CONSTRUCTING THE BODY
The inside story
This chapter is intended to provide an overview of the content of Hippocratic gynaecology: it summarises the assumptions about the female body with which it operates, the terminology it uses for some parts of that body, and the therapeutic procedures which it uses to restore the body to the functions it considers normal. In the process of constructing this summary, it also provides some idea of the range of types of text making up âHippocratic gynaecologyâ; subsequent chapters will consider in more detail the issues of the relationship between text and reality which the Hippocratics raise, and will apply the material outlined here to particular themes which arise not only in understanding Hippocratic gynaecology in terms of the ancient Greek world, but also in appreciating how these texts have been used in later medical debates.
Creating an overview of âHippocratic gynaecologyâ is an artifice which always risks falsifying its object; however, even in antiquity an attempt was made to define the main characteristics of a Hippocratic approach to the body.1 Of the texts which have come down to us under the name of âHippocratesâ, possibly none was written by the historical âFather of Medicineâ. Instead, what has become the âHippocratic corpusâ is a disparate collection in terms of geographical origin, date of composition and, most significantly for this chapter, theoretical position. The material given here must therefore have a certain provisionality, simply because there are so many variations within the texts of the Hippocratic corpus. However, with Ann Ellis Hanson (1996b: 307), I would argue that there are sufficient points of agreement â particularly within the Diseases of Women treatises â to make such an overview worth attempting.
It is also debatable how far any of the material presented here would have been exclusive to the Hippocratics. There are many areas of similarity between the Hippocratic medical texts and pre-Socratic philosophy (Longrigg 1993), and between the ideas put forward in the medical texts and those expressed in Attic comedy (Alfageme 1995), but in this book my focus is on the wider social and cultural context within which Hippocratic medicine was created, and in particular on the practical side of medicine. Medicine is not just about ideas; it is about making people feel better. These two aspects may be closely related, but to focus on the philosophical side may be to miss the point of the wider enterprise: âThe primary aim of medicine is to cure sick peopleâ (Chaniotis 1995: 335). The social context within which a Hippocratic healer worked has been discussed in detail by Geoffrey Lloyd (1979, 1983), and characterised as highly competitive; different types of healer fought for patients, and the Hippocratic healer had little innate advantage over his rivals. Langholf (1990: 126â7) has argued that where Hippocratic theories such as pepsis â which covers the âripeningâ of a substance causing disease as well as the âdigestionâ of food â seem rather vague to us, this may be because they were deliberately kept fairly vague in order to attract a wider clientele. The Hippocratic healer was âmaterially dependent on a public with the broadest possible spectrum of religious and philosophical beliefs, and the less clearly he expressed himself about such matters, the better for himâ (Langholf 1990: 239).
Effective healing can be the result of effective drugs â a topic to which I will return in Chapters 6 and 7 â but work on the anthropology and sociology of medicine shows that it also depends on some degree of communication between healer and patient. If the theories propounded by the healer make no sense at all to the patient, his explanations will be unlikely to reassure her, and his recommendations are less likely to be followed. Aline Rousselleâs approach to Hippocratic gynaecology (1980; 1988) suggests that this material on the function and healing of the body is primarily womenâs lore, taken over by male medical practitioners. For Paola Manuli (1980; 1983), on the contrary, Hippocratic gynaecology consisted of menâs fantasies about the female body. As Seymour Haden put it (above, p. 16), women âare obliged to believe all that we tell them. They are not in a position to dispute anything we say to them.â But the medical encounter, then as well as now, is about patient and practitioner meeting to produce healing; it is in these terms that Lesley Dean-Jones (1994: 27) argues that the Hippocratic treatment of women âmust have been acceptable to them and have squared with their view of their own physiologyâ. If women patients found Hippocratic explanations preposterous, then how could these have been used to produce convincing explanations of why they suffered, let alone to provide the rationale behind therapies to restore their health?
One possible objection here is that the âpatient meets practitionerâ model is anachronistic when considering ancient Greece. When a woman was sick, the person paying the practitioner would have been her male kyrios. Useful here is Joan Caddenâs point, made in relation to the medieval West, that treatment needed to take place within âthe expectations and practices of the patientâs familyâ (1993: 5). In ancient Greece, explanations for the womanâs illness would thus have needed to convince the kyrios, rather than the patient, and may have been most successfully phrased in a way which reinforced his views of female nature. However, we may still ask whether, if these explanations made no sense at all to the patient, she would get better. This may be one of those questions which our sources cannot answer but, by bringing to it a range of comparative data, I will be returning to it throughout this book.
In this chapter I have chosen to start by setting the medical material within the context of the canonical myth of Pandora, the first woman, whose arrival in the world of men ushered in the age of iron, when âdiseases come upon men continually by day and by nightâ (Hes., Erga 102). In doing this, I am arguing from the outset that Hippocratic medicine needs to be seen within the widest possible context of ancient Greek culture, with aspects of its model of the body being shared with society more generally. In terms of the world in which the Hippocratic texts were produced and in which the Hippocratic physicians tried to win control of medical cases, the debate over whether gynaecology is necessary â whether the treatment of women should proceed along different lines from the treatment of men â may be seen as the logical consequence of Hesiodâs programmatic account of the descendants of Pandora, the first woman, as a separate âraceâ (genos gynaikĂŽn, Th. 585â90; Loraux 1978). It is in this context too that the continuation of the debate on the proper treatment of the diseases of women in later classical texts should be seen.
Like a virgin
Thinking about Hippocratic gynaecology in terms of Pandora helps to avoid any assumption that our âgynaecologyâ should be seen as a straightforward equivalent of what the Hippocratics meant by gynaikeia. Gynaikeia is a word which can mean womenâs sexual organs, menstruation, womenâs diseases, or therapies for these diseases, and it is the Greek name for the two long texts in the Hippocratic corpus devoted exclusively to the diseases of women (Diseases of Women 1 and 2). A major concern of Hippocratic gynaecology is the transformation of immature girls into reproductive women; in Greek terms, making a parthenos, a girl who combines the features of being âchildless, unmarried, yet of the age for marriageâ linked on the epitaph of Philostrata (EG 463),2 into a gynĂȘ. To be classified as a mature woman, a gynĂȘ, it was necessary to have given birth: the birth of the first baby ends the process of becoming a woman which started with the first menstrual period demonstrating the readiness of the body, in terms both of the availability of blood from which a foetus can be formed, and the possibility of male semen gaining entry to the womb. The classical Greeks tried to compress this process into the shortest possible amount of time, expecting menarche at age 13 and recommending that girls be married at 14 (King 1985: 180â6; Hanson 1992b: 49).
When Pandora was given to men by the gods, it was not as a gynĂȘ, but in the form of (ikelon, Hes. Th. 572; Erga 71) a parthenos or unmarried virgin (Loraux 1993: 81â2). To have become a gynĂȘ in the full sense of the term, she needed to have given birth, and âfrom her comes all the race of womankindâ. Yet, as Froma Zeitlin (1996) has noted, sexual intercourse is absent from the Pandora myth. Although Pandora is dressed as a bride to be presented as a gift to Prometheusâ foolish brother, Epimetheus, and is the origin of the race of women, there is silence about just what must occur between marriage and birth; instead, âAll is inference. Nothing is stated directly â neither sex nor procreationâ (1996: 58). Zeitlin sees this as part of a deliberate suppression of womenâs sexual and reproductive roles on the part of Hesiod, who argues that only men have any work to do, while women, the source of menâs hard work, remain inside the house taking in all that men can produce.
Hesiod tells the myth twice, both in his account of the origins of the gods, Theogony, and in his Works and Days. Nicole Loraux (1993: 80â1) suggests that, dressed, veiled, and wreathed by the Olympic deities, the Pandora of Hesiodâs Theogony âis her adornments â she has no bodyâ; the emphasis is placed on her elaborate and beautiful exterior which is like that of the immortal goddesses (cf. Erga 62â3). However, a reference which has not been noted in the context of Pandoraâs inside/outside mismatch occurs in the Works and Days: âand he called this gynĂȘ (woman) Pandoraâ (onomĂȘne de tĂȘnde gynaika PandĂŽrĂȘn, Erga 80â1). Taken with the repeated insistence on her virgin form, so that her introduction into the Theogony is formulated in terms of merging the two categories (plastĂȘn gynaika parthenon, 513â14),3 this would suggest that from the outset Pandora is seen as a gynĂȘ, a fully reproductive woman, but masquerading as an innocent virgin. In Works and Days, as well as being âlikeâ a beautiful virgin (parthenikĂȘs kalon eidos epĂȘraton, Erga 63), Pandora is described through two images which suggest the reality that is âinsideâ (en dâara, Erga 77) and which share a strong reproductive message: she is constructed by the gods with âthe mind of a bitchâ (kyneos noos, Erga 67) and ravenous âinsidesâ (gastĂȘr).
Homerâs Agamemnon says that nothing is more like a bitch than a woman (Od. 11.427; Vernant 1979: 105). The domestic dog is comparable to woman in Greek thought, being a predatory beast taken into manâs service, hovering between wild and tame (Redfield 1975: 193â203): as we will see in Chapter 4, the unmarried girl in particular was seen as naturally wild, âuntamedâ (admĂȘs) and âunyokedâ (azyga), to be domesticated into the service of culture. In Aristotle, the dog is explicitly seen as an animal sharing some qualities of humanity. For example, in bitches, swelling of the breasts shows they are ready for intercourse âjust as in peopleâ (HA 574b14â16). However, the later, pseudo-Aristotelian, Problems emphasise what is supposed to differentiate people from dogs: the bitch is often bad-tempered after childbirth, but women are not (894b13â15); the dog is prolific, but people are not (892a38âb1). This last point introduces a feature of the dog which human beings may want to emulate. The bitch was thought to give birth more easily than other animals (Plut. Mor. 277aâb) and to have many wombs, hence the appearance of offspring in litters (Aelian NA 12.16). Even in a human context, while kuĂŽn means âdogâ, kuein means âto be pregnantâ. But dogs also represented âdissolute impudenceâ (Lilja 1976: 22): kuĂŽn is used in comedy for the sexual organs (Henderson 1975: 127, 133). Dogs were thought to have exceptional sexual appetites (Redfield 1975: 194), remaining together in coitus for a particularly long time (Ar. HA 540a24), and having intercourse at every stage of their lives (Ar. HA 574b27), although elsewhere Aristotle says that bitches stop being sexually active at 12 or, at the latest, 18â20 (HA 546a28â34).
Which of these aspects is Pandoraâs bitch-mind supposed to evoke? Insatiable sexual desire, or desirable fecundity: or, perhaps, the fear that one cannot achieve the second without experiencing the demands of the first? The dog features as an ingredient in recipes given in Hippocratic gynaecology, but puppies, rather than mature dogs, were used to cure failure to conceive. The fat of puppies could be cooked and eaten (DW 2.217, L 8.420), or a whole puppy disembowelled, stuffed with aromatic substances, and then used as the basis of a fumigation (DW 2.230, L 8.440; see Chapter 11, pp. 218â19), a procedure in which vapours were passed into the uterus through the cervix in order to open it, return it to its correct position if it had moved elsewhere in the body, or expel substances such as retained menstrual blood which were causing disease. When the respective qualities of the flesh of dogs and puppies are described in the treatise Regimen 2, âdogâs flesh dries, heats and strengthens but does not evacuate ⊠the flesh of puppies moistens and evacuatesâ (2.46, Loeb IV, 318). Intercourse moistens the womb, discouraging it from moving elsewhere to seek moisture, and agitates the body, easing the passage of blood within it. Similarly, puppies moisten the female body, encouraging reproduction. But mature dogs âdryâ the body; dogâs...