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240
BOOK REVIEWS / COMPTES RENDUS
“The Development of the Trotula” is the result of eight years of study of the
most widely used gynecological medical text in the Middle Ages, the Trotula.
This work was mistakenly attributed in its entirety to a woman known as Trotula, a physician from Salerno, the southern Italian port city, which was the
most renowned medical center in the 12th century. Through detailed study,
Green shows that the work is likely a fusion of three different texts. The first may
have been derived in part from an Arabic text translated by Constantinus
Africanus. The second may have been contributed to by Trota of Salerno, and the
third possibly originated from a different author, also from Salerno. These three
texts were fused at a later date, and even later vernacular versions appeared.
Finally in 1544 George Kraut produced a printed version, much reduced in
terms of content.
In the essay on attitudes towards women’s medicine in 14th- and 15th-century France, Green examines possible reasons why Trotula was omitted from the
15th-century writer, Christine Pizan’s book on remarkable women, “Cité des
dames.” She believes that Christine may have associated Trotula with the highly
misogynistic “Sécres des dames,” a text intended to teach men about women’s
bodies, which circulated widely at that time. Lastly, in the essay on female medical literacy in medieval Europe, Green postulates that even though literacy
levels were rising among women in the late medieval period, there was only a
modest increase in women’s ownership of medical literature. She examines various factors which may be responsible for this, such as the exclusion of women
from secondary education and the study of Latin.
The book is aimed at an academic audience which has knowledge in this
area. It is a very detailed, well researched and carefully reported scholarly work.
Consequently it may be a difficult read for individuals who do not have a lot of
background knowledge in this area. But if a reader perseveres, he or she will be
rewarded by meeting fascinating characters such as Trota, the mysterious Salernian physician; Christine de Pizan, the first woman in western literature known
to make a living from her writing; and Constantinus Africanus, the Benedictine
monk and translator of Hippocrates, Galen and many other ancient writings.
The reader will also learn fascinating facts about medical knowledge and beliefs,
as well as attitudes towards women and life in general during the Middle Ages.
I can recommend this book as a fascinating reading experience, which is thoroughly researched and referenced. The book will be especially of interest to
those with an interest in the history of women’s health.
LAURETTE GELDENHUYS
Dalhousie University
The Disease of Virgins: Green Sickness, Chlorosis, and the Problems of
Puberty
Helen King
London: Routledge, 2004, ix + 196 p., £60.00
Helen King’s The Disease of Virgins is an important addition to the historiography
of specific diseases and their ever-changing cultural meanings. Recent works of
this kind include Jock Murray’s history of multiple sclerosis and Roy Porter’s
study of gout, not to mention the growing number of monographs which deal
with such scourges as tuberculosis and cancer. As the preface of the book points
BOOK REVIEWS / COMPTES RENDUS
241
out, however, green sickness presents a particular challenge to the historian. It
was a malady which was known by a variety of names and a shifting array of
symptoms, and it proceeded to “disappear” from the medical landscape during
the first half of the 20th century. The author is not concerned, however, with the
question of whether this disease was “real” or not from a present-day medical
perspective. Instead, she seeks to understand its historical reality—its origins, its
changing identity, and the social functions it served.
King explains how a digestive or liver disorder of women and men, known to
lay people in early modern England as “green sickness,” was transformed during the latter part of the 16th century into a menstrual disorder of young girls,
called by some “the disease of virgins,” and by others “chlorosis,” a name first
used in print in 1619 by Jean Varandal. A key moment in this transformation was
the publication in 1554 of English physician Johannes Lange’s letter of advice to
the father of a sickly young girl named Anna, which helped to re-define green
sickness as a disease of pubescent girls. It also established a new symptom picture of the malady, which included failure to menstruate, a greenish pallor,
weakness, and eating disorders (King does explore the possible relationship to
anorexia nervosa). As long as the Galenic model of the body remained dominant, the common treatments for the disease were bloodletting and marriage—
the latter being of paramount importance because it would “open up” the body
and allow menstrual blood to descend from the body as it should, rather than
cause trouble by flowing in the wrong direction.
Diseases perceived as “new” (like those which “disappear”) raise questions
about the authority of the medical community to define our physical reality.
Part of King’s purpose in this book is to situate the origins of the disease of virgins in the wider context of Renaissance medicine, which saw knowledge of the
Hippocratic corpus greatly expand, but produced no consensus in the profession
regarding the competing claims of Hippocrates, Galen, and newer medical
authorities. Lange made use of a newly translated classical text (Hippocrates’ On
the Disease of Virgins) to show that Anna’s ailiment was known in ancient Greece,
thus doing his part to reinforce the growing authority of Hippocrates in the
field of gynecology. But, as King discovered, nowhere in that work can one find
the actual symptom pattern now put forward by Lange. What it does contain is
the Hippocratic warning that only marriage will cure the health problems which
inevitably beset pubescent girls who remain virgins (though the meaning of
“virginity” is also contested territory). King argues that the early modern disease
of virgins was brought into existence at least partly to manage the sexuality of
young women at a time when a high value was placed on early marriage, and
also, perhaps, when the single state was less valued due to the Protestant Reformation as well as concerns over the uncertain future of the crown under a virgin queen. Of course, the implication that sex cures chlorosis also put physicians
in a morally ambiguous position, a theme King also explores.
This was not a disease which was better understood as time went by. By the
19th century, the idea that it was a liver problem was again becoming popular;
many physicians focused on constipation as its cause; and there was rising
interest in the possibility that it might be a blood disorder named “hypochromic
anaemia.” King relates its disappearance in the early 20th century to young
women’s changing status, but it also seems to have resulted from the fact that
more clearly defined pathological conditions were being identified and named,
creating something of a vacuum where green sickness once was.
242
BOOK REVIEWS / COMPTES RENDUS
In general, the social analysis of the disease, especially from the 18th century
onwards, is not the strongest aspect of this book. For example, it suggests ways
in which the disease of virgins was used to medicalize and control the lives of
young women, but leaves the reader curious to know more. A more chronological, rather than topical, organization of the material might have produced a
stronger understanding of the changing social contexts and uses of the disease
over nearly four centuries; in many places, interpretations from widely separated periods are juxtaposed without a strong sense of what happened in
between. The Disease of Virgins is, nonetheless, a very readable work which does
not gloss over the complexities surrounding this mysterious ailment, and it is
richly grounded in King’s extensive knowledge of the classical legacy.
PATRICIA JASEN
Lakehead University
Written in the Flesh: A History of Desire
Edward Shorter
Toronto: University of Toronto Press, 2005, 321 p., $39.95
Many readers will find this book stimulating, others infuriating. Edward Shorter
has written a history of sexual desire in a way that has come to be expected of his
work. It is well written, engaging, full of wonderful anecdotes, wide-ranging in
time period covered, and controversial in interpretation.
Unlike most books on the history of sexuality which focus on attitudes, he has
written a survey “of longing, of what people yearn to do in their heart of hearts”
(p. 3). His thesis, audacious in its simplicity, is that what people want sexually is
brain-driven, already hard-wired in them, a result of biology. In his words, “the
history of desire is the history of the almost biological liberation of the brain to
free up the mind in the direction of total body sex” (p. 4). For him, the history of
desire is a Whiggish narrative of desire and sensuality found (in some Greeks
and Romans), lost (for most of Western history), and reinvented and expanded
(from the 1870s onward). The book exudes his obvious delight to be living at a
time when he considers total body sex possible.
In 241 pages of text, he takes the reader on a whirlwind tour of the Western
world from the Greeks to the end of the twentieth century. Because he is covering so much time and territory, he focuses on the sexual innovators whom he
sees as the “wave of the future” (p. 9) and whom he depicts as representative of
what the body wants or what he thinks the body wants. The book begins in
antiquity with the attempt to locate a baseline of sexual pleasure for both heterosexuals and homosexuals and lesbians. For heterosexuals, the baseline was
pretty one-dimensional—the missionary position. For homosexuals it wasn’t
any more varied—buggery. As for lesbians, there is little to say since few references exist in the past. What he is clear about, however, is that in those few references no mention of anal sex occurred.
Once he has established the baseline of behaviour, he argues that it did not
change for centuries. This lack of sexual adventure he attributes to social/cultural
hindrances: chronic itching, chronic pain, little privacy, a culture not interested in
the sensual delights, and women having to pay the price of sexual pleasure with
pregnancy and perhaps death. Even his chapter on the Romantics makes clear
that their interest was on sentiments and feeling, not sex. Only in the late 19th
century did sexual variation and experimentation begin to emerge in a serious