Social History of Medicine Vol. 24, No. 1 pp.

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The Image of the Female Healer in Western Vernacular Literature of the Middle Ages
April Harper*
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Summary. This article examines the image of the female healer in a variety of western medieval secular literary texts. Whilst many depictions of the female healer corroborate the findings of recent studies of womens medical practice, the occasional divergences shed light on changes in cultural, religious and societal values. An advantage to viewing female healers in a literary context is the ability it affords the reader to observe her in her total contextas a physician, but also as a wife, possibly a mother, a queen or a member of a village. In each of these situations, a womans healing is depicted as an innate quality of her femininity. The work of the female healer is at once natural and aberrant. Her literary image serves not only to elucidate those qualities, but also shows how the balance and value of them shift in response to changing social, economic and religious paradigms. Keywords: Literature; medieval; female healers; magic; learning

Literature has long been a medium through which a society articulates its values, and individual authors voice their ambitions, fears and criticisms. However, for the historian using literature to develop social constructs, a variety of pitfalls await. Assuming literature to be an accurate reflection of society has occasionally led to what Penelope Johnson has described as a commendable effort, but a technique which backfires because of inadequate historical evidence.1 We must acknowledge that literature is a vehicle for transmission of ideas and ideals and not a mirror, perfectly reflecting the society from which it emanates.2 But should we, as historians, abandon the use of literature in our analysis of the past? Are the pitfalls so extreme that we should relegate our use of literature to pithy illustrations or entertaining examples within more historically based arguments? Efforts to analyse the representations of women, kings, knighthood, nuns and even the law in medieval literature have met with a variety of success and a certainty of controversy.3 Indeed, the traps and complexities of using literature within historical arguments have deterred many from using literary sources in any depth within their work. However, for both the social historian in general and for the social historian of medicine specifically, there can be few better tools to help us answer questions regarding the public perception of the craft, its practitioners and the changes within medicine, especially in reference to the female healer.4

*232 Netzer Administration Building, State University of New York, College at Oneonta, Ravine Parkway, SUNY Oneonta, Oneonta, NY 13820, USA. Email: Harpera@oneonta.edu
1 2

Johnson 1988, p. 388. For comparison, see Kaeuper 2007.

See Johnson 1988; Daichman 1986; Bloch, 1977. For contrast, see Burgwinkle 2004. 4 Mulvey Roberts and Porter (eds) 1993; Porter 1985.

The Author 2011. Published by Oxford University Press on behalf of the Society for the Social History of Medicine. All rights reserved. doi:10.1093/shm/hkq111

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Women and Medicine

Womens health was womens business; the accuracy of this assumption is at the heart of Monica Greens groundbreaking article, Womens Medical Practice and Health Care in Medieval Europe, in which she explores two fundamental questions about womens health and health care in the Middle Ages: namely, who cared for women and what kind of medicine did women practise.5 She challenges the long-held view that the history of womens health care can be considered coextensive with a history of women medical practitioners.6 Collecting data from several key prosopographical studies of physicians in France, England and Italy, Green shows the majority of female practitioners were not midwives. In fact, over two-thirds of women medical practitioners were listed as barbers, surgeons, physicians, leeches, apothecaries, empirics and even sorceresses.7 Debra Stoudt similarly argues against the traditional view that female healers were almost entirely untrained folk-healers and midwives. The twelfth-century German legal records she examined reveal many women practising medicine, most of whom practised surgery, and specifically battlefield surgery. In her study are examples of a female practitioner in Frankfurt who healed mercenaries of their extensive battle wounds, and that of two other women who were locally famous for their surgical skills and wound draughts used in treating wounded soldiers.8 Several German medical compilations also refer to the work and expertise of women. The most striking example of such is Count Palatine Ludwig Vs twelve-volume book of medicine written in Heidelberg in 1502, which includes over 1,300 recipes attributed to female physicians.9 The diversity of female medical practice proven in these studies is reflected in the literature of the period.10 One of the first literary references to female physicians in western Europe comes from Tacitus (c. 56117 CE), who remarked that German women treated the wounds of men and did not shrink away from counting and comparing the gashes.11 Whilst caring for illnesses and injury among family and friends was a customary duty of women in many cultures, Tacitus special mention of this group of women who accompanied the soldiers and possessed specialised skills for healing battle-related wounds implies that some of those women may have been acting as professional healers. Thus the role of women as healers in Germanic society had ancient roots underlying medieval practice. The image of the Germanic and Scandinavian female healer in the early and high Middle Ages reveals womens medical skills to be frequently linked with ritual and the implications of magic. The lack of strict division between magic and medicine was echoed in the names given to the female healer: saga [wise woman], sage femme [wise woman] and belladonna [good woman].12
5 6 7

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Green 1989, p. 434. Green 1989, p. 436. Green 1989, pp. 4413. 8 Stoudt in Furst (ed.) 1997, pp. 1415. Also Wiesner 1986, pp. 94113. 9 Stoudt in Furst (ed.) 1997, p. 15; Keil in Ruh (ed.) 1991. 10 Although it is impossible to cover all vernacular texts of the Middle Ages in the confines of an article, the

literary texts chosen for this study were amongst the most popular of the period, as evidenced in a number of extant manuscripts throughout Europe and, in many cases, their widely translated and reworked state throughout the Middle Ages. 11 Tacitus 1877, pp. 87ff. 12 See Lemay in Kirshner and Wemple (eds) 1985; Talbot and Hammond 1965, p. 211. Monica Green notes the use of the term old woman or wise

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Icelandic sagas of the twelfth and thirteenth centuries frequently mention women healing warriors with skill and magic. Grma the Greenlander from Fstbrra saga and Heir, from Biarmiland in Haralds saga hrfagra are described as leeches and Fiurr the wise healed the injuries of two men wounded in hlmganga, the Norse form of the duel.13 The laying-on of hands combined with runic magic is mentioned in Sigrdrfuml and was also practised as a form of diagnosis in which a mans mother or foster mother would touch her son all over before a battle to determine what wounds he would receive.14 Most examples of healing illustrate women performing surgery and other medical care without magic, but amulets and curing stones were occasionally part of the practice of the healer and specifically, the female healer. The literature depicts their use most commonly as stones of life, which staunch bleeding and have curious, non-medical uses such as making the holder invisible or granting his wishes.15 Many of the texts which describe the use of such magic were written in the twelfth and thirteenth centuries, during and after the Christianisation of Scandinavia. However, topics and people presented in the works were commonly set in the past or covered a large amount of time, encompassing years or even centuries. When analysing the image of magical healing in these texts, it would be a mistake to see the use of magic in healing as a vestige of the past. Although countries such as Iceland were often converted by their kings virtually overnight, often measures were taken to preserve or tolerate the pagan religions.16 These texts are no doubt recreating images of female healing in the past, but most likely, were also commenting on a degree of contemporary practice. An example is found in the descriptions of runic healing in the eleventh-century poem in which a female healer/seer has been called upon to perform a seidr for healing:
Ogre of wound-fever, Lord of the ogres, Flee now! You have been discovered. Have for yourself three pangs, wolf. Have for yourself nine needs, wolf. Three ice runes. These ice runes will grant that you be satisfied, wolf. Make good use of the healing-charms!17

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However, in the wrong hands, such magic could go terribly wrong, as witnessed by Egil Skalagrimsson in his Saga. The runes which were carved into a whale bone to facilitate the seduction of a reluctant girl instead make her deathly ill:
Those who carve without knowledge Should not write the runes [ for] Great misfortune will follow When the secrets are misused
woman should not be understood as midwife but as a general term for healer. Green 1987, p. 43, note 8. 13 Ellis-Davidson in Newall (ed.) 1973, p. 40, notes 20 and 55. See also Steffensen 19678, p. 188. 14 Ellis-Davidson in Newall (ed.) 1973, p. 27.
15 16

Meaney 1981, p. 102. For vestiges of paganism in Scandinavian culture and mediation between pagan and Christian parties in Iceland, see Schn 2004, pp. 1703. 17 MacLeod and Mees 2006, p. 118.

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I have seen ten letters carved Out of a bent bone They brought on the pain That tortured the young girl.18

Egil illustrates that not only were the runes carved in ignorance of their power, but possibly with dark magic as they were forcing the girl to act against her will, which damaged her health.19 The use of magic became more suspect, although still practised in popular medicine and society through the thirteenth century. Evidence of this is shown in the Icelandic civil and religious law code, the Grgs, which states: People are not to do things with stones or fill them with magic power with the idea of tying them on people or on livestock. If people put trust in stones to ensure their own health or that of cattle, the penalty is lesser outlawry.20 While institutions of power became less tolerant, the use of the term magic or the use of magical objects did not necessarily carry pejorative connotations for medieval people. In Malcolm Camerons work on Anglo-Saxon medicine, he notes the use of prayers, charms and chants in preparing medicine.21 For medieval people, a prayer, a charm, or an object all served multiple purposes and the difference between a miracle and magic was often blurred or perhaps inconsequential to the patient who was healed.22 Before the regulatory efforts by the Church and the Faculty of Paris in the thirteenth century, medicine enjoyed a somewhat independent realm of authority. This lack of regulation and the ever-present pre-Christian aspects of some forms of medicine had become concerns for the Church. From a secular standpoint, the independent female healer challenged the power of the universities and the growing professionalism of the male medical practitioners. From a religious point of view, she likewise presented a challenge in the long-standing connections between women, healing and religion in pagan societies, and the newer threats of heresy that defied Church authority, such as Catharism, in which women played a large part and medical/religious rituals such as the laying-on of hands were commonplace.23 The vagaries of womens medical practice were made even more difficult to define within the growing Christian philosophical and scientific circles of the high Middle Ages. The focus of discourse in the philosophies of Anselm, Aquinas and others centred on the source and logical/scientific rationale behind phenomena. This approach had a profound impact upon the image of the female healer. Emphasis in theological writings was placed on topics such as the nature of God and miracles. Miracles were categorised as either contra naturam or praeter naturam. For whilst the learned man understands the miracle of healing, through close study, as a representation of Gods abilities, the ignorant man or woman misconstrues something as miraculous/

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18 19

Sturluson 1976, ch. 35. Higley 1994. The damage caused by female healers aberrant use of magic is a common theme throughout the Middle Ages. See the fabliau Auberee. 20 Grgs 1980, paragraph 7.

21

Invocations served a dual purpose of imbuing the medication with a power but also acted as a timing device in preparation of pharmacopeia. 22 Cameron 2006; Weston 1995; Meaney 1981. 23 See Hancke in Brenant and Dieulafait (eds) 2005; Barber 2000; Grundmann 1995; Moore 1994. For contrast, see Fichtenau 2000 and Hanssler 1997.

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magic which the learned man would understand as natural. This kind of exploration of power and the definition of what was natural also called into question those who worked with nature and the body, and thus the wise woman fell under harsh scrutiny for the source of her healing abilities. The literature of the period reflected this philosophy. When analysing the changes in the depiction of medical care within the literature of the twelfth century onwards, it seems to have become necessary to show that the skills and tools of a physician excluded magic. Thus a greater emphasis in the holiness of especially the female healer and a clear discussion of her power source was needed.24

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Miracles, Magic and Medicine

This conflation of images of women as both good and bad, Christian and demonic, helper and curse is as much about the image of women in general in the Middle Ages as about female healers. And, as with the Ave/Eva split in the images of holy women and queens, we see a definite division in the image of the female healer in the literature of the high and late Middle Ages.25 In their work exploring the relationship between miracles and magic within medicine, both Peter Dinzelbacher and Richard Kieckhefer independently note a division of female healers into a good/bad dichotomy in relationship to their supernatural ability. Both the holy and the demonic engage in a kind of magic, both depend on a secret or specialised knowledge, and both yield impossible or at least remarkable results. The appearance, methods and results of holy cures and unholy magic are remarkably similar, as are the women who practise these seemingly divergent methods of healing. A surprising fluidity exists between images of female sanctity and female heresy or witchcraft; some women, including the extreme example of Joan of Arc, who were suspected of witchcraft, were later recognised as saints. Conversely, some holy women were later exposed as nothing more than impostors, or worse, witches.26 Even more confusing is the practice of a small number of women in medieval life and literature who seemed to alternate between these spiritual states.27 As Kieckhefer notes, magic was not limited to any specific group, but rather saints, wise women and physicians shared a common magical tradition.28 What separates the two identities of healer and witch is not their ability to heal or the means by which they did so, but the source of the power they drew upon to enact their healings.29 This dichotomy is obvious in literary works from the twelfth and thirteenth centuries, as is a growing discomfort with and intolerance towards those who would cross the increasingly rigid lines between holy and demonic powers of healing. An excellent case study is the romance of Tristan.30 The earliest extant form of the romance, Brouls Tristan, draws
24

Bynum 1988. Thanks to Sumi David for sharing her expertise and sources on the subject. 25 Nelson in Baker (ed.) 1978, pp. 3177; Crawford 2007. 26 An excellent example is Guglielma of Brunate who is still locally venerated, but whose links with heresy deny her canonisation. 27 Herzig 2006; Bynum 1988, pp. 224.

Kieckhefer 1990, p. 57. Kieckhefers argument is controversial. For a different approach to the connection between holiness and witchcraft, see Klaniczay 19901. 29 Dinzelbacher 1995; Kieckhefer 1994. 30 First mention of the tale is in the eleventh-century Welsh Triadsalthough recent scholarship argues a long oral tradition going back to 780. Schoepperle 1913, pp. 2837; Bromwich (ed.) 1961, p. 329.
28

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heavily on Celtic themes and narratives styles, exhibiting a world in which monsters, fairies, magic and Christian figures intertwine without conflict. Although written in the twelfth century, Brouls work is representative of the early Arthurian legends, such as Culhwch ac Olwen and the Mabinogion, in transgressing borders between the holy and unholy, as well as between supernatural power and educated skill.31 Although written almost contemporaneously, the Arthurian romances differ from the sagas in their representation of healing and magical power. Whilst the sagas often exhibited the power of words, spells, charms and divining in medicine, the foci of healing power in the romances is often through wondrous herbs and unguents potions and artefacts with marvellous, mechanical properties.32 Although the materials still possess wondrous and marvellous properties, the emphasis placed upon their use shifted from the mystical to the medical. While the manuscript of Brouls Tristan has been terribly damaged and much of the opening chapter has been lost, the text frequently makes mention of powerful potions brewed by women, and Tristans lover, Iseult, is mentioned as the healer of his wounds. Within Brouls Tristan, all female characters practise some form of medicine without discussion of source or training, but also without detail of the medical treatment given which, in light of the detailed descriptions of treatment given in texts which preceded Brouls work and those which followed it, seems to be an anomaly. The explanation might be in the missing portion of the work. Upon analysis of later manuscripts which derived from this version of the story, complex images of healing are found that illustrate both skill and a holy power source in the will of God. However, such an assumption would argue for an unchanging image of the female healer within the textual cycle, which evidence from other versions and later texts discredits. An alternative, though undoubtedly controversial understanding of the image may be that Brouls Tristan is a transition piece in the image of the female healer. Rather than engage in the debate over power source and nature of healing as miraculous/magical, the author merely relied on womens timehonoured position as providers and healers to facilitate the story. The next major work devoted to the Tristan story is likewise named after its author, Thomas.33 Within Thomas Tristan (c. 1170), both Iseult and her mother, the Queen of Ireland, have superb healing powers. The Irish queen is an accomplished apothecary. She not only brews the deadly poison with which she tips her brothers sword, but also makes a powerful love potion for her daughter. The example of this queen illustrates the difficulty of diametrically classifying medical skills, and the difficulty that not only the audience but a patient might have in understanding the nature of healing. The malice of her first concoction stands in opposition to the love that prompts her to brew the second potion to aid her daughter in making the best of a loveless marriage. The queen is also a renowned healer who is able to cure Tristan of his wounds, which no other physician in England was able to heal. Thomas version, written in the second half of the twelfth century, contains no discussion of the source of the queens power and no qualifying statements or judgements on her actions.
31 32 33

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Although the extant manuscripts date to the thirteenth century, linguistically, the works may date to 100060. Blakeslee 1985.

Kieckhefer 1990, p. 106; Watkins 2008. Lacy (ed.) 1998.

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However, by the thirteenth century, a dramatic change occurs in the depiction of the female healer. In the prose Romance of Tristan (c. 1240), a clear division is made between the healing techniques of women healers and the sources of their power.34 The first woman to use medical arts in the romance is the stepmother of Tristan. Worried that Tristan will not allow her child to inherit its fathers title and lands, the stepmother sets out to murder the young Tristan. The narrator comments on the queens exceptional ability to brew a poison that was so well prepared and so clear that it could be mistaken for cool water. However, her attempt to kill her stepson goes horribly wrong when a young maid unknowingly gives the poison to the queens infant son. While investigating the babys death, it is concluded that since poison was involved, either a lady or a maiden committed this treachery.35 The connection between a woman and poison seems obvious to the characters, and perhaps even the audience. The misuse of herbal knowledge is the crime of a woman. The woman is then vilified by the narrator as ungodly, standing in stark contrast to the next example of a female healer in the text: the young princess Iseult. After fleeing his fathers murderous household, Tristan comes to serve in his uncles realm. Acting as his uncles court champion, Tristan is injured in a battle with the Irish champion, the Morholt. Although he defeats the Irish knight, Tristan is cut by the mans lance which has been tipped with a deadly poison brewed by the knights sister. Tristans wound cannot be healed and he is shunned by the court on account of the stench of the putrid flesh. Trusting his life to Gods direction, Tristan sets sail and arrives in Ireland, where he is cared for by the Princess Iseult. The description of the princess, her skill, the source of her power and her healing methods stand in stark contrast to the devious, treacherous and ungodly medicine of Tristans stepmother. Iseult is praised as a healer who has more experience in such matters than any man or woman and will attend to it for the love of God and for pitys sake.36 The description of her care emphasises knowledge and the divine source of her powers: She examined his wound and applied such herbs as she thought would be beneficial to him she was sure she would soon have him hale and hearty with Gods help Tristan was in the room for ten days, and each day the young girl took care of him and dressed his wound as she saw fit she took another look at the wound and after she had examined it closely she had Tristan carried out into the sun so that she could see more clearly and she said to him, Now I understand what prevented you from recovering for so long. The lance-head which wounded you was poisoned. All those who tried to heal you were deceived, since they failed to notice the poison. Now that by the grace of God Ive seen it, rest assured that Ill help you with His help. Tristan was extremely pleased to hear this, and said that he hoped God would grant her the power. The young girl sought and procured what she felt would be the most effective for drawing out the poison. And when she had extracted it, she did her best to bring him back to health.37
34 35

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Curtis (ed.) 1994. Curtis (ed.) 1994, p. 12. Womens connection to poison is a common theme in medical writings.See Roig 1988.

36 37

Curtis (ed.) 1994, p. 43. Curtis (ed.) 1994, pp. 435.

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The account of Iseults treatment of Tristan illustrates her skilled use of observation, diagnosis, treatment and dressing, but perhaps even more importantly, constantly reinforces that the source of her power and success is holy. The German reworking of the story in the mid-thirteenth century by Gottfried von Strassburg likewise draws attention to the distinction between sources of medical power, and its importance in the construction of the image of the female healer.38 In the German version it is Iseults mother who is credited with Tristans poisoning and his cure, thus exemplifying the dual nature of medicine and of the theriac she employs, which can cure or kill. The narrator is quick to reveal that her skills are not magical, but come from medical knowledge.39 This statement provides a vital clue in tracking the changing image of the female healer, for by the fourteenth century, the division is no longer just between sources of power, but between learned and unlearned practice. An excellent example is found within Boccaccios Decameron III:9, wherein Gilette, the daughter of a physician, treats the King of France. Though the king is sceptical of her abilities, she declares: Sire, said the girl, you are sceptical of my powers because I am young and because I am a woman; but I would have you know that my powers of healing do not depend so much upon my knowledge as upon the assistance of God and the expertise of my late father, Master Gerard of Narbonne, who in his day was a famous physician.40 Gilette openly acknowledges that she does not have knowledge. Her skill is derived from experience and expertise of her father, placing her as an empiric, rather than a university-educated and licensed physician. She places the value of this experience on the same level as the assistance of God both of which rank higher than the philosophical training of the physician. Whilst it is difficult to know whether to interpret this as a humorous slight against self-assured female empirics, or as Boccaccios support for them, it is clear from the writings of contemporary licensed physicians and surgeons that this lack of knowledge and dependence upon God and experience was exactly what made the female healer not the capable saviour of men, as depicted in literature, but a danger to all. For example, in his La Grande Chirurgie, Guy de Chauliac (130068) testifies to the practice of many healers who have no formal training and worst among these are women surgeons who simply invoke God and the saints.41

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The Educated Female Physician

A progression in the image of the female physician similar to that illustrated in the Tristan cycle is found in the late twelfth-century Arthurian romances of Chrtien de Troyes. Although the female healer is common in these tales, the source of her power remains a divisive issue in constructing her image. Chrtien makes extremely few references to either witchcraft or godly intervention in the medical treatment of his heroes. However, there are important Christian overtones in the glimpses he provides of women caring for the injured and ill. For example, in the romance of Erec et Enide we are told that
38 39

Gottfried von Strassburg 1978. Gottfried von Strassburg 1978, line 6954.

40 41

Boccaccio 1972, p. 245. Guy de Chauliac 1997.

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Enide arms Erec using neither spell nor charm in doing so.42 The inclusion of such a statement by the author appears to be an important distinction that sets the ministrations of Enide in opposition to women of the sagas and early Arthurian tradition. Chrtien also appeals to an educated form of healing when he describes Enides care of Erec after he is wounded in battle. She gives him invalids food and drink: wine mixed with water; for unmixed it is too strong and heating.43 The implication of this passage is a learned form of treatment in accordance with humoral theory. Enides immediate care makes it possible for Erec to journey to his friend Guivrets castle to receive medical attention from his fellow knights sisters. On three occasions, Chrtien notes the sisters are maidens. They live in isolation, beauty and tranquillity. The likeness of the sisters enclosure to that of a convent is clear, and their practice is clearly devoid of magic or any demonic taint; rather, they exhibit a highly professional level of care: Guivret escorted Erec to a delightful, airy room in a remote part of the castle. His sisters exerted themselves to cure Erec and Erec placed himself in their hands, for they inspired him with perfect confidence. First, they removed the dead flesh, then applied plaster and lint, devoting to his care all their skill, like women who knew their business well. Again and again they washed his wounds and applied the plaster. Four times or more each day they made him eat and drink, allowing him, however, no garlic or pepper Then to bring his colour back, they began to give him baths. There was no need to instruct the damsels, for they understood the treatment well.44 The treatment, in its removal of dead flesh and use of lint to dress the wound, is similar to that advocated in the Surgery of Roger Frugardi (Roger of Salerno) c. 1170.45 However, the daily washing of the wound and reapplication of the bandage proves to be more curious, as it places this seemingly dry wound treatment in the midst of the wound debate of the thirteenth century. For over 1,000 years, most physicians and surgeons held to the teachings of Galen (130200 CE), which encouraged the bringing forth of laudable pus in the treatment of wounds. By the thirteenth century, surgeons including Hugh de Lucca, Theodoric Borgognoni of Cervia and Henri de Mondeville, advocated a dry wound treatment in which wounds were washed, sometimes with wine, and bandaged without the added irritants and corrosives to encourage pus. Far from being laudable, pus was viewed as a negative result of injury and contrary to healing.46 This debate raged throughout the thirteenth century, making Chrtiens work all the more noteworthy. For how do we understand the presence of what appears to be a case of dry wound treatment in a mid-twelfth-century literary text?47 Although such detail could call into question the dating of the piece, the historical evidence within and surrounding the work firmly points to the twelfth century. Many other writers of this period, as illustrated in the Tristan romances, simply omitted detail in healing treatments; in fact, there was little precedent for detailed medical

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Chrtien de Troyes 1970, lines 691746. Chrtien de Troyes 1970, lines 516972. 44 Chrtien de Troyes 1970, lines 5183215. 45 Hunt (ed.) 1994, vol. 1, p. 46
42 43

46

For dry wound treatment, see Theodoric 1960, vol. 1, pp. 1379. 47 Macdougall 2000, p. 254.

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descriptions in secular texts. Inclusion of such detail seems more in line with Chrtiens tendency to assert his wide-ranging knowledge than as a literary trope. For example, in other works he uses his characters to espouse advice on topics such as theological debate and secular law with accuracy and expertise.48 As court poet to Marie de Champagne, Chrtien would presumably have access to court physicians or would have been part of an intellectual community including medical practitioners. Do we then understand this to be evidence of an earlier beginning to the wound debate than medical texts indicate?49 Equally puzzling is the herbal element to the sisters healing, for they deny the knights garlic and pepper. Garlic had long been known as an all-purpose theriac. Both garlic and pepper had humoral warming properties that would often be used in wound treatment. The denial of such standard treatment might, upon first consideration, be viewed as evidence of Chrtiens lack of medical knowledge.50 However, it is far more likely that such treatment may have communicated to the audience the severity of Erecs wounds. Perhaps Erec was so badly injured that a quick heating of his body through use of pepper and garlic would produce a radical change in his humours which could have proved traumatic or even fatal. This understanding of the passage seems to be most congruent with a similar passage later in the text in which Erecs wife Enides cares for him in the forest after he is attacked by a band of knights. Erec is badly injured and suffers great blood loss in the battle. In her delicate care of her husband, Enide waters down his wine, a humoral agent with warming properties, in accordance with the severity of his wounds. The virginal state and cloistered lifestyle of the sisters evoke the image of the nun, but the reference may be even more pointed. The treatment also bears a close resemblance to the humoral and healing techniques found within the writings of the abbess and philosopher, Hildegard of Bingen. Hildegards medical works, the Physica and the Causae et Curae, written between 1150 and 1160, demonstrate not only her particular understanding of Galenic humoral theory, but also contain detailed discussion of diagnosis, regimen and medical treatment to restore the balance of humours.51 Chrtien wrote Erec et Enide only ten years after Hildegards medical works were completed. His works are the first to deviate from casting the wife or a mother-figure of the hero as his healer and to cast cloistered virgins in this role instead. Although it is impossible to state with any certainty that Chrtien was evoking the image of Hildegard and her expertise, the timing of this shift in the literature does seem significant, even without any reference to a contemporary healer. The image of learned female religious figures implies not only a virtuous vessel and a holy source of the healing, but it also places the healing within the education and skills of an educated person and more precisely, a woman whose authority, power and practice was sanctioned by the Church.52 The increasing formalisation of medical education in the twelfth century and descriptions of detailed medical treatment are found in a variety of other romances and lais, such as the late twelfth/early thirteenth-century Aucassin et Nicolete. In this poem, the protagonist falls from his horse, dislocating his shoulder. Nicolete diagnoses the
Chrtien de Troyes 1981, lines 47955006. Theodoric 1960, vol. 1, pp. 1379. 50 Jacquart 1990.
48 49 51 52

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Hildegard 2008 and 1990. For Augustinian approaches to wonder, marvels and miracles, see Bynum 1997.

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problem through palpation and manipulation of the joint and puts the shoulder back into place manually. She then anoints the shoulder with herbs and trusses it in place with the hem of her chemise.53 In her twelfth century lai, Les Deuz Amanz, Marie de France continues this trend toward the professional with the inclusion, not of an educated heroine or a nun, but of an actual female physician trained at Salerno. The female lover urges the hero to seek a female physician: I have kindred in Salerno, of rich estate. For more than thirty years my aunt has studied there the art of medicine, and knows the secret gift of every root and herb. If you hasten to her, bearing letters from me, and show her your adventure, certainly she will find counsel and cure. Doubt not that she will discover some cunning simple, that will strengthen your body, as well as comfort your heart.54 In a similar vein, the character of Morgan, who appears in a wide variety of Arthurian works, is first encountered in tenth- and eleventh-century texts as a shadowy fairy/ pagan goddess figure who is just as capable of murder as she is of healing with her herbal knowledge and magical powers. A maker of wondrous bandages and ointments that cure even the gravest of injuries, Morgans ministrations are often sexually charged and associated with dark magic. She is often as deadly as she is helpful. In contrast, by the early twelfth century, Morgan is cast, not as a vengeful fairy or a magical medic, but as a great healer and is entrusted with the mortally wounded Arthur.55 However, in the early fifteenth-century Mort dArthure, the discomfort with the pagan elements of her character and healing and perhaps her role as an uneducated healer were unpopular enough to warrant her complete dismissal from the role of physician.56 When Arthur is injured in this version of the tale, a surgeon from Salerno was called to heal the king.57

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The Diminishing Presence of the Female Healer

Although emphasising her godly source of power and skill made the female healer of literature more acceptable, from the fourteenth century onwards, a subtle decrease in the presence of female healers across all genres of literature becomes apparent. This continues into the fifteenth and sixteenth centuries to the almost total exclusion of these characters. The exclusion or limitation of female practitioners in literature echoed developments in medicine itself from the twelfth century onwards. The rise of the universities and subsequent licensing of physicians excluded women, who were barred from study at the universities and thus from legally practising within the field as medicine changed from a skill to a profession. The guidelines in the Rules of the Medical Faculty of Paris, 12704, required those seeking licensing in medicine to attend courses for five and a half to six years, in order to guarantee proper medical knowledge so as to reduce the number of charlatans, and indeed the competition.58 More restrictions were passed against Jews,

53

Bourdillon (ed.) Aucassin et Nicolete 1970, sec. 26, lines 1014. 54 Marie de France 1986, lines 12042. 55 Lacy 1993, vol. 5.

56 57

Malory 2004. The sex of the surgeon is not mentioned. 58 Denifle (ed.) Chartularium Universitatis Parisiensis 18919, vol. 1, pp. 48890.

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pharmacists and surgeons in 1271 and against illicit practice of medicine in general in 1352.59 These likewise limited the ability of women to practise medicine by restricting the kinds of medicine and treatment they could perform. The terminology of these restrictions grouped all female healers together with old wives, monks, rustics, herbalists and students not yet trained or coming from foreign parts ignorant of the science of medicine.60 Although the emphasis seems to be on separating those practitioners who heal from those who could harm, the real effect of these regulations in excluding women is apparent in the trials of female physicians, such as Jacqueline Felicie.61 In 1322, she was brought to court on charges of practising medicine without a licence.62 Though Jacquelines defence brought forth many witnesses with compelling testimony of her excellent skills, and her methods of diagnosis and treatment were indicative of skilled training, the Masters of Medicine declared her still to be guilty of violating the law. Jacqueline protested that the law specifically mentioned amateurs and quacks, neither of which category applied to her, as illustrated in the review of her skills. Regardless, the masters determined that the philosophy and science of medicine could not be learned through experience, and that Jacquelines practice constituted a threat to the lives of her patients. No doubt the competition empirics such as Felicie offered to the licensed physicians of Paris also played a part in their decision. The court went on to sentence three other female practitioners alongside Felicie and would later use the case as precedent against other female practitioners such as Peretta Peronne in 1411.63 Peronne was brought before the court by the surgeons confraternity of St Cosmas and St Damien. Similarly, it was not only the gender of Peronne that presented a challenge to the surgeons, but her role as their competitor. Her trial transcripts specifically mention that she was brought forward due to her insistence to advertise herself publicly as a surgeon, even placing a sign to the effect outside her door. Peronne was forbidden to practise surgery and her medical books were brought to the faculty for inspection. Although she asserted she was a skilled and a proven practitioner, Peronne was found to be uneducated in her surgery and her herbal knowledge.64 The importance of learned medicine and understanding of textual sources was upheld in her conviction. The emphasis upon text-based education and university training was not only the concern of the faculty of Paris. The Chancellor of the Faculty of Medicine at Montpellier, Laurent Joubert, spoke openly in opposition to the use of empiric observation over textbased logic. He especially targeted: ignorant women who know not even to read or write and know nothing at all about medicine, as to discourse and reason a doctor, considering the nature of an illness and the forces of the patient will prescribe the quality of the nourishment better than the most knowledgeable (or rather) the most vain and presumptuous woman in the world.65
59 61 62 63

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Denifle (ed.) Chartularium Universitatis Parisiensis 18919, vol. 1, pp. 51618. 60 Denifle (ed.) Chartularium Universitatis Parisiensis 18919, vol. 4, pp. 4067. See Levin in Levin et al. (eds) 2000; Brooke 1995.

See Green 2007. Amt 1993, pp. 10812. Broomhall 2004, pp. 545. 64 See Dumas 1996. 65 Broomhall 2004, p. 57.

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The debate in literature and in law over the superiority of knowledge versus experience was being carried out with a sharp division between the voices of authority and the voices of the healers and patients. The challenge to authority was felt at many levels and seemed to target not only the licensed physicians, but also the bodies that granted them their authority as wellthe university and ultimately the Church. For whilst the claim to have the support of God placed female healers in literature and reality in the category of good healing, it had a curious side-effect of claiming direct interaction with God. This would seem to sanctify womens breaking of the licensing laws, placing them outside of authority and crossing dangerous boundaries. Such challenges to authority and disregard for social, legal and spiritual boundaries did not coincide well with religious reform movements of the period, two primary goals of which were the consolidation and supremacy of ecclesiastical power and the cleansing of the Church from any vestiges of pre-Christian or heretical traditions.66 Empirics such as Felicie often crossed boundaries between the categories of physician, surgeon and apothecary. Felicie herself was known for a special theriac she brewed which could cure any ailment. This lack of respect for boundaries and the mystery surrounding their work often associated empirics with the old wives and other suspect healers in the medieval medical marketplace. The issue of the source of healing power was of key importance to a Church set on removing the last vestiges of paganism from Europe, as well as rooting out any taint of heresy. The prominent role of women in heretical groups of the twelfth and thirteenth centuries was of concern to the Church as well. Women, in groups such as the Cathars, were practising non-sanctioned forms of medicine, and appropriating the rites of sacrament.67 Groups such as the Beguines were also undermining traditional male roles by not allowing men, including priests, into their communities.68 Although the impetus behind this action was to assure the purity of their convent, it was an appropriation of male power and Church authority. As John Coakley shows in his exploration of the relationship of holy women and ecclesiastical men, the main source of conflict lay in the fact that the two sets of powers are based on putatively different authorities: an authority derived from outside the structures of the church in the first instance, and one derived from within those structures in the second. Mens powers were in preaching, teaching and governing the church, but women heeded their own individual callings.69 In this atmosphere, and with the increasingly close ties between the Church and the universities, any infringement of male spheres of authority, or any conduct that bypassed or went contrary to Church authority or doctrine, was met with an increasingly harsh penalty. Felicies presence within the male-dominated realm of medicine, her threat to that institution and her continued empirical method of practice made her a threat to both Church and university. This dual threat is echoed in her dual punishment of a heavy fine, as well as excommunication.70

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66 67

Grundmann 1995. Hancke in Brenon and Dieulafait (eds) 2005. 68 Neel in Bennett et al. (eds) 1989.

69 70

Coakley 2006, p. 7 Magner 1992, p. 110.

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Conclusion
By the sixteenth century, the image of the female healer in literature was relegated almost entirely to fairy figures. Her presence was limited and her relation to the real female healer and her medical knowledge would be severedshe was a fantastical creature with mysterious abilities, not a physician. The detailed accounts of healing became absent and the otherworldly fairy functioned more as a deus ex machina rather than a representative figure of the female healer. The progressive exclusion of women from education, professional licensing and the male sphere of power had succeeded in limiting the legal practice of women, and by association had eliminated their literary counterparts.71 The final image of Malorys work is Morgan sailing away with the injured Arthur to the mystical lands of Avalon where he is destined to be healed and someday return to his kingdom, but what of his female healer? Was she intended to return as well or was she to disappear or continue to practise her craft in the mists of obscurity, relegated to the fringe of both society and the imagination? What was the fate of the image of the female healer in literature? Knights and soldiers in literature did not stop fighting who healed them? Did the healers of literature disappear? Here again, the healer of literature seems to echo the trends of the female healer in society. By no means did the female healer of reality disappear, for despite the efforts of the authorities, women were still practising medicine. Peretta Peronne complained that there were many female surgeons and healers who were practising their crafts and were not being prosecuted.72 Women such as Novella dAndrea were found, like Gilette of the Decameron, continuing their fathers medical workin Novellas case, she even gave her fathers lectures to his medical class when he was ill.73 The small numbers of female practitioners found in excellent studies such as those of Monica Green show the presence of women in a variety of medical careers and imply larger numbers of female healers who practised undocumented.74 No longer prominent, but certainly not gone, the female healer in literature reflects the search for her counterpart in history. The frustrating glimpses and partial stories of these women place historians of medicine and historians of literature on equal footing, attempting to avoid the pitfalls of their assumptions while creating an image of the female healer. And perhaps in this way, the images constructed in literature can aid the historian in supplying yet more information as we interpret the ideals and images of the female healer as well as adding voices to the historical debate over her place and practice in society and how that society, at all levels, viewed her.

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Acknowledgements
I am grateful for the time, patience and excellent suggestions of my editors, Clare Pilsworth, Debby Banham and the external readers. Many thanks must also go to Sumi David, Linsey Hunter, Elizabeth Thomas, Caroline Proctor and Iona McCleery for their time, friendship and generosity in sharing their enthusiasm, ideas and sources.

71 72

Green 1989. Dumas 1996.

73 74

Fulda 1904. Green 1989.

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