Little Red Riding Hood and the Invisibility of Older Women

Content Warning: Discussion of Cannibalism, Sexual Assault, Violence.

How old was Little Red Riding Hood? In the earliest, 16th-century versions of the tale, she was around the age of puberty. Other details you might not know include the wolf making the girl eat her grandmother’s flesh (including her sexual organs and breasts) and drinking the old woman’s blood from a bowl before attempting to ravish the girl. But, using her guile, Little Red Riding Hood escapes, with the help of washerwomen who were working on the nearby river. This was a story about a young girl who was not ready to be initiated into the adult world of sex, represented by the wolf (and the blood), who was saved by her own resourcefulness and by a network of older women. To survive the lustful wolf, a combination of youthful wit and the wisdom of age was needed.

You might be wondering where was the woodcutter who saved Little Red Riding Hood (and, in some versions, the grandmother too). Well, he wouldn’t show up until later, effectively replacing the feminine wisdom gained through experience represented by the washerwomen with the image of a ‘good’ and brave man, in contrast to the wicked and savage wolf.

Contextualising Fairy Tales: Little Red Riding Hood in Historical Context

It is often said that fairy tales used to be much ‘darker’ stories and that they have been diluted throughout the centuries – just think of Disney’s saccharine versions of many famous tales. I think that’s too simplistic. But the changes fairy tales go through do tell us a lot about the context in which the stories are being told. There are no ‘right’ or ‘wrong’ versions – and even tracing the ‘original’ story can be a fraught task. Fairy tales often seem to exist in a world of their own: they belong to no one and to everyone, their centuries-long history creating a kaleidoscopic story in which multiple versions coexist, often contradicting themselves, and they can always be reinvented. Being atemporal is one of the many charms of these kinds of tales.

Yet stories are always created (and re-created) in a specific context; they reflect culture and are firmly grounded in a specific time and place. Fairy tales give us clues about what a society values, fears, prioritises, or considers taboo. Little Red Riding Hood was a 16th-century tale from the French countryside. It was a world in which older women were believed to possess ‘secret’ knowledge about the human body: they knew about the mysteries of childbirth and reproduction. They had ‘womb knowledge’: knowledge about the uterus, sure, but also knowledge gained through their bodily experience and sexuality, such as having children themselves. By the 18th century, the world of childbirth was rapidly changing: man-midwives (accoucheurs), surgeons, and physicians were gradually replacing traditional midwives and matrons in the birth room. Maybe it’s no coincidence that Little Red Riding Hood’s story changed: she was rescued by a strong and skilled man, instead of the washerwomen.

You might be thinking that this is a stretch – and I won’t make a case for the woodcutter’s axe being a stand-in for the man-midwife’s forceps, I promise. Still, childbirth was becoming increasingly medicalised (we could even say ‘masculinised’) in this period, and it is possible that changes in popular fairy tales reflected that change. In any case, the colour red in the story is often associated with menstruation and sex – most famously, by psychoanalysts such as Bruno Bettleheim. Although I should probably mention that there was no red cape in the earliest versions. But there was the bowl full of grandmother’s blood from which the girl drank – perhaps symbolically assimilating her adult womanhood through blood, whether from menstruation, loss of virginity, or childbirth. In this version, initiation into the adult world is connected to fertility and reproduction. Reading fairy tales as though they exist outside a specific cultural context is a pet peeve of many historians – myself included. But let’s come back to the older women.

When I started researching 16th and 17th-century recipe books – which included everything from making strawberry preserves, removing bodily hair, writing in invisible ink, and provoking an abortion – I was surprised at how many menstruation recipes I found. Much of women’s health (not to mention fertility) was connected to having regular periods, and both the quantity and quality of the blood were important factors. But, if menstruation was so central, how come I couldn’t find any recipes about menopause? Of course, the word menopause itself didn’t exist yet (it was usually just called the ‘cessation of the terms’ or the ‘end of the flowers’), but maybe I could find recipes about how to treat its symptoms…? But no, remedies to treat these women were nowhere to be found.

Menopause and Transformation: Shifting Roles of Older Women

Many older women report feeling invisible as they age – ‘Invisible Women Syndrome’ is real – and menopause is still under-discussed. In the early modern period, it was usually believed that menopause made the female body closer to the male; according to the humoral theory, the body became drier with age, which explained why there was no excessive blood to purge. Medical writers believed the womb literally shrivelled, becoming unfit for procreation. The Hippocratic theory of the seven-ages-of-man, according to which the body underwent changes every seven years, meant that menopause should be expected at around 49 years old – although writers reported it earlier or much later than that.

With age – and menopause – came facial hair, the loss of teeth, and osteoporosis, which could affect someone’s posture. It is not a coincidence that all of these characteristics were associated with witches, too. There is much overlap between gender and age where witchcraft is concerned. (You can read more about witches and old age here.) Older women could be despised, but they could also be feared. Free from the concern of accidental pregnancy, post-menopausal women’s sexuality and agency could develop beyond what society considered acceptable. Importantly, they could subvert patriarchal values, which they could transmit to young women, and stand in the way of men.

A Deeper Look at Little Red Riding Hood’s Symbolism

Let’s go back to Little Red Riding Hood. In the earliest versions of the story, attitudes about the body, sex, and age can be found everywhere. When the wolf meets the girl, he asks her which path she will take to visit her grandmother: the ‘pins’ path or the ‘needles’ one? Modern readers might imagine these words to describe different kinds of trees in both paths – maybe conifers? But there’s more to it than that. In 16th-century France, pins and needles symbolised different ages for girls. Pins are easier and younger girls would learn to use them first. Plus, they have no opening. Using needles requires time and skill – and needles are made to be penetrated by thread, in a not-very-subtle domestic metaphor for marital sex. If this sounds like a stretch, stick with me. Young girls received pins from admirers and brides received needles to celebrate their entry into adult womanhood. This means that French listeners would probably understand that this is a story about sex. 

So, depending on which version readers had access to, the lesson was different. In later retellings (such as the French version by Charles Perrault or the German one by the brothers Grimm), the girl is taught the importance of obeying her elders and not straying from the (single) expected safe path, not trusting strangers, and learning to differentiate between men who are predators and those she can trust. In the earliest, peasant incarnation, however, the girl learns to trust herself and her guile. When she becomes frightened of the wolf, she tries to leave the bed and run away, but he won’t allow her. So, the girl tells him she needs to do pipi, to which the wolf replies that she can just urinate on the bed. Eventually, Little Red Riding Hood persuades the wolf to let her go outside to relieve herself with a rope tied around her leg so she can’t run away. Once she’s out of the cottage, she ties the rope to a tree and runs towards the river. On the bank across from her, there are washerwomen working. They throw a sheet to the girl and pull her across the river and to safety. When the wolf finds out he has been fooled, he too asks the washerwomen to bring him across the river the same way they did the girl. The women comply, only to let go when the wolf is in the water, causing him to drown.

In this tale, innocence gives place to wit, and instead of a solitary male rescuer, the girl is saved by a group of women – and by herself. She is taught the importance of (female) community. Like her grandmother, the older women who help Little Red Riding Hood might be past the point where they would attract male attention – which many would see as a blessing. But through their lived, bodily experience, they have amassed important knowledge, that can be useful for those younger than them. Just like the girl correctly intuited, they know the wolf is not to be trusted.

These different readings reflect distinct societies and cultures. France in the 16th century was not the same as Germany in the 19th. Not to mention regional variations and all the changes that happened when tales told by countryside peasants were adapted to suit the urban elite. Because fairy tales are by definition ever-changing and contradictory stories, their nature allows and welcomes these contrasting readings. If I had to choose, though, I’d stick to the version with the washerwomen – I just can’t resist a story of female community. Not to mention the cannibalism, and the strip tease that happens before the wolf attacks the girl. But I’ll write about that some other time.

Further Reading

Bruno Bettleheim, The Uses of Enchantment: The Meaning and Importance of Fairy Tales (Penguin, 1976).

Robert Darnton, ‘Peasants Tell Tales’, in The Great Cat Massacre and Other Episodes in French Cultural History (New York: 1984), pp. 9-72.

Mary Douglas, ‘Red Riding Hood: An Interpretation from Anthropology’, Folklore 106, 1995, pp. 1-7.

Julie-Marie Strange, ‘Fairy Tales of Fertility’, in The Routledge History of Sex and the Body: 1500 to the Present, edited by Sarah Toulalan and Kate Fisher (New York: 2016), pp. 296-309.

Yvonne Verdier, Façons de Dire: Façons de Faire: La Laveuse,
la Couturière, la Cuisinière
(Paris, 1979).

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Key Concepts

What is the ‘Doctrine of Signatures’?

In the early modern period, an impotent man might be prescribed boiled orchid roots. But why? Well, they resembled testicles and were consequentially believed to be useful in improving male potency. If you think this sounds weird, stay with me. Efficacy aside, prescribing this remedy makes sense… if you accept the premise of the doctrine of signatures, one of the most influential ideas in the history of medicine. But what exactly was it?

Origins, Development, and Principles of the Doctrine of Signatures

The doctrine of signatures was a way of understanding the world based on analogy and symbolic thinking. In Greek antiquity, Pythagoras (c. 570 – c. 495 BC) had described nature as ruling both the macrocosm and the microcosm. Humans mirrored in their bodies (the ‘microcosm’) the larger world around them (the ‘macrocosm’). Blood brought life to the body, just like water streams did to the land, while bones were like rocks. Hippocratic writers developed this idea, as did later Neoplatonists. If the world was composed of a network of correspondences, that gave people clues about how best to treat the body when it fell ill. (Hence the orchid root treatment mentioned above.)

Being a part of nature, the perfect remedy could be found by those who knew how to ‘read the book of nature’, that is, understand the hidden signs and clues that indicated which plants (though animal and mineral medicines were used as well) could help treat the issue, based on their shape, texture, colour, or smell. So, just like the testicle-looking orchid roots, the phallic roots of mandrake could also be indicated to treat fertility issues in men. (You can read more about early modern aphrodisiacs and fertility here.)

Connections to Medical Practices and Theories

Renaissance scholars, including Paracelsus (1493-1541) and Giambattista Della Porta (1538-1615) developed this theory in their works, describing how all natural things corresponded and dialogued through this network of hidden meanings. Renaissance writers reconciled the doctrine of signatures with Christianism: it had been God, in his wisdom and power, who had decided to fill the Earth with medicines to treat all ailments. Benevolently, he had indicated the therapeutic value of plants through their appearance, with exterior signs. It was up to humans to investigate and find out cures, through observation and experimentation.

This principle was eventually called ‘doctrine of signatures’ following the publication of The Signature of All Things in 1621, by Jakob Boehme (1575-1624), in which he articulated the belief in this network of natural beings. For people like Della Porta, who described himself as a ‘magus’, ‘natural magic’ was largely dependent on understanding these relationships and making use of them to transform nature, creating ‘wonderful and miraculous things’. The doctrine of signatures allowed people to understand the governing principles of the universe, from the minuscule hair strand to the majestic sun and the planets. Astrological medicine was closely connected to the doctrine of signatures (and I will write about ‘zodiac man’ some other time!).

Applying the doctrine of signatures to medical practice was linked to sympathetic magic as well, and the medical idea that ‘like cures like’ (similia similibus curantur) through sympathy or affinity. However, although these theoretical concepts emerged from learned writers and influenced popular practice, they were also influenced by empirical knowledge and the practice of ‘traditional’ healers. Early modern medicine was a mix of many different traditions from myriad sources, which sometimes contradicted each other, and which could be adapted to different contexts and individual cases. For Nicholas Culpepper (1616-1654), who wrote in the vernacular for a wide readership, the doctrine of signatures was essential for all those hoping to take care of their health.

Moreover, the doctrine of signatures was combined with the humoral theory. The natural elements deeply affected the humours within the human body, causing imbalance and, therefore, illness. Fortunately, health could be restored using nature and her remedies: many plants were shaped like the organ or part of the body they could treat. So, if you had an eye disease, you could treat it with the aptly named plant eyebright, whose flower resembled a human eye. If the issue was jaundice, which caused the skin to turn pale and yellowish, saffron would be useful, while for brain-related problems, walnuts were indicated. For respiratory conditions affecting the lungs, the also aptly named lungwort plant would be helpful. You get the idea.

Legacy, Modern Influences, and Reassessing Folk Medicine

The doctrine of signatures might appear outlandish today. This all-encompassing, all-connected understanding of the world, exemplified by the doctrine of signatures, has arguably never been as dominant as it was during the early modern period. And even then, there were those who opposed it. By the 19th century, it was relegated to the domain of magic, with Victorian occultists creating tables of magical correspondence to map the network of symbols. However, many practitioners working outside the framework of orthodox, Western medicine, such as herbalists and homoeopaths, rely on some form of analogical thinking for their cures, indicating the long-lasting influence of the doctrine of signatures. Nicholas Culpepper’s herbal has virtually never been out of print since its publication in the mid-seventeenth century. And it is undeniable that interest in the doctrine of signatures encouraged many to study and research plants.

With the development of medical knowledge, as well as chemistry, botany, and pharmacology, researchers started to identify the active compounds in plants, making a plant’s appearance irrelevant to understanding its therapeutic use. Still, we should be mindful of judging our ancestors too harshly for their ‘outlandish’ beliefs.

As Michel Foucault wrote in The Order of Things, the symbolic and analogical thinking exemplified by the doctrine of signatures was crucial in how humanity structured the world around us. And, while it developed differently depending on time and place (think of traditional Chinese medicine or Ayurveda, both of which make use of this kind of reasoning), the idea of a network connecting all parts of nature, including humans, is ultimately a profoundly human belief.


Jakob Boehme, The Signature of All Things: De Signatura Rerum (CreateSpace, 2017) (originally published in 1621).

Geronimo Cardano, De Subtilitate Libri XXI (Basel, 1554).

Giambattista Della Porta, Phytognomonica (Naples, 1588).

Paracelsus, Essential Theoretical Writings (Leiden, 2008).

Further Reading:

Ernst Cassirer, The Individual and the Cosmos in Renaissance Philosophy (Oxford, 1963).

Lawrence Conrad, Michael Neve, Vivian Nutton, Roy Porter and Andrew Wear, The Western Medical Tradition, 800 BC – 1800 AD (Cambridge, 1995).

Roy Porter, The Greatest Benefit to Mankind: A Medical History of Humanity from Antiquity to the Present (New York,1997).

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A Grip on the History of Forceps in Medicine

Content Warning: Discussion of childbirth, obstetric violence, maternal and infant mortality.

On a cold winter evening in 1600, Peter Chamberlen the Younger found himself attending to a labouring woman on the outskirts of London. The mother-to-be had been in labour for over 48 hours, and the situation was dire. Despite his wealth of experience, Peter feared that both the mother and child might be lost. With time running out, he made the fateful decision to use a secret tool that he and his brother, Peter Chamberlen the Elder, had been developing: a pair of obstetrical forceps. Miraculously, the mother gave birth to a healthy baby boy, much to the relief and amazement of everyone present. Little did they know that this life-saving tool, hidden away in a locked box, would revolutionize childbirth and save countless lives in the centuries to come. Just to give you an idea, today in the UK around 7% of deliveries in the NHS involve the use of forceps.

At the same time, the history of forceps highlights the gradual transition of birth from a ‘natural’ to a ‘medical’ event, with physicians competing with midwives and taking over childbirth. The rise of forceps is very closely connected to the creation of the field of obstetrics. To make things even more interesting, for decades this tool was surrounded by secrecy, making us question who should have access to medical knowledge. So, let’s try to get a grip on the history of forceps.

The Origins of Forceps

The earliest known references to forceps can be traced back to the ancient Egyptians, Greeks, and Romans, with physicians like Hippocrates and Galen mentioning the use of forceps-like instruments in their writings. The word forceps itself comes from the Latin formus (hot) and capere (to grab). But these early tools were very rudimentary compared to the later, more anatomically refined designs that emerged in the early modern period.

The history of forceps became inextricably linked to the Chamberlen surgeons, especially the brothers mentioned above, Peter Chamberlen the Elder (1560-1631) and Peter Chamberlen the Younger (1572-1626). The Chamberlen family were French Huguenots who emigrated to England in 1569 and became prominent in their field. (Still, no one really knows which of them created the design for their famous forceps.) Peter the Elder served as a physician to Queen Anne, the wife of King James I, and later to Queen Henrietta Maria, the wife of King Charles I. His younger brother was appointed the royal physician to both King James I and King Charles I. But it was their newly designed forceps that cemented their fame.

A Family Secret

For over a century, the design of this tool was a closely guarded secret since the Chamberlen brothers realised how their forceps set them apart from other medical practitioners, be they midwives, physicians, or surgeons. Before forceps, the situation was difficult for babies who were stuck in the birth canal. Sometimes surgeons were called to remove them with hooks, often in pieces, in the hope of saving the mother.

When the Chamberlens were called to attend difficult births, the brothers brought their forceps in a large (and locked) box. No one was allowed to see the instrument, not even the person giving birth. The labouring mother was usually blindfolded, and all others present were removed from the room. As soon as the baby was born, the secret tool was hidden away in its box once more.

What made the Chamberlen forceps so unique was its unique, ‘gentler’ design: the blades were curved (imagine soup ladles), to conform to the baby’s head, minimising the risk of injury during the extraction. Crucially, the blades could be locked together at the handles with a spring, after being inserted separately, facilitating the delivery. Plus, being made of steel, their forceps were easy to clean.

The Chamberlens’ Detractors

Rumour had it that the Chamberlens had the highest success rates for delivering the baby safely and the mother surviving. Many women believed that they had higher chances of a safe birth with their help, which made the brothers highly sought-after and, unsurprisingly, deeply resented by their competitors. One of their critics even wrote a poem against them ending in:

‘To give you his character truly compleat
He’s Doctor, Projector, Man-Midwife, and Cheat.’

The Chamberlen brothers were members of the Guild of Barbers and Surgeons, who were never highly regarded by physicians since they hadn’t formally read medicine in Oxford or Cambridge. The Chamberlens were also not popular among midwives. In 1634, Peter had petitioned the king to create a Midwives Corporation which, of course, he intended to run. That did not go well with midwives.

Forceps and Secrecy

It probably didn’t help the Chamberlens’ popularity that they refused to share their secrets with other medical practitioners. Keep in mind that this was a time before patents to protect their design and they would make no money from sharing it. Still, when you think about how many people could have been spared if they shared their secrets, it’s hard to sympathise with the Chamberlens. Hugh Chamberlen was unapologetic:

‘My fathers, brothers,and my self […] have, by God’s blessing, and our Industry, attain’d to, and long practis’d a Way to deliver Women in these cases without any Prejudice to them or their infants. […] I will not take apology for not publishing the Secret I mention we have to extract Children without Hooks. […] I do but inform that the fore-mention’d three Persons of our Family, and my Self, can Serve them in these Extremities, with greater Safety than others.’

Meaning that, if you wanted a safe delivery, you better hire a Chamberlen, which meant you had to live in London and be able to afford their fees. Otherwise… well, too bad for you!

Openness at Last

The secret design remained hidden within the Chamberlen family for generations. In 1670, Hugh Chamberlen travelled to Paris to sell the design to the French doctor Francois Mauriceau, one of the most well-known ‘man-midwives’ of the time. You might be wondering how come the Chamberlens were willing to share their design. Well, Mauriceau won a bet. Chamberlen needed to prove that a forceps delivery was quick and safe, otherwise, Mauriceau would have the right to buy the secret.

Mauriceau chose the woman on whose body they would decide their wager: she had rickets and a malformed pelvis. Both mother and baby died following a horrific delivery in which Chamberlen perforated the woman’s womb and Mauriceau attempted a caesarean section. We know next to nothing about her, the woman who died over a bet between two medical practitioners. In the end, the sale wasn’t made, and Chamberlen returned to England.

According to legend, he eventually moved to the Netherlands, where he sold the design to a local doctor. However, the story goes, this ‘forceps’ was only composed of one half, and was, of course, useless. Hugh Chamberlen’s son, also named Hugh, eventually allowed the design to be made public in England in the early eighteenth century. There is even a monument to him inside Westminster Abbey.

But where did the original forceps go? Well, it was hidden (probably by Peter Chamberlen) under the floorboards of his Essex home, where it was found in 1813, by the mother of the family then living there. By then, many competing designs had been created by other obstetricians.

After the Chamberlens

Forceps opened the door to a flood of innovations and ‘birth gadgets’, including the (to me, very silly) ‘self-operated forceps’. Can you imagine trying to use forceps on yourself while giving birth?!

Post-forceps, medical men were increasingly present in the birth room. The Chamberlens became known as ‘man-midwives’, helping popularise this concept. Other changes followed; midwives were used to attending people giving birth on birth stools or chairs, but physicians preferred their patients lying down so that they could use their tools more easily.

Forceps became popular for many reasons, including that physicians believed that some elite women were ‘too fragile’ to push. However, their use was contentious from the beginning. Just take a look at this passage from a poem against forceps, penned by John Maubray, the author of the Female Physician:

[Forceps] Kill many more INFANTS than they save and ruin
Many more WOMEN than they deliver
[…] I would advise you to practice Butchery rather than MIDWIFERY…

Following the height of their popularity in the nineteenth and early twenty centuries, their use gradually faded, especially as caesarean sections became more widespread. Still, the history behind forceps begs one of the most crucial questions in the social history of knowledge: who should have access to knowledge? Crucially, it also asks the (always feminist) question: who should make decisions about our bodies?


John Maubray, The Female Physician (London: James Holland,1724).

Francois Mauriceau, The Diseases of Women with Child, translated and annotated by Hugh Chamberlen (London: T. Cox and J. Clarke, 1793).

Further Reading:

A.    C. Banks, Birth Chairs, Midwives, and Medicine (Jackson: University Press of Mississippi, 1999).

K. Das, Obstetric Forceps: Its History and Evolution (Leeds: Medical Museum, 1993).

B. Hibbard, The Obstetrician’s Armamentarium (San Anselmo, CA: Norman, 2000).

R. H. Epstein, Get me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank (New York: Norton, 2010).

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Motherhood and Wet Nurses: Breastfeeding in Early Modern Times

If you were living in early modern England (say in the 17th century), there were so many things to consider after you had a baby. But one of the main decisions had to do with breastfeeding: should the mother feed the child herself, or should a wet nurse be hired? (A wet nurse was someone whose job was to care for and breastfeed the baby.) If you chose the latter, how would you choose a wet nurse? Luckily, there was no lack of advice available. Midwifery manuals, recipe books, and domestic guides offered plenty of information, as did sermons at church and conversations with friends and family.

One of the main issues discussed had to do with the controversy over wet nurses. What defined a ‘good’ mother? What role should women have in society? Wet nurses exemplified a commodification of the reproductive body and were viewed with suspicion – yet wet nursing was arguably one of the most common occupations for women at the time.

So, how was breastfeeding understood from a medical point of view? And I don’t mean the use of breast milk as a remedy, which you can read about here. (I also wrote on this subject as a guest blogger on the Recipes Project – you can read the post here.) Well, according to the humoral theory, women stopped menstruating when they got pregnant because the blood was used to nourish the foetus. After birth, it travelled upwards in the body and, through heat, was transformed into milk, to continue its role of feeding the baby. That was why nursing women did not menstruate. Additionally, breastfeeding was usually considered incompatible with sexual activity, as sex might stimulate menstruation and, therefore, dry the milk. The same was true for aphrodisiacs such as celery. Since ancient times, nursing had been used as a contraceptive – and we know today that exclusive breastfeeding can delay the return of fertility, although it varies from one person to another.

That posed the first problem for someone who just had a child in early modern England. If you breastfed the baby, that would probably mean you wouldn’t get pregnant straight away. If you were someone who didn’t want to, such as a peasant wife with plenty of children already, great. But what if you were a queen, and your main job was to produce heirs? For instance, Anne Boleyn is said to have wanted to breastfeed her daughter Elizabeth herself, but because of the pressure to have a son, was not allowed to. Wet nurses were just a fact of life, a fixture of wealthy households and an integral part of society. Royal wet nurses were well paid and enjoyed a comfortable life as well as the prestige of nourishing and caring for royal children.

So, for those who couldn’t or didn’t wish to breastfeed, wet nurses were the best option. (Both animal milk and pap, a mixture using bread, were a less-than-ideal alternative, unsuitable to very young babies.) Wet nursing was one of the most significant female occupations in this period, and one of the most common ways for women to earn money. Many of them would be employed privately by families, but some worked for hospitals (such as the London Foundling Hospital) or were employed by parishes to take care of abandoned children. For families with means, the choice of a wet nurse was a very important matter.

But why was that? As Thomas Raynalde wrote, the ‘affections and qualities [of the wet nurse] passeth forth through the milke into the child, making the child of like condition and manners’. Breast milk had the potential to shape babies, to make them more similar (and emotionally attached to nurses) than to their biological families. In Shakespeare’s The Winter’s Tale, Leontes is glad his wife Hermione (whom he believes to be wicked and adulterous) did not nurse their son, thereby contaminating him. (You can read more about it here.) Breast milk was often used in Elizabethan plays as a metaphor for purity/contamination, but also for influence and transformation, such as in Lady Macbeth’s invocation for her milk to be exchanged for gall.

The 16th and 17th centuries were a paradoxical time in England: medical and moral discourse grew increasingly anti-wet nurses, urging women to breastfeed their own children. Yet the number of wet nurses hired by aristocratic families grew. For centuries, wet nurses had been eyed with suspicion, but it was the Reformation that inspired a surge of Protestant writings condemning them and advocating for mothers to nurse their babies. There were two main arguments against wet nurses. The first was medical: milk was the primary agent of heredity, it was what shaped children into the adults they would become, from their health to temperament and physical form. The mother’s body became ‘porous’ through breastfeeding, with the sharing of fluids between mother and infant helping to attain humoral balance and, therefore, health. Medical writers also highlighted the importance of breastfeeding for the mother-child bond, and as the basis for maternal and filial love.

The second argument against wet nurses was less medical and more moral. The nurse’s character was intimately connected to the quality of her milk. The ‘wrong’ nurse could do more damage than good to her charge, through breastfeeding. Protestant writers often described wet nurses as ‘drunkards’, ‘sluts’, or ‘gossips’, corrupted from the inside. Babies could become morally as well as physically degraded by ‘bad milk’, but they were also at risk of neglect, as it was widely believed that only mothers could ‘truly love’ their babies.

Motherhood and breastfeeding are fascinating topics – I’ve only scratched the surface of this subject in this text. Breastfeeding had long been idealised and associated with the sacred, as we can see in the many depictions of the Virgin Mary nursing Jesus. It was undeniably intertwined with sex and sin, but it was also the mark of a true Christian mother. With the Reformation, breastfeeding gradually changed from a ‘sacred’ duty to a ‘natural’ one, which implied a misogynistic perception of wet nurses as potentially diabolic and ‘unnatural’, a deviant version of motherhood.  Wet nurses could disrupt the social order, by corrupting children and occupying a bigger role within the family than they ought to. Still, for wealthy women who mostly didn’t breastfeed their own children, they were a necessity, even if potentially dangerous.


Jacques Guillemeau, The Happy Delivery of Women (London, 1612).

Henry Newcome, The Compleat Mother: Or An Earnest Perswasive to all Mothers (especially those of Rank and Quality) to Nurse their own Children (London, 1695).

Ambroise Paré, Works (London, 1634).

Thomas Raynalde, The Birth of Mankinde (London, 1598).

Jane Sharp, The Midwives Book (London, 1671).

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Why Did People Try to Induce Menstruation in the Past?

Imagine that you’re a 16th-century person flicking through the pages of Alessio Piemontese’s best-selling book, which contained everything from how to make invisible ink to how to make strawberries preserve. And then you come across this most interesting ‘secret’:

An other remedie verie good, and well knowen of women. Take a sweet Apple, and make him hollow within, make a pouder of Nutmegs, Mace, Synamon, of each halfe a dragme, Cloves halfe a scruple: put all this within the Apple with a little Suger, and rost it under hote ashes, and give of it onto the woman ever when the paine commeth onto hir. But if the paine increase so much that hir life is in doubt, put to all this two graines of Opium, and sodainly the paine will depart.
Alessio Piemontese, The Secrets of the Reverend Maister Alexis of Piedmont, 1595

But why would people try to stimulate menstruation? Well, in premodern Europe, the humoral theory was the main framework for understanding the body: the four humours (blood, black bile, yellow bile, and phlegm) needed to be balanced for a person to be healthy. Regular menstruation was the expected purgation of the female body, and so menstruation was believed to be essential for the health of women of childbearing age.

However, one of the main reasons people were so interested in inducing menstruation had to do with conception. Menstruation was thought to ‘clean’ the womb, preparing it for the male seed.  The English midwife Jane Sharp even mentioned that having your ‘flowers’ regularly was what made you fertile and ready for the ‘fruit’ – the baby.

You might be thinking that these recipes to purge the womb sound very much like abortion recipes as well. After all, they’re all meant to make the uterus contract and expel its contents, whether that’s a ‘retained period’ or a foetus. And you’re right. The difference between the two was much blurrier than some people would like to believe. This is why abortions (especially before foetal movement) were not usually condemned in premodern times.

What does that tell us? Well, what made a recipe an emmenagogue (a formula meant to stimulate a retained period) or an abortifacient (a recipe meant to provoke an abortion) was not necessarily the ingredients or the methods involved. Rather, it was the intent of the one using the recipe and – crucially – their bodily state.

Let’s come back to the Sweet Apple medicine above. At first, it looks like a recipe to stimulate menstruation. The mention of pain makes us think of dysmenorrhoea, or period pains, as well. Yet opium sounds a bit excessive, doesn’t it? And what about the mention of the woman’s life being in danger? Surely, readers could understand this pain as more than the usual discomfort of menstruation: this was also the pain caused by the purgation itself. If a pregnant person used this formula to provoke an abortion, the opium could help them deal with the pain it caused.

From 1555, when Alessio Piemontese’s Secrets were first published in Italian, to the end of the 17th century, when reeditions and reprints of these recipes started to decline in number, recipes like these multiplied. This allowed recipe books to be marketed as ‘updated’ and ‘improved’ versions of previous editions. But the recipes did not only grow in number. These formulas became more specialised and varied. They included internal medicines (such as pessaries or herbal drinks) as well as external remedies (such as ointments to be applied around the vulva or medicinal baths). The ‘sweet apple’ recipe mentioned above was a less-frequent case of an ‘edible’ remedy. Most of these formats of medicine coexisted in the same book and were offered to readers as different ways of treating the same ailment.

However, these formulas also left ample room for readers to adapt them and personalise them to their lives. People complemented these recipes with their previous knowledge and allowed them to actively manage their bodies. That the same recipe could be used to induce menstruation in the case of amenorrhoea and provoke an abortion is, therefore, not surprising.

The history of medicine is never straightforward, especially where gender is concerned. Menstruation recipes were rarely just one thing; instead, they condensed and combined knowledge in new ways, encouraging different kinds of moral agency and choice from the reader while at the same time alerting/suggesting that many of these emmenagogue recipes could be used as abortifacients.

Recipes like these could (and surely were) used for different purposes, and with varying degrees of success. Books like Piemontese’s Secrets combined ingredients and methods in new ways, but it was the reader who ultimately had control over how a recipe would be used. It was their body that determined if the ‘sweet apple’ would merely stimulate menstruation or provoke an abortion. People had more agency than historians tend to believe. In this instance, it was the body, the womb itself who decided what this recipe would be about. Besides that, it must have tasted lovely. But please don’t go trying 16th-century medicines at home! Just save the apples for baking a pie instead.


Alessio Piemontese, Secreti del Reverendo Donno Alessio Piemontese (Venice: Sigismondo Bordogna, 1555).

Alessio Piemontese, The Secrets of the Reverend Maister Alexis of Piedmont (London: Thomas Wight, 1595).

Jane Sharp, The Midwives Book, Or the whole Art of Midwifry Discovered (London: Simon Miller, 1671).

Further Reading:

Menstruation: A Cultural History, edited by Gillian Howie and Andrew Shail (London: Palgrave Macmillan, 2005).

Regulating Menstruation: Beliefs, Practices, Interpretations, edited by Etienne van de Walle and Elisha Renne (Chicago: Chicago University Press, 2001).

Sara Read, Menstruation and theFemale Body in Early Modern England (New York: Palgrave Macmillan, 2015).

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Key Concepts

What are the ‘Non-Naturals’?

When I was growing up, I was told to avoid cold showers if I was having my period. I was also not supposed to leave the house with my hair wet unless it was summer. When we travelled to the mountains, my maternal grandmother would ‘fill her lungs with forest air’. She claimed to feel instantly healthier.

We all heard similar things, but the origin of this advice is often unclear. Going beyond family anecdotes, there’s the vast world of complementary and alternative medicine (CAM), from which much of this knowledge derives. Born in no small measure from a deeply felt disappointment at orthodox medicine, this discussion is often framed as an opposition between traditional and empirical knowledge and a medicalised, intervention-based, hospital-centred model of care. So, alternative medicine often focuses on lifestyle: diet, exercise, sleep, and overall well-being are taken into consideration.

Paradoxically, this feels old and new at the same time. For instance, the adoption of a more plant-based diet can be seen as a trendy choice by some today, while for others it is linked to a long tradition of accumulation of knowledge, often by marginalised communities (think of Buddhist monks, for instance).

As always, I am struck by how studying the history of medicine can help us navigate the present. But this is a (very) big topic, and I want to concentrate on the idea of ‘non-naturals’ in the past. So, first things first. If we think of a 16th-century person interested in buying a book about domestic medicine at their local fair, they would usually be able to choose between two big groups: books with recipes for common ailments, and regimens for a healthy life. The first group was usually about treating a specific problem, while the latter was about preventing disease in the first place.

From Hippocrates in the 5th century BCE to the 18th century, the main framework through which Europeans understood medicine was the humoral theory.  People had four humours (blood, phlegm, black bile, and yellow bile), and it was believed that their imbalance was responsible for illness. But humours were of course not the only factors in explaining health (or the lack thereof). If recipes were aimed at treating the sick body, regimens were guides to conserve health. Treatment and prevention were two sides of the same coin: medicine was not only a healing art but the art of preserving health.

So, how would a 16th-century person go about preventing illness? Besides keeping humours in balance (with bloodletting and similar methods), they needed to be mindful of the six ‘non-natural’ things which determined health: food/drink, exercise/rest, air, sleep, evacuation, and emotions. Described by Hippocrates and further developed by Galen in the second century CE, guidelines about the non-naturals abounded in medieval and early modern medical texts, especially regimens of health, authored by physicians. But what did they say? And how do they relate to my grandmother breathing in the pine-scented forest air?

1. Food and Drink

In the same way that people had individual constitutions, so did foods and beverages, which could be hot, cold, dry, or wet. These qualities should be taken into consideration when choosing and preparing foods and drinks. For instance, wine was believed to ‘heat’ the body, which is why it should be drunk in moderation, especially by those who had a choleric or sanguine temperament. Pregnant or nursing people should water their wine down to diminish its heat. It was believed that the stomach was responsible for concocting food before it would be distributed in the body by the blood. Because they influenced the digestive process, some foods such as raw vegetables were believed to prepare the stomach for a meal, while others would be more suited to ‘closing’ the stomach afterwards. (Have you ever wondered why the French finish a meal with cheese? That’s why.)

2. Exercise and Rest

Exercise improved bodily functions: for instance, it heated the body, promoting digestion. It opened the pores, allowing waste to leave the body through sweat. For Galen, exercise should be vigorous, accompanied by accelerated breathing. But later physicians cautioned people to be moderate and to adapt exercise to their individual needs. They could be active (such as walking) or passive (such as being transported in a carriage). Those who could not partake in strenuous activities could resort to baths or massages, which would attain similar health results. Sounds much nicer to me than jogging – and closer to a spa day!

3. Air

The air was a common cause of concern for 16th-century people. Was it cold or hot? Humid or dry? Depending on the person’s constitution, age, gender, and the season of the year, the air could have different effects. For Avicenna, the 11th-century Persian physician who so greatly influenced Western medicine, the air should be temperate: light, bright, moving gently, and smelling sweet. Corrupted air was deemed to cause plague, for instance. People were advised to purify the air with fire and scented herbs. Physicians often prescribed a change of location to their patients, in the hope that illness could be cured in a place where the air was different. The brain was thought to be particularly vulnerable to it – have you ever noticed when you visit a museum how people in the past always seem to be wearing headwear or hats in the paintings? Besides fashion, the concern with air directly influenced architecture. An ideal Italian villa in the Renaissance would have been high up to enjoy the breeze and the sun, but not too exposed to inclement winds. And don’t even think about building your dream house next to a sewer – but who would, if given the choice?

4. Sleep

Regimens of health directed people about how, for how long, and when one should sleep to maximise their health. The main concern was with digestion, as it was believed that sleep was caused by the vapours rising from the food in the stomach to the brain as it was digested. Daytime naps were not advised, as they wouldn’t be long enough for digestion to be complete. Plus, they could cause laziness. As wealthier parts of the population started to nap in the 17th century, it was thought that a wooden chair would be ideal: not too comfortable was the goal. Sleeping on your back was not advised, as these vapours could get blocked in the brain. Elevating your head and sleeping on one side would be better for digestion as well as protecting the brain. Ideally, you should switch sides every couple of hours… But I’m not sure how often people followed this advice after a rich mutton stew and wine!

5. Evacuation

Within the humoral understanding of the body, corrupt or excessive humours often needed to be purged, and impurities, expelled. The regular purging of the body was seen as essential to maintaining one’s health: bloodletting, inducing vomit, provoking sweat, as well as stimulating retained menstruation were all important parts of preventing illness – and not just treatments for it. Superfluous fluids might cause blockages if not removed from the body, and these ‘excrements’ went beyond urine and faeces. My grandmother (the paternal one this time) believed we should brush our hair vigorously, especially before bed. That would make sense to our hypothetical 16th-century person buying a book at the local fair. Combs were essential in removing the ‘excrements of the head’, and combing one’s hair was not just about vanity, but about preventing brain issues by making sure that what needed to be expelled from the body didn’t cause any obstructions. Think of barbers and their connection to medicine (especially barber surgeons). They took care of people’s hair, beards, nails, ears, teeth, and skin, mainly for hygienic purposes. They even had separate comb sets for beards and hair – you wouldn’t want any cross-contamination with your head’s excrements!

6. Emotions

The Greeks called them ‘passions’, the ‘accidents of the soul’. Today, we might talk of mental health instead. A person’s emotional life was thought to greatly affect their health. This was mainly because these fluctuations influenced the heart, responsible for heating the body through heat. Emotions would have a direct effect on the body’s temperature and, as we have seen, the balance between hot/cold and wet/dry was central in the humoral understanding of the body. So, physicians advised their patients to be careful with the passions most likely to disturb their humoral balance: someone of a choleric temperament should be careful with anger or hate, as they would make the body drier and hotter. The key was moderation, as a sudden emotional change could trigger disease or even death. Remember all the stories of people dying from a broken heart in literature? The non-naturals are behind that idea.

The non-naturals are a vast topic, in the same way that the humoral theory is. Understandings of both varied greatly across time and space, and this text can only hope to give the briefest introduction to this subject. Whole books can be (and have been) written about each of the non-naturals. I hope that the fun examples I chose helped to illustrate the logic behind this way of thinking about how what we would today call ‘lifestyle’ affects the body and health. My grandmothers might have been a bit off with their advice. But they were the heirs to a long tradition of trying to be as healthy as possible and to live a long life – and isn’t that what we all want?


Avicenna, A Treatise on the Canon of Medicine of Avicenna (London: Luzat, 1930).

Castore Durante, Il Tesoro della Sanità (Venice: Andrea Muschio, 1586).

Rodrigo Fonseca, Del Conservare la Sanità (Florence: Semartelli, 1603).

Galen, De sanitate tuenda: A Translation of Galen’s Hygiene (Springfield: Thomas, 1951).

Hippocrates, Airs, Waters, Places (London: W. Heinemann, 1923).

Bartolomeo Paschetti, Del Conservar la Sanità (Genoa: Giuseppe Pavoni, 1602).

Further Reading:

Sandra Cavallo and Tessa Storey, Healthy Living in Late Renaissance Italy (Oxford: Oxford University Press, 2013).

David Gentilcore, Food and Health in Early Modern Europe: Diet, Medicine and Society (1450-1800) (London: Bloomsbury, 2016).

Sasha Handley, Sleep in Early Modern England (New Haven, CT: Yale University Press, 2016).

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Giving Birth in 17th-century England: A Tentative List

What to do, what to buy, what to organise, what to cook, what to read… I made so many lists when I was pregnant that it would take a new list to organise them all! Expectant parents are bombarded today with information about how to prepare for the arrival of a baby. Yet childbirth itself has never been more medicalised and arguably out of families’ control. But what about the past, before social media, Amazon wish lists, and insipid hospital food? Here’s a list of how to prepare for a new baby in 17th-century England.

Caveats: I have considered an ‘average’ English family, composed of a married woman and man of middling social status (think of the husband as a yeoman or merchant). The things listed here would usually follow this order, but each community and family had specific practices. Like all lists, this is non-comprehensive but should give you an idea of what life was like for new parents at this period.

1. Confirming the Pregnancy and Spreading the News

Unlike today, a missed period was not usually thought to automatically indicate pregnancy. It wasn’t until quickening that pregnancy was confirmed (when foetal movement could be first felt). From then on, people could announce the news. Some mothers might prepare in case childbirth didn’t go smoothly, although that wasn’t very common. (You can read more about writing to the unborn child here.)

2. Engaging a Midwife

Most people lived close enough to a midwife to have her help in the delivery. For the ones living in cities, there was a choice of practitioners. Friends’ recommendations, price, and reputation were all considered when a midwife was hired.

3. Hiring a Nurse

A temporary nurse would be hired to help around the house for the month following the delivery. She would help take care of the baby and mother, but her main role was to perform the domestic duties left unfulfilled by the one who had just given birth.

4. Inviting the Gossips

In the final months of the pregnancy, the expectant mother would issue invitations to her female relatives, neighbours, and friends, to attend her birth as her ‘gossips’, or ‘god-sibs’ (siblings in God). The women she chose would help her and the midwife, by making food, keeping company, and supporting her during the birth. The mother could expect at least half a dozen gossips.

5. Preparing the Birth Chamber

As the birth approached, the family would make sure to have the essential items for the delivery: candles, extra linen, a straw pallet bed, maybe a birth stool or chair, swaddling bands for the newborn baby, food and drink for everyone involved in the birth, herbal medicines, and (hopefully) the midwife’s fee. Before the Reformation, relics could be used, as well as rosaries, crucifixes, prayer books, and birth girdles with images of the Virgin Mary or St Margaret. (You can read about an amazing 15th-century birth girdle here.) The expectant mother would also seek the blessing of her local priest for a safe delivery.

6. Summoning the Midwife and Gossips

When labour began, the husband, perhaps helped by a servant, would go from door to door calling the gossips and midwife to come to attend his wife during the delivery. (This was later called ‘nidgeting’.)

7. Enclosing the Mother

If she wasn’t already in confinement, the gossips and midwife would move the labouring woman to a separate space from men as soon as they arrived. This was usually already set up, at least in part. Windows would be shut and covered by curtains or makeshift fabrics, to keep the daylight and the air out. Keyholes would be blocked so that no air came through them either. Candles would be lit as well as a fire. A birthing stool would be available (often brought by the midwife) for the use of the labouring woman.

8. Nourishing the Mother

The gossips would make sure that the person giving birth received nourishment (often under the midwife’s advice). They would offer her warm drinks made of wine, especially caudle, which contained sugar, spices, and eggs. (Check out this 14th-century recipe for caudle!)

9. Delivering the Baby

Midwives’ techniques varied greatly, but they were usually highly experienced. They might examine the woman to see how the birth was progressing and suggest which position would work best for the delivery. They could also manually remove the placenta after the birth if so needed. If the baby was unresponsive, the midwife would probably be the one to revive it. The midwife or a gossip would tie and cut the umbilical cord.

10. Cleaning and Swaddling the Baby

One of the gossips would probably be responsible for washing and swaddling the infant. Swaddling was deemed essential for babies in this period, to make sure their limbs grew correctly. It was also thought to keep babies calm and to make life easier for the one taking care of them, as it helped babies sleep.

11. Showing the Baby to the Mother and Breastfeeding

After the baby was ready, the mother would finally be able to see it. Breastfeeding would be encouraged unless the family was wealthy enough to hire a wet nurse. In that case, she would probably have been engaged earlier, around the same time as the nurse. Breast milk could be used to treat abscesses in the mother following childbirth, as well as eye or skin conditions in the newborn baby. (I wrote about breastmilk as medicine here.)

12. Lying-In

After the delivery, the mother’s lying-in period would begin. This would last for around 3 to 5 weeks and be comprised of three phases.

  1. In the first stage, she would be in her bed, and the room would remain darkened. The mother’s vulva would be washed with herbal solutions, but her sheets usually wouldn’t be changed. She would not perform any household duties. A nurse, hired for the lying-in period, would help around the house.
  2. In the second stage of lying in, she would be able to sit up and move around the room, and her bedclothes would be replaced. This was when close female friends would usually visit her. It was a time of female sociability and bonding. Caudle would be offered to visitors as well.
  3. In the final stage of her lying-in, the mother would be able to move around the house, but not leave it. More visitors would drop by, including men. Light household duties could now likely be performed by the mother.

Significantly, it was usually the person who had given birth who decided when to move from one stage of lying-in to the next.

13. Baptism

During the lying-in period, the baby would usually be baptised, without the parents’ presence. The godparents (usually three people) would act in their place, and the baby would be welcomed to the community.

14. Tipping the Midwife

At or right after the baptism, the godparents and gossips would usually tip the midwife for the safe delivery of the child. The father of the child would typically have paid and tipped the midwife after the birth.

15. Resuming Sexual Activity

It was inadvisable for sex to take place until the lying-in period was completed. Once the month was over, however, husband and wife could go back to sleeping together. (Of course, it’s impossible to know how much this injunction was followed.)

16. Churching

After her lying-in period was complete, the mother should only go outside the house after having been ‘churched’. (She usually wore a veil on the way to church to go around this unpractical norm.) Escorted by her gossips, the mother would go to church and kneel in a specific area separate from others, often called a ‘childbed pew’. During the service, the woman would thank God for her safe delivery. Specific Psalms would be said (116, 121, or 127), as well as the Lord’s Prayer (Kyrie Eleison). She would then make offerings to the priest and clerks and would be welcomed back to the community. This ceremony was much contested during the Reformation – but that’s a topic for another day!

Giving birth in 17th-century England was a process of separation, transformation, and reincorporation full of specific customs. Gender was a crucial aspect of these practices: the woman giving birth was separated from men and surrounded only by those of her sex and finally, reintegrated into society. Significantly, this was a female collective ritual, that inverted the usual power dynamics within families. In a patriarchal society such as 17th-century England, that was no small feat. This female world assured that, after birth, the mother’s body belonged to her, not her husband, at least for a while. She wouldn’t fulfil her domestic or sexual duties. This is why I find the female culture of childbirth so fascinating: it is a form of resistance, a fight for autonomy – even if short-lived.

(If you’re interested in this subject, I had a lovely talk with the wonderful doula Carly Lokrheim last year comparing past and present childbirth. You can watch it on YouTube.)

Further Reading:

David Cressy, Birth, Marriage, and Death: Ritual, Religion, and the Life-Cycle in Tudor and Stuart England (Oxford: Oxford University Press, 1997).

Amy Licence, In Bed with the Tudors: The Sex lives of a dynasty from Elizabeth of York to Elizabeth I (Gloucestershire: Amberley Publishing, 2012).

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Green Sickness and Virginity

From the mid-16th century to the early 20th century, young girls described as suffering from bodily weakness, dietary disorders, heart palpitations, fainting spells, paleness, and an absence of menstruation (amenorrhoea), were often given the diagnosis of ‘green sickness’, the ‘disease of virgins’. But what was this medical condition? And what can it tell us about the way that female sexuality and puberty were understood in the past? I believe that social and cultural anxieties around young women’s developing sexuality were behind this disease’s construction, and its treatment ultimately aimed to control this sexuality.

But first things first. Medical historians are often asked about the contemporary equivalent of a given condition in the past. But it’s usually a bad idea to try comparing historical sources describing illnesses with how we understand medicine today. Green sickness has been associated with several modern conditions, from anorexia nervosa to pica, malnutrition, or anaemia. However, tempting as they may be, retrospective diagnoses can be misleading. For starters, we can’t assume that all the people described as suffering from the same condition indeed were. But the main issue is that there’s often not a direct contemporary equivalent to diseases of the past.

Our understanding of diseases and the body change more through time than we realise, and green sickness was a disease born out of the humoral understanding of the body, which prioritised fluids over organs as what determined medical conditions. In the case of green sickness, blood (and specifically menstruation) was central. Blockages in the natural economy of fluids, such as menstrual retention, were a serious medical concern. Therefore, it is not surprising that treatments included recipes to provoke menstruation, often using ‘hot and dry’ ingredients, such as onions, ‘red’ sage, betony, or rue. So, where does marriage come into that?

Let’s take a step back and start by thinking of the name ‘disease of virgins’ itself. How do we name diseases? Naming implies defining a condition and, often, gendering it (‘mother’s thumb’ is a great example). ‘Disease of virgins’ implied that it was mainly young women going through puberty who could develop the condition, although not exclusively. The pale colour of the skin was also central in how it was known and remained an important aspect of the description of the disease of virgins. In the early 16th century, it was called ‘white fever’ or ‘green jaundice’, which became green sickness – a disease in its own right rather than a kind of jaundice. The disease was famously associated with virginity in 1554 by the physician Johannes Lange, taking inspiration from Hippocratic writings as well as contemporary vernacular medicine. In the 17th century, with the rise of Greek names for medical conditions (such as catamenia for ‘menstruation’), green sickness became ‘chlorosis’, from the Greek chloros, a yellowish shade of green. Finally, in the 19th century, it was called hypochromic anaemia, and it disappeared from medical teachings and writings in the 1920s and 1930s.

This did not mean that patients suffering from green sickness had green skin, although it emphasised paleness. Letting go of the literal ‘green’, it could also symbolise youth and (sexual) inexperience. And that’s where marriage comes into play. Like fruits turned ripe and left on a tree would rot, girls ‘ripe’ for marriage who remained unmarried were at risk of developing this condition. The English midwife Jane Sharp wrote in 1671 how this disease ‘is more common in maids of ripe years when they are in love and desirous to keep company with a man’.

But ‘green’ could also mean other things. In Shakespearean fashion, it could also signify envy, as young girls could envy older women’s experience and their access to the world of sex (think Snow White, but in reverse!). Besides that, green was also associated with nature, and sex itself (prostitutes were often depicted wearing green in early modern imagery).

Menstruation itself was often referred to as the ‘flowers’, which, following the horticultural metaphor, preceded the fruit (a child). However, the absence of menstruation, one of the main symptoms of green sickness, was an ambiguous sign. What if the ‘innocent’ girl had become pregnant? Contrary to today, the absence of menstruation was not always associated with pregnancy, which would usually only be confirmed by ‘quickening’ (when the pregnant person felt foetal movement). Still, it could raise uncomfortable questions, especially in a patriarchal society where property rights followed a patrilineal logic. It’s not surprising, therefore, that if a young girl stopped menstruating, marriage was advised. This allowed socially and religiously accepted sexual activity, which was thought to have medical benefits to women while keeping them firmly in the role of wives and mothers.

So… was the ‘disease of virgins’ just a convenient excuse to police female sexuality? That would be too simplistic, yet it is striking how many conditions would fit this mould. Nymphomania, which became a prominent disorder from the 17th century, was also gendered, affecting women and young girls – coincidentally, particularly when they started menstruating. Masturbation was an important symptom and again, this condition was also best treated by marriage, which kept developing sexuality within a heterosexual and patriarchal institution.

But green sickness patients were described in a very different way to nymphomaniacs. Like many other medical conditions (think of Victorian ‘hysterical’ women), this was a disease of ‘delicate femininity’, which could even make girls more attractive, by underlining their fragility and getting them closer to the feminine ideal. In the construction of the ‘disease of virgins’, the emphasis on paleness was central, and the racial aspect shouldn’t be underestimated. This was a disease connected to whiteness: patients had a pretty ‘rosy and white’ complexion. Physicians described the beauty of their patients, who were often blondes. Besides race, there was a class element at play as well: green sickness was rarely diagnosed in countrywomen, who were thought to be stronger and used to more physical work. Green sickness was a disease of ‘weak’, ‘fragile’ people. It could even affect ‘feeble boys’, although this was much rarer. For instance, Shakespeare mentioned male green sickness in Henry IV Part 2, describing these young men as ‘fools and cowards’. Misogyny meant that a man suffering from this disease was effeminate and fragile, and his masculinity was threatened.

Young girls suffering from the ‘disease of virgins’ were described as passive and submissive by physicians, often in an eroticised way. These inexperienced girls were in sharp contrast to the ‘difficult’ hysterics of the late 19th and early 20th centuries described by Freud and other psychoanalysts. The innocent patient suffering from green sickness was much more pliable than the more sexually experienced, ‘manipulative’ hysterics. However, both conditions were heavily gendered, relied on misogynistic ideas, and could be treated in similar ways (such as with electric shocks).

How a society constructs medical conditions can give us insight into how the body is understood. In the case of the female body, it is not unusual for medical discourse to find ‘natural’ ways of explaining women’s inferiority to men, or to justify our role in the domestic sphere, as wives and mothers. The ‘disease of virgins’ was not a stable category: the perception of symptoms, causes, and appropriate treatments varied depending on time and place. Because of the vagueness and variety of how symptoms presented, this diagnosis could mean many different things. At certain points in time, virtually any girl behaving like a moody adolescent could be diagnosed as suffering from green sickness. This was also true for hysteria. Medical categories shift with time, often reinforcing gender norms under the guise of biology.  As its name indicates, the ‘disease of virgins’ was thought to affect primarily pubescent girls, whose sexuality was starting to develop. The easiest ‘treatment’ was therefore marriage and socially sanctioned sexual activity, which ensured the status quo wouldn’t be too disrupted by these ‘desirous maids’.


Jane Sharp, The Midwives Book (London: 1671).

John Tanner, The Hidden Treasures of the Art of Physick, (London: 1659).

Johannes Lange, ‘De morbo virgineo’, in Medicinalium epistolarum miscellanea (Basel: 1554).

Luis Mercado, De mulierum affectionibus, (Cordoba: 1579).

Further reading:

Helen King, The Disease of Virgins: Green Sickness, Chlorosis and the Problems of Puberty, (London: Routledge, 2004).

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Key Concepts

What is the Humoral Theory?

‘He was trying to gather up the scarlet threads of life and to weave them into a pattern; to find his way through the sanguine labyrinth of passion through which he was wandering’
(The Picture of Dorian Gray, Oscar Wilde)

Humours are everywhere. People can react cholerically to an insult, music can make us melancholic, time with friends can lift our spirits, and we can be in good or bad humour. This is not surprising. The humoral theory has a long history, beginning with the Greek Hippocratic writers in the fifth century BC, being reinterpreted by the Roman physician Galen in the second century AD. Humorism survived thanks to its translations into Latin in the medieval period and started to be taught in the newly founded universities. Later, the humoral theory was incorporated into vernacular medical texts in the early modern period. It remained the primary way to conceptualise medicine and the body until well into the nineteenth century.

For over two millennia, humorism (or humoralism) was the framework within which people thought about and practised medicine, especially in the West. It is the backdrop for most of our discussions about the history of medicine and gender, which is why it is such an important topic. So, what were the humours?

The humours were fluids or spirits (humon in Greek means fluid) concocted in the stomach in the heat of the digestion, which circulated in the body. There were four humours: blood, phlegm, yellow bile (choler), and black bile (melancholy). All bodies contained the four humours but in different proportions, which could vary according to gender, age, and the season of the year. Each person had a different combination of humours, which determined their temperament, personality, and physical health: humorism saw the mind and body as deeply connected. This is why we still have adjectives such as melancholic, choleric, sanguine, and phlegmatic to describe people.

The humours were associated with the natural world, such as seasons and elements, but they also corresponded to a life stage and a specific organ. This web of connections was the basis for how illnesses would be treated. Foods deemed hot, such as spices and red meat, could be used to treat an excess of phlegm or melancholy, heating the body. (For the same reason, they could act as aphrodisiacs.) On the other hand, cucumber and melon would be appropriate to counteract an excess of yellow bile. Physicians could also advise patients to change their location, going somewhere where the weather was more suited to treat their condition.

HumourBloodPhlegmCholer (yellow bile)Melancholy (black bile)
Life StageChildhoodOld AgeYouthMaturity
Personality Traits Brave
Astrological BodyJupiterMoonMarsSaturn

The delicate balance of humours determined a person’s natural good health; therefore, illness was contra-natural, often resulting from a humoral imbalance. Besides changes in their diet and environment, physicians could prescribe herbal remedies to counteract their patient’s condition. Moreover, if a humoral excess or lack caused illness, physicians recommended treatments such as enemas, emetics, purging, and bloodletting to restore the lost balance. Besides that, they gave patients specific advice about diet, exercise, and sleep, which might help rebalance their humours. Some of these medicines might shock us today – the use of leeches to treat haemorrhoids comes to mind! – but they mainly consisted of empirical knowledge adapted to fit the humoral understanding of the body.

For instance, menstruation was deemed essential for women of fertile age, as it was the body’s natural purgation. This is why amenorrhea (the lack of menstruation) was usually considered a serious medical concern, as blood would accumulate in their bodies and cause illness. Herbal remedies to stimulate uterine contractions and provoke menstruation were ubiquitous in medical texts: saffron, parsley, pennyroyal, cinnamon, cyclamen, and mugworts were some of the ingredients in these formulas. 

Humorism changed through the centuries, combining local influences and merging traditions. However, for centuries, the four humours’ paradigm was orthodoxy among physicians, surgeons, midwives, and patients alike. It was challenged at times, such as by the rise of chemical medicine and Paracelsianism in the sixteenth century. Still, it remained central to how the body was understood in premodern times. It was a deterministic system: people might treat illnesses but not change their physical and psychological makeup.

Humours do not survive only in our language. Humorism underpinned how the body was understood, both in physiological and psychological terms, for centuries, until the germ theory of disease supplanted it. Humours went beyond the medical domain, shaping how we think about the body and surviving perhaps most clearly in the arts and literature. For instance, as Shakespeare’s Richard II asked people to achieve a bloodless resolution to their conflict, he referenced physicians’ bloodletting practices. This play on words between purging excessive blood and a bloody fight would have been clear to Shakespeare’s contemporaries:

Wrath-kindled gentlemen, be ruled by me;
Let’s purge this choler without letting blood:
This we prescribe, though no physician;
Deep malice makes too deep incision;
Forget, forgive; conclude and be agreed
(Richard II, Shakespeare)

After the Enlightenment and the Industrial Revolution, a new mechanical understanding of the body, conceptualised as a machine composed of parts that could be disassembled, replaced the humoral system. The germ theory became the primary way to understand diseases, made possible by technological advances and more precise microscopes in no small measure. However, we have also seen a return to a more holistic understanding of the body over the last fifty years. Medical practitioners and patients alike have started to explore alternative medical models inspired by traditional Chinese and Ayurvedic medicine, which consider individuality and understand the body as a whole. This is not a return to humorism as it used to be centuries ago; still, it is striking how Hippocratic doctors would approve of this paradigm change.


Galen, De Temperamentis. Translated by P. N. Singer and Philip J. van der Eijk (Cambridge: 2018).

Hippocrates and Heracleitus. Nature of Man, Regimen in Health, Humours, and Others. Translated by W. H. S. Jones (Cambridge, MA: 1931).

Jacques Jouanna, Hippocrates (London: 1999).

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