VEILED PROBLEMS
Women in Medicine
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Galen was once called to the bedside of a troubled woman suffering from insomnia. His examination revealed no fever, no trace of illness, nor any other notable physical findings. He wondered if her issues arose from an imbalance of one of the four bodily humors, perhaps black bile causing depression, or a worry that she was hesitant to disclose. The woman did not answer Galen’s questions, and, when pressed, she hid her head under her scarf.
Bust of a veiled woman. Roman, 193–211 CE. Marble. Said to be from the Greek islands. H. 66 cm. Metropolitan Museum of Art: Fletcher Fund, 1930; 30.11.11. Photo: Metropolitan Museum of Art. Public domain.
This lady not only veiled herself literally, but she was also surrounded by other women in the house who restricted the physician’s access to her. In order to assess the situation, Galen spoke with her maid and kept the patient company when an acquaintance visited to chat about dancing at the theater. In the course of her discussion with this friend, the doctor observed the woman’s color change when a particular dancer came up in conversation. Was the dancer the cause of the patient’s troubles? To confirm his diagnosis, Galen felt her otherwise steady pulse suddenly shift to a wild rhythm at the mere mention of the dancer's name.
A runaway pulse is a love story, to be sure, but this case also illustrates the place of women in Roman medicine more generally. Women are obscured in ancient medical history and seldom have a voice of their own—whether as patients, as practitioners, or even as paradigmatic bodies. Galen’s care for the lovesick lady was mediated by a coterie of women.
Funerary relief depicting a woman having her hair dressed by a coterie of women. Roman, ca. 220 CE. Rheinisches Landesmuseum Trier, Germany. Photo: © GDKE / Rheinisches Landesmuseum Trier, Foto: Th. Zühmer.
In almost all of his stories about female patients—approximately twenty-five cases, only fifteen of which are Galen’s own clients—we read of male doctors’ indirect treatment. It was considered inappropriate for a woman to be alone with a male doctor since modesty was a high priority, and other women therefore acted as go-betweens. Male doctors, Galen included, collaborated with midwives and female care providers, especially when treating gynecological and obstetric matters. In fact, the only exception we find is Galen’s cure of the wife of a man called Boethus, a special case that proves the rule: after working with her midwives unsuccessfully to treat “female flux,” the physician took sole control after asking her husband, at some risk, for permission to “do as I like regarding your wife.” The scene of Galen’s request and Boethus’s consent—the exceptionally rare case of a male doctor being granted direct access to a female patient, especially in a conservative household—is the dramatic turning point of the story and even more important than Galen’s successful treatment. And it was the husband’s consent that was required, not the patient’s own. Roman women lived lives separate from those of visiting men, and such patriarchal structures extended to their medical care.
Most of Galen’s case histories (approximately 350 throughout his extant writings) recount stories of male patients, and the ideal body in his studies was male.
The Doryphoros, or “Spear-Bearer.” Roman, 120–50 BCE. Pentelic marble. Italy. H. 198.1 cm; W. 48.3 cm; D. 48.3 cm. Minneapolis Institute of Art: The John R. Van Derlip Fund and gift of funds from Bruce B. Dayton, an anonymous donor, Mr. and Mrs. Kenneth Dayton, Mr. and Mrs. W. John Driscoll, Mr. and Mrs. Alfred Harrison, Mr. and Mrs. John Andrus, Mr. and Mrs. Judson Dayton, Mr. and Mrs. Stephen Keating, Mr. and Mrs. Pierce McNally, Mr. and Mrs. Donald Dayton, Mr. and Mrs. Wayne MacFarlane, and many other generous friends of the Institute; 86.6. Photo: Minneapolis Institute of Art. Public domain.
In the ancient world, doctors theorized the sexes differently and debated whether there were diseases specific to women; Galen himself believed that women had different humoral constitutions and therefore had a set of conditions to which they were particularly susceptible. When he did see female patients, he treated them according to Hippocratic principles and for conditions that could occur in both men and women (insomnia, fevers, coughing blood, difficulty breathing, stomach problems, an ankle rash) as well ailments that occur only in women (female flux, breast cancer, miscarriage, amenorrhea). It is not surprising that he provided the very highest quality of care, but it is notable that these stories seldom consider the role of the specific female anatomy. Despite the prominent interest in gynecology in the history of ancient medicine, Galen wrote no practical treatises on the subject, and, when the topic did come up, he wrote in a theoretical way. Galen was concerned with regular menstruation as a sign of health since too much blood can disturb the balance of the humors, but men can also suffer from a buildup of blood in other ways. Even stories about female-specific ailments are not usually illustrative of a problem necessarily unique to women. The similarities in Galen’s approaches to treating men and women suggest that he was attuned to the obvious differences between the sexes, yet he did not regard women as belonging to a totally separate medical category.
Galen includes only as much contextual social information about his female patients as is necessary to his stories about them. He occasionally mentions a woman’s social status, but seldom her name, and never her profession. Yet even these details, too, tell some of the tale: “Pylades” is the name of the dancer who sent the lovesick woman’s pulse racing, and the afflicted patient is identified as “Justus’s wife.” What happened next, Galen doesn’t say. . . .
