Medieval Women as Physicians: What the Records Show

Ask who practiced medicine in medieval Europe and the usual picture is of male physicians in university gowns, with women confined to the birthing room. The surviving records are messier. Tax rolls, court cases, licences, notarial contracts and a handful of chronicles show women treating wounds, eyes and serious illness, sometimes for pay, sometimes for queens and popes, sometimes in defiance of the men who wanted the field to themselves. At the same time, some of the most famous “medieval women doctors” owe more to later admirers than to medieval evidence. What follows is a survey of what can be documented, and of where the story has been embroidered.

Who counted as a medical practitioner

The first problem is one of definition. Medieval sources use a scatter of words, Latin fisica, surgica and cirurgica, French mirgesse,¹² and they rarely tell us how much of a woman’s working life went into healing. Monica Green, a historian of medieval women’s medicine who surveyed the subject in a 1989 article in the journal Signs,³ proposed a working definition that Cheryl Tallan quotes in her encyclopedia entry on medieval Jewish women doctors: “Women who at some point in their lives would have either identified themselves in terms of their medical practice or been so identified by their communities.”¹

That definition is broad on purpose. It takes in women called doctors, women called surgeons, midwives and healers whose status is unclear. Tallan observes that the boundary between doctor and healer was blurred in practice, and that medicine was rarely anyone’s full-time job. Green’s own example, quoted by Tallan, is Mayrona of Manosque in Provence, called fisica, who is never recorded in the act of healing; most of the forty-five documents that name her concern her other business, money-lending.¹ A woman could be known as a physician and still leave almost no trace of her patients.

Green’s broader findings, summarized in Maaike van der Lugt’s review of her 2008 book Making Women’s Medicine Masculine, set the frame for the rest of this survey: women did practice medicine and surgery in the Middle Ages, and they treated men as well as women, but their numbers tended to fall toward the end of the period as licensing became more effective and male-run guilds gained power.⁴

A wise matron at Salerno, and the making of “Trotula”

Southern Italy supplies the earliest celebrated case. Orderic Vitalis, a monk writing in Normandy in the twelfth century, described a well-traveled scholar named Ralph Mala Corona who had mastered grammar, dialectic, astronomy, music and medicine. In the city of Salerno, Orderic says, long home to the greatest schools of physicians, Ralph found no one his equal in the medical art “praeter quamdam sapientem matronam,” except for a certain wise matron.⁵ (Thomas Forester’s 1853 English translation renders the city as Palermo and the phrase as “unrivalled except by one most skilful matron”; the Latin of Le Prévost’s edition reads Salerno.⁶)

Orderic gives no name. Historians have long been tempted to identify the matron with Trota,⁷ a Salernitan woman to whom medical writings were attributed, and through her with “Trotula,” the name attached to a widely copied set of texts on women’s diseases and cosmetics. Green’s research, as van der Lugt summarizes it, separates these figures. The Trotula is an ensemble of three texts, and only one of them speaks in a distinctly female voice; the other two were written by men. “Trotula” is best understood as a literary persona, distinct from the historical Trota of Salerno, who wrote a general work on medical treatment.⁴ Green studied some 150 manuscripts and early printed copies of the Trotula, and found that the readers and owners of medieval texts on women’s medicine were overwhelmingly male.⁴ (Readers interested in how these texts handled menstruation can see our history of menstruation.)

The fuller biography that circulates today is harder to trace. A 2020 article in Hektoen International gives Trota the surname de Ruggiero, a birth around 1050, marriage to the physician John Platearius, two physician sons, and a death in 1097 followed by a funeral procession more than three kilometers long.⁸ No medieval source for these details was located in research for this article. Mélanie Lipinska’s 1900 history of women physicians, which accepted the identification of Orderic’s matron with Trota and treated the de Ruggiero name as an old tradition, also shows where parts of the story came from: the family name appears in early modern authors, including Antonio Mazza’s history of Salerno printed in 1681, and Lipinska herself remarked that Mazza’s attribution of further works to Trota would be more valuable had he named his sources. The marriage to Platearius was a hypothesis of the nineteenth-century Neapolitan scholar Salvatore De Renzi.⁷ Such details should be read as later tradition, not established fact.

What the Salernitan texts do show is that women’s remedies were cited there. Lipinska noted references in Salernitan writings to cosmetics and treatments used by “Salernitan women,” the mulieres Salernitanae.⁷ Those references point to practicing women whose names are lost, which is closer to the general medieval pattern than the story of a single famous professor.

Hildegard of Bingen and the question of authorship

The other woman almost always named in this context is Hildegard of Bingen (1098-1179), abbess of the Rupertsberg convent, visionary and author.⁹ Two works on nature and medicine are attributed to her, known as Physica and Causae et Curae.⁷ According to Foxhall, recent scholars generally accept Causae et Curae as Hildegard’s work, though perhaps as a rough draft she never put into final form, and its authorship is still debated.⁹

Hildegard also shows how modern concerns get projected onto medieval women healers. Katherine Foxhall has traced how the historian Charles Singer, writing in 1917, diagnosed Hildegard’s visions as migraine from the imagery in her Scivias, and how that retrospective diagnosis outlived its author, reappearing for decades in medical and popular writing.⁹ Singer’s purpose, Foxhall argues, was partly to fit Hildegard into a narrative of scientific progress by explaining away her religion.⁹

In van der Lugt’s summary of Green, Hildegard and Trota appear as exceptions that prove a rule: both were only marginally involved in the new scholastic medicine of their time.⁴ Their fame tells us more about what later readers wanted from the Middle Ages than about how most women healers worked.

Women in the records: licences, taxes and contracts

For ordinary practice, the best evidence is administrative, and much of it concerns Jewish women. Because Jews were barred from medical schools, Tallan explains, Jewish practitioners of both sexes trained by apprenticeship, often within their families, and in some places up to ten percent of Jewish doctors were women.¹ Their names survive mainly in Christian records: notarial registers, council minutes, tax decisions, court files and licences.¹

A sample shows how varied the documents are:

• Paris, 1292. A woman named Sarre is listed in the city’s tallage roll as la mirgesse, the doctor.¹
• Manosque, 1321-1322. A Jewish surgeon called Hava, or Fava, treated a wounded Christian man. When the court asked whether she had touched the wound, she was able to say that her son had handled the patient while she gave instructions and supplied the medicines.¹
• Marseille, 1326. Sara de Saint-Gilles, widow of a physician, contracted to teach medicine to a pupil named Salvetus for seven months, providing his board and clothing in return for the fees he earned. Tallan calls her the only woman definitely known to have taught medicine in the Middle Ages.¹
• Barcelona, 1342. Astruga was licensed to practice surgery on Jewish patients without first sitting an examination. In 1387 two women of Lérida, Na Bellaire and Na Pla, had their licences from Pedro IV of Aragon confirmed.¹
• Catania, 1376. Virdimura was examined by physicians of the royal court and given leave to practice throughout the Kingdom of Sicily, saying she wished to care for the poor who could not afford other doctors’ fees.¹
• Aragon, 1381. Na Floreta Çanoga attended Queen Sibila.¹
• Rome, 1399. Manuela and her son Angelo, physicians to Pope Boniface IX, were exempted from taxes.¹
• Würzburg, 1419. Sara received the bishop’s permission to practice medicine throughout the diocese, paying two florins for the privilege and ten more in tax and contributions.¹
• Frankfurt, 1428. A Jewish woman doctor named Serlin asked the council to excuse her from taxes on the grounds of her skill and popularity, and was refused.¹

These documents describe women who were paid, licensed, taxed and questioned in court like other practitioners. They also show the limits of the evidence: they record transactions, not the content of care.

Paris, 1322: a faculty draws a line

By the fourteenth century, the university-trained physicians of Paris were working to control who could practice in the city. The fullest record is the case brought in 1322 by the medical faculty against Jacoba Felicie, a woman accused of practicing without the faculty’s approval. The documents are printed in the Chartularium Universitatis Parisiensis. They cite a statute, which the editors date to about 1220, forbidding anyone who had not been made a master of medicine at Paris and approved by the chancellor from practicing in the city and its suburbs, on pain of excommunication and a fine of sixty Paris pounds. The faculty’s lawyer accused her of practicing “non arte sed sorte, immo sorde”: not by skill but by luck, indeed by filth.²

The case deserves its own full treatment, and Green has devoted an article to it and to the influence of The Portable Medieval Reader on the canon of medieval women’s history.¹⁰ Only one point matters for this survey. Jacoba was not alone. On November 2, 1322, parish priests reported that they had formally warned six people to stop practicing under the same penalties. Besides Jacoba they named two men styled magister, Stephanus Burgondus and Jacobus Lepele; Johanna conversa, whom the editors’ notes identify as the wife of a cloth-cutter and record as later condemned to the sixty-pound fine; Margarita de Ypra, described as a surgeon; and Belota, described as a Jew.² In one document, four women of different backgrounds appear alongside men as practitioners whom the licensed faculty wanted out of the market.

The editors’ own heading for the witness inquiry of October 1322 notes that the witnesses spoke very well of the accused.² The dispute was not about whether she healed patients. It was about who had the right to do so.

Literacy, licensing and the narrowing of women’s medicine

Why did women’s place in medicine shrink as the Middle Ages went on? Green’s answer, as van der Lugt presents it, rests on literacy as much as on law. Most women, and more women than men, lacked basic reading skills even in their own language, so they never had equal access to the text-based medical learning that grew up from the twelfth century onward. Because medieval culture ranked theoretical learning above hands-on knowledge, women could not match men’s authority even in treating women’s diseases.⁴ Van der Lugt adds a point Green acknowledges: restrictive licensing also targeted illiterate male practitioners, and the deepest inequalities in care were between rich and poor and between town and country.⁴

The same review recounts a story, not in Green’s book but in the reviewer’s view an apt illustration of her argument, that the theologian Giles of Rome said he had heard from a famous physician. During a heated argument among physicians about female physiology, a woman “who knew and understood Latin” broke in and held up her baby as evidence.⁴ Her Latin was the exceptional part. It was what allowed her into a learned debate at all.

By the end of the Middle Ages, in Green’s account, normal childbirth was the one area that women controlled outright. Even there, midwives were not counted among the medici, and in difficult births they were expected to call on male physicians.⁴ The rise of male authority over women’s medicine, she argues, was a process running from the twelfth century to the fifteenth, which is why van der Lugt concludes that her work disproves the idea of the Middle Ages as a golden age for women’s control over their own bodies.⁴

The evidence, then, supports two claims at once. Women practiced medicine across medieval Europe, as physicians, surgeons, eye doctors and teachers, and the records place them in Paris, Provence, Catalonia, Sicily, Rome and the German cities. But they did so mostly outside the universities, often without leaving their names, and under growing pressure from institutions that defined medicine as something learned from books. The famous names, Trota and Hildegard, stand at the edge of this history. Its center is the long list of women known only from a tax roll or a summons.

Footnotes

1. Tallan, “Doctors: Medieval,” Shalvi/Hyman Encyclopedia of Jewish Women (Jewish Women’s Archive). ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴

2. Chartularium Universitatis Parisiensis, vol. 2, nos. 811, 813 and 816. ↩ ↩² ↩³ ↩⁴

3. Green, Signs 14 (1989). ↩

4. van der Lugt, review of Green, Medical History 53 (2009), 592-593. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹

5. Orderic Vitalis, ed. Le Prévost, vol. 2, p. 70 (book III). ↩

6. Orderic Vitalis, trans. Forester, vol. 1, pp. 423-424 (book III, ch. 5). ↩

7. Lipinska 1900, pp. 86-89, 97 and 135-139. ↩ ↩² ↩³ ↩⁴

8. Rodilla and López-Castellano, Hektoen International, 2020. ↩

9. Foxhall, Medical History 58 (2014), 354-374, introduction, notes 1, 14, 52 and 76. ↩ ↩² ↩³ ↩⁴

10. Green, Medieval Feminist Forum 42 (2006). ↩