies, but they were seldom identified by occupational
titles in surviving records, and therefore the breadth of their activities is
only now being teased out.18

15. Maryanne Kowaleski, Local Markets and Regional Trade in Medieval Exeter (Cambridge:
Cambridge University Press, 1995), p. 168.
16. Olwen Hufton, “Women without Men: Widows and Spinsters in Britain and France
in the Eighteenth Century,” J. Fam. Hist., 1984, 9  : 355–76, on p. 363.
17. Pamela Sharpe, Adapting to Capitalism: Working Women in the English Economy, 1700–
1850 (Basingstoke: Macmillan, 1996), p. 1.
18. For examples of women’s participation in early modern economies, see Amy M.
Froide, Never Married: Singlewomen in Early Modern England (New York: Oxford University
Press, 2005), pp. 117–53; Monica Chojnacka, Working Women of Early Modern Venice (Balti-
more: Johns Hopkins University Press, 2001); Marjorie Keniston Mcintosh, Working Women
in English Society, 1300–1620 (Cambridge: Cambridge University Press, 2005); Sheilagh
 Introduction  

Here, I suggest that we momentarily dismiss the boundaries and occu-

pational titles that we assume structured health care and begin with a
heuristic blank slate. The questions, I think, are not of the form “what are
the boundaries?” but rather how historical actors create, invoke, and break
boundaries in particular situations. One of the most well-known moments
when a female healer comes into conflict with men over her healing prac-
tices is the 1322 prosecution of Jacoba Félicié by Paris doctors.19 We might
read this episode as evidence that women were not allowed to be healers
in late medieval Paris—or (more correctly, in my view) that women often
pursued quite successful, even lucrative healing careers, and only rarely
came into conflict with medical authorities who were themselves just com-
ing into being. Rather than seeing some fixed boundary at work here, we
might want to ask what the specific circumstances were that prompted
these men to invoke a gender barrier.
Two specific issues point to the potential gains of ignoring the bound-
aries traditionally invoked by historians of medicine, at least as an explor-
atory measure. First, it will help us to get beyond the often-cited deroga-
tory comments about female healers made by male practitioners in the
medieval and early modern period. Years ago, Roy Porter reminded us
that the use of the term “quack” often told us more about the speaker
than about the person he or she was describing.20 This insight has been
developed in a sophisticated way by Margaret Pelling in her examination
of the College of Physicians of London. She shows that its members strove
to create binary oppositions between themselves and other practitioners.
They worked hard at maintaining these divisions precisely because the
“other” was all too similar to themselves.21 To put it differently, it took sus-
tained cultural work for the College’s physicians to demarcate themselves

Ogivie, “How Does Social Capital Affect Women? Guilds and Communities in Early Modern
Germany,” Amer. Hist. Rev., 2004, 109  : 324 –59. On the specific issue of occupational titles
see, e.g., Darlene Abreu-Ferreira, “Work and Identity in Early Modern Portugal: What Did
Gender Have to Do with It?” J. Soc. Hist., 2002, 35  : 859–87; Cordelia Beattie, “The Prob-
lems of Women’s Work Identities in Post Black Death England,” in The Problem of Labour in
Fourteenth Century England, ed. James Bothwell (York: York Medieval Press, 2001), pp. 1–19;
Gayle K. Brunelle, “Policing the Monopolizing Women of Early Modern Nantes,” J. Women’s
Hist., 2007, 19  : 10–35.
19. Eileen Power, “Some Women Practitioners of Medicine in the Middle Ages,” Proc. Roy.
Soc. Med., 1922, 15  : 20–23; Pearl Kibre, “The Faculty of Medicine at Paris, Charlatanism and
Unlicensed Medical Practice in the Later Middle Ages,” Bull. Hist. Med., 1953, 27  : 1–20.
20. Roy Porter, Health for Sale: Quackery in England, 1660–1850 (Manchester: Manchester
University Press, 1989), p. 2.
21. Margaret Pelling, Medical Conflicts in Early Modern London: Patronage, Physicians, and
Irregular Practitioners, 1550–1640 (Oxford: Clarendon, 2003).
  mary e. fissell

as special or different in a crowded marketplace. In this issue, Deborah

Harkness’s exploration of female healers in Elizabethan London builds
upon this theme by recovering what she calls an uncontested middle
ground. Despite the vituperative comments by physicians like John Securis
and John Hall, or the occasional splashy prosecution by the College of
Physicians, many women worked in health care in Elizabethan London
very successfully: they enjoyed positions of relative security and public
acceptance, working in hospitals and for parishes that provided health
care for their less fortunate members. What the work of scholars such as
Pelling and Harkness suggests is that the outrage expressed by physicians
and surgeons about female healers must be understood as situational, and
as specific interventions in longer-term campaigns of self-fashioning and
self-promotion. Many (if not most) Londoners, it seems, would not have
endorsed these physicians’ shrill comments. Others used the prosecution
function of the College only when a healing encounter (with a male or
female healer) had gone badly wrong; the vast majority of encounters went
smoothly and remain largely unremarked in the historical record.
Second, ridding ourselves of assumptions about the boundaries between
male and female practitioners may help us to better understand the com-
plex relationships between the healing that took place within a model of
economic exchange, and that which did not. There has often been an
unspoken assumption that women’s healing was limited to the domestic
sphere, and that it remained largely outside the commercial realm. These
assumptions have rarely been voiced; instead, they have structured the
kinds of questions and problems we have investigated. We now have a
much richer historiography about women’s work and participation in the
economy of early modern Europe. Those histories suggest that women
were often a significant part of the processes of commercialization and
commodification that characterized European economies in this period.
In other words, as Elaine Leong’s essay in this issue suggests, we can no
longer assume that women merely plucked herbs from their gardens and
made simple domestic remedies in their kitchens, in some way insulated
from the larger concerns of the market. There was no such opposition:
as Leong shows, one female gentry healer in the late seventeenth and
early eighteenth centuries was making very substantial quantities of
medicines for her household and her neighborhood, employing both
domestically produced ingredients and all kinds of more exotic materi-
als, and even complex preparations, purchased from an apothecary. As
in other patterns of consumption, the purchase and use of medicines
integrated female consumers into what was becoming a global economy.
For example, in the 1740s, Mrs. Christian, who lived in a fairly remote
part of northwest England, participated in the global economy in her
 Introduction  

consumption of a wide range of medicines made from ingredients that

originated in the Caribbean, Africa, and India, and from various points
around the Mediterranean.22
By abandoning the assumption that women’s healing was solely small-
scale and domestic, we can frame a new series of questions. First, we can
ask, what is the relationship between healing within the context of eco-
nomic exchange, and that which happens outside it? For example, we
know from the work of a number of scholars that the exchange of recipes
for remedies was a very common social practice. Manuscript recipe books
themselves testify to the rich social networks of interaction that produced
the array of recipes inscribed in a single volume. These interactions seem
to have taken place outside of economic exchange; that is, most people
do not seem to have sold recipes. Of course, there were spectacular excep-
tions: in 1729, James Papaw, a Virginia slave, was freed by the Council in
exchange for revealing his remedy for obstinate venereal diseases, and was
given an annual pension of £20 the following year for working on other
cures.23 By and large, however, recipes were gifts, not commerce.
However, recipe books did not exist in a bubble wholly insulated from the
market. Further consideration of these books points us in two directions
when we think about the economics of healing. First, recipes themselves
became commodities: in England in the 1650s, printed remedy books,
clearly bearing the traces of their manuscript origins, became best-sell-
ers. These small books listed recipes, often in seemingly haphazard array,
with attributions as to their origins. Such books both claimed to be the
product of an individual aristocratic woman’s labor, as in the bestselling
Elizabeth Grey, Countess of Kent’s book A Choice Manual of Rare and Select
Secrets, and the work of the individuals named as authors of individual
recipes.24 However, the book itself was produced for profit, and no doubt
provided a tidy return to publisher and bookseller, going into at least
twenty editions.

22. Jean E. Ward and Joan Yell, eds., The Medical Casebook of William Brownrigg, M.D., F.R.S.
(1712–1800) of the Town of Whitehaven in Cumberland, Supplement no. 13 to Medical History
(London: Wellcome Institute for the History of Medicine, 1993), pp. 128–36.
23. Philip D. Morgan, Slave Counterpoint: Black Culture in the Eighteenth-Century Chesapeake
and Lowcountry (Chapel Hill: Published for Omohundro Institute of Early American History
and Culture, Williamsburg, Va., by University of North Carolina Press, 1998), p. 625.
24. Elizabeth Grey, Countess of Kent, A Choice Manual of Rare and Select Secrets in Physick
and Chyrurgery; collected, and practised by the Right Honorable, the Countesse of Kent, late deceased
(London, 1653), Wing K310B. On this text, see Laura Lunger Knoppers, “Opening the
Queen’s Closet: Henrietta Maria, Elizabeth Cromwell, and the Politics of Cookery,” Renaiss.
Quart., 2007, 60  : 464 –99, for fascinating insights into this issue. See also Jayne Archer, “The
Queen’s Arcanum: Authority and Authorship in The Queen’s Closet Opened (1655),” Renaiss.
J., 2002, 1  : 14 –26.
10  mary e. fissell

Second, the gift exchange of recipes must be understood within the

larger context of patronage relations, which also structured much of the
relationship between wealthy patients and their healers.25 While it is true
that these recipes were not exchanged for cash, this is not to say that they
were exchanged innocent of any expectation of return. Indeed, we must
pay greater attention to the systems of patronage that structured much of
early modern European life in order to understand a kind of countervail-
ing force to the process of commercialization in medicine. In this issue,
the essay by Cathy McClive on female medical experts in court shows us
the workings of an ancien régime patronage system: French midwives
purchased so-called venal offices and struggled to maintain their rights
to them, even at moments when their expertise was being overthrown.
Sometimes, patronage enabled a female healer to succeed against what
seem like strong odds. For example, Harkness shows us the healer Marga-
ret Kennix, protected by none other than Queen Elizabeth, while McClive
suggests that midwife Marie Garnier was protected from the legal conse-
quences of her misreading of a female body by the connections she had
made as wet nurse to Louis XIV. In her pathbreaking article on gossip
and the structure of Louise Bourgeois’s career as a royal midwife, Yaarah
Bar-On reminds us that despite the protomodern appearance of licens-
ing systems and other seemingly professional apparatuses, early modern
Europe was not a meritocracy, and often the skills of a courtier might have
been more significant than the mastery of technical detail.26
Another way in which we might productively abandon some custom-
ary boundaries is in our definition of healing: we can make it as broad
and inclusive a category as our sources seem to warrant. I would propose
that we embed healing within a larger framework of what Kathy Brown
and I have called “bodywork,” which overlaps with Montserrat Cabré’s
and Monica Green’s term “techniques of the body,” and with Sandra
Cavallo’s suggestions about artisans of the body.27 Using bodywork as a

25. And patronage relations structured interactions between poor patients and their
healers also. Gianna Pomata recounts the story of Angelo Ratti, a seventeenth-century
carpenter who sought advice from the noted physician and surgeon Antonio Valsalva and
from the dean of the college of medicine, when he thought he had been cheated by an
unlicensed healer: Gianna Pomata, Contracting a Cure: Patients, Healers, and the Law in Early
Modern Bologna (Baltimore: Johns Hopkins University Press, 1998), pp. 125–27.
26. Yaarah Bar-On, “Neighbours and Gossip in Early Modern Gynaecology,” in Cultural
Approaches to the History of Medicine, ed. Willem de Blécourt and Cornelie Usborne (London:
Palgrave, 2004), pp. 36–55.
27. See Cabré, “From a Master to a Laywoman” (n. 13) and Green, “Bodies, Gender,
Health, Disease” (n. 10); Sandra Cavallo, Artisans of the Body in Early Modern Italy: Identities,
Families and Masculinities (Manchester: Manchester University Press, 2007).
 Introduction  11

category enables us to start at the bedside of the sufferer, attending to

the physical labor entailed in the care of the sick. I am not proposing
that we replace the category “medicine” with bodywork; rather, that we
investigate the relationship between the work we consider medicine and
the broader category of attending to the human body, and perhaps place
medicine and its learned traditions within or next to the larger category
of bodywork or body technologies.
A wide range of people performed some kind of labor that involved
the human body. Both birth and death were processes that often involved
an array of specialized help. Midwives, “gossips,” wet nurses, and monthly
nurses all participated in the care of the parturient woman. Dying people
were attended by “watchers,” paid to sit up with them, and bodies were
prepared for burial by layers-out. And death might involve a macabre array
of laborers—such as executioners, often thought to have specific healing
talents, and gravediggers, who diagnosed dead bodies to keep tabs on the
spread of the plague in Florence, work done by searchers in London. The
healthy body was attended to by laundresses, barbers, bathhouse-keepers,
domestic servants, and of course, physicians, while surgeons, apothecaries,
bonesetters, oculists, dentists, physicians, and a host of others ministered
to the ailing body.
Several examples illustrate what I mean by the category “bodywork” and
its ambiguous and sometimes ambivalent relationship to healing. First,
there are searchers, the elderly poor women hired by London’s parishes
to inspect the bodies of the sick and dead for signs of the dreaded plague.
Now the subject of a fine study by Rachelle Munkhoff, searchers were for
centuries written off as elderly and ignorant, although (to be anachro-
nistic) the data they collected generated Bills of Mortality, eagerly mined
by practitioners of political arithmetic, and subsequently by historians.28
In other words, although any one individual searcher might have been
denigrated, the knowledge they collectively produced provided crucial
data upon which social policy was made: Should theaters be reopened?
Should the king and his court abandon the capital city? Should burials be
forbidden at night? In her essay in this volume, Deborah Harkness notes
a searcher who also worked as a midwife, demonstrating expertise at the
beginning and end of life—suggesting the ways that bodywork sometimes
coincides with what we more often recognize as health care.
Second, barbers and wigmakers existed at the boundaries of medi-
cine, yet firmly within the category of bodywork. As historians such as

28. Rachelle Munkhoff, “Searchers of the Dead: Authority, Marginality, and the Inter-
pretation of Plague in England, 1574 –1665,” Gender & Hist., 1999, 11  : 1–29.
12  mary e. fissell

Nancy Siraisi and Margaret Pelling have reminded us, attention to the
appearance of the body was long considered to be a part of medicine, or
at least a legitimate concern for a physician.29 Indeed, one of the Trotula
texts and a section of the first English book on midwifery are devoted to
cosmetics. The close and overlapping relationships among moral worth,
physical attractiveness, and health meant that attending to the body’s sur-
face had implications beyond what we think of as “health.” For example,
helping children to grow up “straight”—that is, not crippled, rickety, or
deformed—clearly had moral as well as aesthetic meaning. In German-
speaking cities, the institution of the bathhouse provided a venue for a
range of practitioners who let blood, cupped, gave massages, and offered
various other procedures, both therapeutic and health-enhancing. I think
that if we want to attend to how individuals made choices among a range
of practitioners, we cannot exclude, say, a bloodletting wigmaker on the
basis of his guild affiliation or supposed lack of training; instead, we need
categories broad enough to include him and his services. And, lest we
get sniffy about whom we wish to investigate under the rubric of “history
of medicine,” let us remember that we live in a moment when cosmetic
plastic surgery is televised as entertainment.
Third, how do we consider wet nurses in relation to medicine? Cer-
tainly, the choice of a correct wet nurse was a topic addressed by many a
physician. But wet nurses also provided health care to their charges, and
sometime to others.30 In the essay by Harkness in this issue, she recounts
the story of Sir Hugh Plat’s wet nurse offering him a recipe for gout, an
ailment not usually associated with babies! Perhaps her identity as a wet
nurse was irrelevant in this context—perhaps she was just an older woman,

29. Nancy Siraisi, Taddeo Alderotti and His Pupils: Two Generations of Italian Medical Learning
(Princeton: Princeton University Press, 1981), pp. 281, 283; Margaret Pelling, “Appearance
and Reality: Barber-Surgeons, the Body, and Disease,” in London 1500–1700: The Making of
the Metropolis, ed. A. L. Beier and Roger Finlay (London: Longmans, 1985), pp. 82–112.
30. See Dorothy McLaren, “Nature’s Contraceptive: Wet-Nursing and Prolonged Lacta-
tion, the Case of Chesham, Buckinghamshire, 1578–1601,” Med. Hist., 1979, 23  : 426–41;
McLaren, “Fertility, Infant Mortality, and Breast Feeding in the Seventeenth Century,” ibid.,
1978, 22  : 378–96; Valerie Fildes, Wet Nursing: A History from Antiquity to the Present (Oxford:
Blackwell, 1988); Fildes, “The English Wet-Nurse and Her Role in Infant Care 1538–1800,”
Med. Hist., 1988, 32  : 142–73; Linda Campbell, “Wet-Nurses in Early Modern England: Some
Evidence from the Townshend Archive,” ibid., 1989, 33  : 360–70; Mary Lindemann, “Love
for Hire: The Regulation of the Wet-Nursing Business in Eighteenth-Century Hamburg,”
J. Fam. Hist., 1981, 6  : 379–95; Leah L. Otis, “Municipal Wet Nurses in Fifteenth-Century
Montpellier,” in Women and Work in Preindustrial Europe, ed. Barbara Hanawalt (Bloomington:
University of Indiana Press, 1986), pp. 83–93; Christiane Klapisch-Zuber, “Blood Parents and
Milk Parents: Wet Nursing in Florence, 1300–1530,” in Women, Family and Ritual in Renaissance
Italy, trans. Lydia G. Cochrane (University of Chicago Press, 1985), pp. 132–64.
 Introduction  13

presumed to have accumulated a store of healing knowledge like many

other women (and men). Wet nurses provided just that mix of health care
and bodywork that excluded them from many accounts of the history of
medicine grounded in a tripartite model of physician, surgeon, and apoth-
ecary, but they were health-care resources in their neighborhoods.
Each of my examples highlights the different aspects of what I am call-
ing bodywork. Searchers were skilled in hermeneutics: they could read
the surface of a body, dead or alive, and transform it into a diagnostic
datapoint. Barbers or wigmakers who let blood provided a well-known
therapeutic intervention; they did not prescribe this intervention, but
rather patients sought them out once they had decided that bloodletting
was in order, or another practitioner had prescribed the procedure. If
you will, searchers provided knowledge, and barbers provided practice.
My third category, wet nurses, provided care—perhaps the most difficult
category of all.
If we want to understand both women’s involvement with healing, and
how healing was on occasion gendered, we must focus on care. The very
long periods of illness that early modern sufferers experienced entailed
massive amounts of care, work that was often too ordinary or too unre-
markable to be recorded in writing, but was usually performed by women:
wives, mothers, daughters, domestic servants, and slaves. The endless
series of expulsive medicines, be they purges, vomits, or sweats, meant
substantial quantities of nursing care and laundry. Indeed, even England’s
poorer subjects might expect to receive such care from a local welfare
system, while on the Continent, hospitals and nursing orders provided the
same. The language used to describe such activities is rich. In the records
of the Old Poor Law, England’s local welfare system, women are paid as
nurses, sitters-up, watchers, and layers-out; they “do for,” they “help,”
they “attend.” Men are rarely mentioned in relation to this kind of work,
although four of them were paid to “hold Jem Smith till he got sober.”31
The work of caring overlapped with that of washing: single men evidently
almost never did laundry in early modern England; even those on poor
relief might have a woman to wash for them, paid for by the parish. Car-
ing also slid into boarding, or what was sometimes called “nurse-keeping,”
which might mean wet-nursing, sick-nursing, rearing older children, or
“doing for” men who lacked female relatives to provide such labor. In a
sample of London working women in the late seventeenth century, Peter
Earle found fifty-six whom he characterized as doing health-care work,

31. Samantha Williams, “Caring for the Sick Poor: Poor Law Nurses in Bedfordshire
c. 1770–1834,” in Women, Work and Wages in England, 1600–1850, ed. Penelope Lane, Neil
Raven, and K. D. M. Snell (Rochester: Boydell, 2004), pp. 141–69, on p. 151.
14  mary e. fissell

three-quarters of whom were “nursekeepers.”32 Our own rapidly greying

society will need more and more of just such services.
Broadening our view of who was providing health care in the Middle
Ages and early modern period by stressing “care” makes sense when we
think about medicine itself. The care/cure dichotomy is, after all, a mod-
ern one that does not even exist in some languages.33 Hardly anyone was
“cured” of an ailment in the early modern period: they endured, and
they survived—or they died. But the course of their illness was not often
dramatically altered or shortened or terminated as a result of medical
intervention—that paradigm is largely a post-magic-bullet one. Good
medicine was expectant: it involved provoking the body to heal itself, often
by expulsive means that required a great deal of intimate bodily care, and
diet was a crucial therapy. Even much of the work of surgery entailed weeks
of daily wound care rather than the dramatic interventions that character-
ize modern operative surgery. Preparing food and providing bodily care
was largely a female task and was gendered as such.34 Nor should these
insights shape only our understanding of women’s work. As Pelling has
shown, even the most elite seventeenth-century physicians were, in her
phrase, “compromised by gender,” in part because of physic’s association
with the care of the ailing body and with food production, both often the
task of women in that society.35 Because the work of care was often that of
women, gender expectations were woven into all healing practices.
In suggesting that we consider healing in relation to other forms of
care of the body, I do not mean that we should ignore all categories or
boundaries. Rather, I would like to pose a question: at what points do we
see a very strong emphasis upon the gender of a healer? that is, when

32. Peter Earle, “The Female Labour Market in London in the Late Seventeenth and
Early Eighteenth Centuries,” Econ. Hist. Rev., 1989, 42  : 328–53. On the category “nurse-
keeper,” see the germinal essay by Margaret Pelling, “Nurses and Nursekeepers: Problems
of Identification in the Early Modern Period,” in The Common Lot: Sickness, Medical Occupa-
tions and the Urban Poor in Early Modern England, ed. Pelling (London: Longmans, 1998),
pp. 179–202.
33. Today, many states do not certify home health aides as health workers—yet they are,
of course, hired to provide health care!
34. See Felicity Riddy, “Looking Closely: Authority and Intimacy in the Late Medieval Urban
Home,” in Gendering the Master Narrative: Women and Power in the Middle Ages, ed. Mary C.
Erler and Maryanne Kowaleski (Ithaca: Cornell University Press, 2003), pp. 212–28, for a
fascinating exploration of the gendering of care in relation to patriarchy. Patriarchy, Riddy
claims, stops at the chamber door, because of the gendered nature of bodily care.
35. Margaret Pelling, “Compromised by Gender: The Role of the Male Medical Prac-
titioner in Early Modern England,” in The Task of Healing: Medicine, Religion and Gender in
England and the Netherlands 1450–1800, ed. Hilary Marland and Margaret Pelling (Rotterdam:
Erasmus, 1996), pp. 101–33.
 Introduction  15

will only one gender do, and why? Then we can ask about those areas
of healing that are more commonly (but not exclusively) performed by
one sex or the other, and explore how and why these seeming patterns of
inclusion and exclusion worked in practice. Part of the answer we already
know: women were not allowed to study medicine at universities, and
urban apprenticeships to surgeons and apothecaries were largely limited
to boys, although in various circumstances women performed much the
same work. There, the civic function of apprenticeship and its customary
outcome—assuming a civic role as a male head of household—explains
much of the gender imbalance. At the risk of generalizing too soon, it
seems to me that there were actually only a few instances in early modern
Europe when categorically one sex was almost always required: in normal
childbirth, and for what I might call brute-force operative surgery—that
is, amputations, cutting for the stone, and, as the document published
by Katharine Park in this issue illustrates, Caesarean section. Many other
examples—medicine on shipboard, the healing roles of executioners,
sacerdotal healing that was primarily spiritual (including exorcisms)—are
second-order effects of gender roles: it is not the healing as such that is
gendered, but the social roles through which that healing is accomplished.
Thus, since women almost never worked aboard ships in this period, it is
not surprising that women were not ship’s surgeons (who, of course, also
had to perfom brute-force surgery). As in the example above, appren-
ticeships were both training and an entrée to participation in male civic
life, so only widows (who functioned in their husbands’ stead) worked as
apothecaries or physicians or surgeons per se (and even here, it is difficult
to know what they actually did).
In our world, replete with dual-career couples, it can be easy to forget
that the household, rather than the individual, was often the productive
unit in medieval and early modern Europe. The family business, be that
bleeding and cupping, making medicines, cutting hair, or even writing
and practicing scholarly humanist medicine, was structured in such a way
that we often cannot know which person was doing exactly what work.
Apprentices and domestic servants, who might function as de facto off-
spring for the better part of a decade, were integral to household pro-
duction, but so too were wives and daughters. It is only through histori-
cal happenstance, such as the death of the head of household and his
replacement by his widow, that we can glimpse the complexity of labor
relations within the household.
The essays in this volume, taken together, suggest that we might situate
women’s healing (and women as patients) in two interconnecting frames:
work, and household/family (perhaps better theorized as “domestic”?).
16  mary e. fissell

Both categories point to the need to continue to integrate women heal-

ers into women’s history as well as medical history. For example, both
Harkness’s and Cabré’s essays show us women who healed in domestic
settings all the time. Harkness’s women worked in institutional settings
that mimicked the domestic, providing homes and fictive kin for those
who lacked them yet were deemed deserving of community help. We
badly need comparable studies of the nursing orders in Catholic hospi-
tals; nuns were among the most significant health-care providers, yet they
remain almost invisible in the historiography of early modern medicine.
Starting with the household or family also helps us to link healers and
their patients. Rankin’s essay shows us how one woman as both healer and
patient navigated a complex world of choices, staunchly maintaining her
own views of bodily function despite opposition from family and healers
alike. Leong’s work reintegrates the domestic into the commercial boom-
town that was late seventeenth-century England.
Paying attention to the domestic contexts of women’s healing also
underlines what appear to be very long structural continuities in women’s
experiences of health and healing. The women whom Cabré describes
provided a wealth of healing to each other in their homes, bringing in
various male healers when needed. A few centuries later, had Rankin’s
duchess had the good fortune to live in such an urban community (and
had she been perhaps a little less cranky), her experiences of ill health
might have been quite similar—and much the same might be said of Eliza-
beth Freke. As women’s historians have suggested, the boundary between
medieval and early modern often seems irrelevant or even nonexistent
for women.36 We have yet to construct a chronology of changes crucial
for women and healing—or for men, for that matter.
Any consideration of such changes will need to address an issue cen-
tral to the histories of Victorian women and medicine mentioned at the
beginning of this essay, which is as yet underexplored for the early modern
period. Simply put, what is the relationship between ideas about the body
and actual experiences of health, both good and bad? Rankin’s essay shows
us how a determined woman framed her illness according to her own
ideas about the body and about the relationships among signs, symptoms,
and disease processes. Work such as Barbara Duden’s study of Johannes
Storch’s patients suggests that patients had rich and fully developed ideas
about how their bodies worked, but we have very little understanding of
how those ideas existed in some kind of dynamic relationship with ideas

36. See, e.g., Judith M. Bennett, “Confronting Continuity,” J. Women’s Hist., 1997, 9  :
73–94; Bennett, “Women’s History: A Study in Continuity and Change,” Women’s Hist. Rev.,
1993, 2  : 173–84.
 Introduction  17

in medical texts or embodied in physicians’ and surgeons’ practices. As

Katharine Park’s recent book suggests, at moments the female body was
paradigmatic for an understanding of all bodies.37 At other times, the
male body seems to have been the template. How do shifts such as these
interact with lived experience?
Finally, by questioning the usual categories through which we have
understood early modern medicine (themselves often the legacies of wish-
ful thinking by elite physicians), and by broadening our remit to consider
all work that focused on the body, I hope to encourage us to see the many
ways in which medieval and early modern women were involved in heal-
ing. However, these suggestions do not just pertain to women. Men did
“bodywork” in many settings, perhaps as pastors exorcising the demons
that tortured a person physically as well as spiritually, or as domestic ser-
vants curling their masters’ wigs, killing lice, and attending to other details
of appearance. Not all males were heads of households, model patriarchs
with clearly defined “occupations.” The parameters within which bodies
were healed and cared for need further recovery—although differences
between “public” and “private” may have been evinced in many settings
and circumstances, their meanings and deployment were very different in
the early modern period than in our own.38 So, too, the presumptions we
bring about the autonomous, self-directed, highly individuated persons
who we think we are, and the bodies that those entail, would have been
quite alien four or five centuries ago. Looking at women, health, and
healing, in other words, prompts questions about men as well.

mary e. fissell is a professor in the Department of the History of Medicine

at the Johns Hopkins University, 1900 East Monument Street, Baltimore, MD
21205 (e-mail: mfissell@jhmi.edu). Her current research interests include
developing a robust theory of vernacular knowledge and writing a cultural
history of Aristotle’s Masterpiece, a bestselling guide to sex and reproduction first
published in 1684. Recent publications include Vernacular Bodies: The Politics of
Reproduction in Early Modern England (Oxford University Press, 2004).

37. Katharine Park, Secrets of Women: Gender, Generation, and the Origins of Human Dissection
(New York: Zone Books, 2006).
38. Here I follow Michael McKeon, The Secret History of Domesticity: Public, Private, and the
Division of Knowledge (Baltimore: Johns Hopkins University Press, 2007).