Category Archives: Series: Women’s Health

Like an alien in a strange old world – Reading Mesopotamian medical texts on women’s healthcare

By Ulrike Steinert

Decoding medical cuneiform texts often makes you feel a bit like a detective who has entered a mysterious, foreign world of words and ideas. Not few of my Assyriologist colleagues would probably favour other topics, rather than studying Mesopotamian medical texts, because they are hard to understand, full of strange disease names and unknown drugs, and because these texts have a reputation of being technical, monotonous and boring.

Not surprisingly then, Mesopotamian medical texts remain a poorly known corpus, and few scholars have worked on the subject or published books for a general audience.[i] Although the majority of the texts are still unavailable in proper editions and translations, the situation is steadily improving. Beside a growing number of publications every year, cuneiform medicine is becoming an increasingly recognised topic, and a few research projects are currently investigating these texts, preserved on thousands of fragments of clay tablets and scattered in various museums.[ii] The fragmentary nature of the corpus, consisting of diagnostic and therapeutic texts as well as handbooks on materia medica, written during the 2nd and 1st millennium BCE, and the difficulty of decoding them connected with the cuneiform writing system and the genre (especially the use of many multivalent logograms) have contributed to the lagging behind of research in this field, compared e.g. to Egyptological research on medical papyri.

Let me describe some of the difficulties posed by the Mesopotamian medical texts, specifically those concerned with treating women, to a modern reader. These difficulties result to a considerable degree from cultural differences e.g. between ancient and modern concepts of physiology, disease and therapy.

One problem for the modern scholar is to grasp ancient disease concepts and ideas of physiology from symptom descriptions. The gynaecological texts form a small sub-corpus among the majority of medical tablets devoted to diseases which are normally not gender-specific and which use the male body as a general model. Thus, while the latter diagnostic and therapeutic texts begin with the formula “If a man (suffers from ailment X/symptoms X, Y, Z)”, the gynaecological texts begin with “If a woman …”. The gynaecological corpus, not unlike the modern medical discipline, focuses on female reproduction: (in)fertility, complications occurring during pregnancy, birth, and in childbed, but also includes treatments for abnormal vaginal bleeding and other fluxes, as well as renal, rectal and gastro-intestinal ailments in women. Yet, because the perspective of gynaecological texts was restricted to the diagnosis and treatment of abnormal phenomena, they do not contain descriptions and explanations of normal physiological functions, such as menstruation, which have to be inferred from the sparse information gleaned from the medical texts or other text genres.

A Babylonian tablet with medical prescriptions for women, ca. 7th cent. BCE. Source: Cuneiform Digital Library Initiative ( photo/P238756.jpg)
A Babylonian tablet with medical prescriptions for women, ca. 7th cent. BCE. Source: Cuneiform Digital Library Initiative (

For instance, Babylonian healers collected treatments “to stop a woman’s blood” in case “a woman’s blood flows and does not stop”, leaving us at loss to decide whether this refers to unusually heavy menstrual bleeding or to abnormal haemorrhage due to other causes. Beside blood, the texts also treat discharge of “fluids” (literally “water”) from the vagina, which depending on the context, refers to phenomena which modern medicine has come to differentiate, like amniotic fluid (premature rupture of the membranes) and vaginal discharge due for instance to leucorrhea. It becomes clear that the Babylonian healers do not share our differentiations of symptoms and diseases, and that progress with the texts will only be made by investigating their system of ideas about what goes wrong in the body when disease occurs.

This undertaking is somewhat hampered by another characteristic of Mesopotamian medical texts, namely that the writers (Babylonian and Assyrian healers and scholars) rarely recorded their theories (e.g. discussions which took place in the classroom and in scholarly discourse). Yet, some of their concepts of the body, health and disease emerge, often implicitly, from disease aetiologies, names, and from metaphors found especially in the incantations that accompanied medical treatments. These characteristic traits of Mesopotamian medical texts form a contrast to Greek and Roman medical writers who often speculated in writing about physiological processes such as menstruation, conception and the nature of female illnesses based on humoral theory.

Another challenge arising from Babylonian medical texts is to understand the “logic” of ancient medical treatments and recipes even though the majority of the drugs are unidentified, and to reconstruct the cultural context in which the texts were used, e.g. how medical consultation and application of treatments actually took place. Thus, it is still debated whether Babylonian (male) healers actually examined women (and applied the prescribed remedies like tampons), or whether the symptom descriptions in the texts stem from what the patients observed themselves and told the doctor. In upcoming posts on fumigation in Mesopotamian and Hippocratic gynaecology, I will illustrate an approach to discover principles of coherence between the use of particular materia medica and specific complaints.

[i] A real primer presenting a comprehensive overview of Mesopotamian medicine is Markham J. Geller’s Ancient Babylonian Medicine. Theory and Practice. Malden / Oxford, 2010.

[ii] The most ambitious of these projects in terms of scope is “BabMed”, a project at Freie Universität Berlin, consisting of a small research team led by Markham Geller. An overview of publications about Mesopotamian medicine can be found in the regularly updated bibliographies in Le Journal des Médecines Cunéiformes (

Curdled Milk in the Breast

By Jennifer Park

In one of the most visceral images of corruption within the body, the ghost of Hamlet’s father describes his murder by poison at the hands of Claudius:

Upon my secure hour thy uncle stole,
With juice of cursed hebenon in a vial,
And in the porches of my ears did pour
The leperous distilment; whose effect
Holds such an enmity with blood of man
That swift as quicksilver it courses through
The natural gates and alleys of the body,
And with a sudden vigour doth posset
And curd, like eager droppings into milk,
The thin and wholesome blood: so did it mine. [emphasis mine] (1.3.61-70)

The power of the image comes from comparing the curdling effects of poison on the blood to the daily and material reality of milk going bad. As we and our early modern counterparts were familiar, the process of milk putrefying involved the separation of the solids and the liquids of the milk, as Shakespeare so eloquently put it, “like eager droppings into milk.” If the thickening of blood could be described in terms of the curdling of milk, I wondered: could the danger of curdled blood be applied quite literally to breast milk, which was thought to be a form of blood?

My investigation of this as a potential phenomenon began by considering Old Hamlet’s speech alongside the transformation Lady Macbeth calls for, to “make thick my blood…Come to my woman’s breasts, / And take my milk for gall” (1.5.43, 47-8). Her references to her milk have been explored as one of Shakespeare’s many references to breastfeeding, and central to discussions of early modern breastfeeding was the status of human breast milk. Since antiquity, as Laurence Totelin has written, breast milk was held to be an especially nutritive substance with healing qualities. It was a powerful substance capable of changing or altering the children who ingested it because it was thought to be “white blood” or “‘twice-concocted’ blood manufactured in the mammary glands from blood itself.”[1] But as I am interested in the darker underbelly of milk as an easily corruptible substance, I wanted to find out more about milk curdling and to what extent it was a physiological as much as a culinary phenomenon.

There were a variety of early modern remedies directed towards breastfeeding women, treating everything from “for a milk sore in the breast,” to “A Medecine to to drye vpp a woemans Milke troubling her in Childbedd,” to remedies “To Increase A Womans Milk” or “For a woman that hath lost her milke.”[2] Among these, sure enough, I found remedies that specifically mentioned the curdling of milk in the breast, providing some clues about the physical pain and hardness associated with the problem. Lady Frances Catchmay provided a remedy “for a Womans brest that is curdeled | wth milke” in her manuscript receipt book.[3] So too, Philip Stanhope recorded two receipts, one from “L[ady]. Hu.” for a remedy “Against the sorenesse of any breasts by reason of the Curdling of milke in womens Breasts,” and another for “A Cattaplasme for Breasts that are hardned with congealed milke.”[4]

Credit: Wellcome Library, London. Philip Stanhope, MS 761, f. 197v, c. 1635.

Lady Ayscough’s receipt book provided a remedy for “Brest curdled with Milk to help,” but also one “For a Breast wherein | the Milk is wharled & knotted”–what an image!–which required a massage to “breake the wharles | easily with your finger morneing and euening.”[5]

Wellcome MS 1026, 1692
Credit: Wellcome Library, London. Lady Ayscough, MS 1026, f. 83r, 1692.

Clearly, curdled milk in the breasts was a common problem, and a painful one at that, even, as one recipe notes, causing “rednes inflamation | swelling paine and torment.”[6] In light of evidence that milk could in fact curdle in the breasts, Lady Macbeth’s desire to “make thick my blood…And take my milk for gall” (1.5.43, 48) can be read as need for physiological hardening to accompany her emotional stoicism. Regardless of whether we think that Lady Macbeth’s spirits could enact such a transformation upon her body, or if she means it purely for the sake of metaphor, her desire for such a painful state is in stark contrast to the solace that most women were seeking for their breast pain. For such a well-documented problem among early modern women, how much more unnatural that Lady Macbeth should wish it! Perhaps we can’t help but admire her intention to practice what she preaches to her husband: no pain, no gain.


[1] Ken Albala, “Milk: Nutritious and Dangerous,” in Milk: Beyond the Dairy: Proceedings of the Oxford Symposium on Food and Cookery, 1999, (Devon, UK: Prospect Books, 2000), 21. See also Victoria Sparey’s discussion of blood and milk in “Identity-Formation and the Breastfeeding Mother in Renaissance Generative Discourses and Shakespeare’s Coriolanus,” Social History of Medicine 25.4 (2012), pp. 781-87.

[2] Anne Brumwich (and others), Wellcome MS 160, f. 89v, c. 1625-1700; Mrs. Corlyon, Wellcome MS 213, f. 38v, 1606; Elizabeth Jacob (and others), Wellcome MS 3009, f. 78r, 1654-c. 1685; Jane Jackson, Wellcome MS 373, f. 111r, 1642.

[3] Lady Frances Catchmay, Wellcome MS 184A, f. 35v, c. 1625.

[4] Philip Stanhope, Wellcome MS 761, ff. 182v, 197v, c. 1635.

[5] Lady Ayscough, Wellcome MS 1026, ff. 112v, 83r, 1692.

[6] Townshend Family, Wellcome MS 774, f. 21v, 1636-1647.


Early Modern Breast Surgeries and Recipes

I’ve been a teaching assistant twice for a two-semester survey of the history of western medicine offered at the Johns Hopkins University. The full sequence takes undergraduates from Hippocrates to Obamacare, with the second semester covering the Enlightenment to the present. One of the pleasures of teaching a discussion section during the second semester is that it allows me to explore the history of our own institution with a group of undergraduates, many of whom themselves hope to work in healthcare and perhaps to study medicine at Johns Hopkins.

William Halsted. Source: National Library of Medicine, IHM. 101417923.

A key, fascinating figure in the early history of Hopkins–and one who bridges central course themes as we shift from the early modern, to the modern, to the contemporary–is William Halsted. He was one of the “Big Four,” a brilliant surgeon, an accidental cocaine addict. Halsted is well known for his role in the history of mastectomy, and in this as in other areas of his career he can illuminate these themes for students. His life and career, for example, epitomize the promises and perils of developments in nineteenth-century surgery. I also believe that the history of radical mastectomy has particular power for many because the tensions that the measure introduced into the lives of sufferers continue to be recognizable in our own. We all have friends and family who have suffered from and with cancer and cancer therapies, and many have faced decisions over difficult breast surgeries. These tensions also persist at the level of public policy. For instance, just in the last few days, as I was preparing this post, I listened to a contentious panel discussion on the American public radio program “The Diane Rehm Show” about routine mammography.

I don’t want to suggest that our and our loved ones’ medical experiences are in any way the same as Halsted’s patients’, much less those of early modern people who contemplated going under the knife, but I do want to suggest here that making such connections may help us and our students think about and empathize with historical actors who often seem very foreign from us. Recipe books might seem like poor sources for doing this, but if we look closely I think that there is in fact evidence of a great deal of emotion and drama. It is visible, for instance, in recipes that heal breasts, especially breasts threatened by dire maladies and consequently surgeons’ tools.

Halftone of Bodleian Library window. Source: National Library of Medicine, IHM. 101409068.

As scholarship such as Lucinda Beier’s on the London surgeon Joseph Binns has shown us, workaday early modern surgeons did not perform much invasive surgical work.1 Opening the body and reaching into it with tools and chemicals was usually a last resort, but it was one some surgeons and sufferers were willing to undertake. Operations like craniotomy, lithotomy, and, of course, limb amputation are the best known pre-modern measures. Surgeons also sometimes cut into afflicted breasts, removing portions of breasts or even amputating them entirely.

A vivid instance of an early modern breast surgery can be found in the writings of Richard Wiseman. Wiseman was sergeant-surgeon to Charles II and an influential surgical author. One of his published cases describes the sufferings of a twenty-six-year-old “Country maid.”The woman was afflicted with an ulcerated cancer of the right breast “arising from some accidental Bruise.” It had progressed to a grim stage. Wiseman decided the breast could not be cured, and urged that it should be cut off before “a Fungus” which he thought lay deep in the breast “should be fixed to the Ribs.”

Richard Wiseman. Source: National Library of Medicine, IHM. 101432120.

Wiseman won some sort of consent, though how ready it was is perhaps indicated by his explanation that she and her companions “were not unwilling that it should be cut off” and that their decision took a month. Wiseman himself seems to have been much more eager, having just received “the Royal Stiptick liquor” at the king’s command. He saw the surgery as “seasonable” for experimenting with it, in the presence of “some Friends who desired to see the efficacy.”

I should warn you that his description of the operation is difficult to read. Like many early modern surgeons’ description of operations, it also largely occludes the patient and her experience. I will quote it at length here, however, because I think that it gives a powerful glimpse of what an invasive procedure was like at this time. But please skip the next two paragraphs if that is not a glimpse you’d like to take. Wiseman’s associate, the physician Walter Needham,

pulled up the Breast while I made a Ligature upon the basis of it, and cut it off. The two Arteries bled forcibly out, till Doctor Needham applied a wet Button [lint soaked in the water] on the one, and… [an assistant] applied the other… [One] stopt the Bleeding at that very instant… but the bloud dribbled from under the other: which we supposed happened by reason of the bloud streaming upon it in the putting it on. But by the application of a fresh Button the Bleeding there also stopped. During this the Lips of the wound were brought nearer to each other by a cross stich. We then applied our Digestive with convenient Bandage over it, and laid the Patient in her Bed. [They left, and] In our absence she fainted, and upon the drinking a draught of cold water vomitted, and her Breast bled through the Dressings. Upon sight thereof I took off the Dressings, and seeing one of the Arteries seepe, I applied a fresh Dostil [dossil], and stopt it: but it being night, and dreading mischief might happen if it should bleed again, I sent for a small Button cautery, and that way secured it. (“I secured that Artery by the touch of a hot Iron,” he explained in another account of the operation.)

The woman had some difficulties after the operation, but she returned to the country a month and a half later. Once there, however, the cicatrix “fretted off” and the ulcer grew. She returned to Wiseman, who treated her successfully. “Since which time,” he concluded, “I have seen her often in Town in very good health, and her Breast firmly cicatrized, without pain or hardness.”3

It’s surgical measures like this that give us a sense of what what authors and compilers had in mind when they collected remedies that saved breasts destined for the knife or powerful chemicals. The Johanna St. John collection, featured in a number of earlier posts here, has a striking example. It is “For a Cancer in the Breast”:

A piece of a sheep skin taken off the Flank of the sheep lay the skin side to the breast changing it once in 12 hours & in hot weather once in 6 hours this was used to a woman whose breast was to be cut off but was not broke & it kept her very many years without any pain or trouble & at last died of another disease La Child knew the woman to whom it was taught by a French man.4

This tale, as well as the information about the provenance of the remedy and the presence of similar examples, indicates the involvement of collectors in a world of remedies for serious medical problems that offered them the chance to control the measures they used and offered them the hope of avoiding the most unpleasant. Quacks offered something similar when they peddled non-mercurial pox treatments.5

I am very interested to know whether you’ve found similar sorts of material in recipe books that might give evidence of therapeutic preferences. I’m also interested in how recipes (these sorts and others) have been or could be used in teaching the history of pre-modern medicine, especially to students in survey courses. In my favorite activity from the first half of our survey, we give groups of students a selection of seventeenth-century medical advertisements and ask them to think about what the advertisers were offering, how they offered it, and why it may have been appealing to consumers. Would it be possible to design similar sorts of lessons using selections from recipe collections? How else can we use collections and recipes in the classroom, especially when teaching students that are new to early modern history and working with primary sources?



1 “Seventeenth-Century English Surgery: The Casebook of Joseph Binns,” in Christopher Lawrence (ed.), Medical Theory, Surgical Practice: Studies in the History of Surgery (London: Routledge, 1992): 48-84, and Sufferers and Healers: The Experience of Illness in Seventeenth Century England (London: Routledge & Kegan Paul, 1987), chp. 3.

2 Michael McVaugh, “Richard Wiseman and the Medical Practitioners of Restoration London,” Journal of the History of Medicine 62 (2007): 125-40. He briefly discusses this case on 133-34.

3 Eight Chirurgical Treatises, 3rd ed. (London: for B.T. and L.M., 1697), Wing W3106A, pg. 108-109, “Observat. of a Cancerous Breast cut off.” Phil. Trans. 8 (1673): 6039. Italics removed.

4 Wellcome MS 4338, fol 18v. I’ve modernized the spelling here.

5 For instance: Andrew Wear, Knowledge and Practice in English Medicine, 1550-1680 (Cambridge: Cambridge University Press, 2000), 271.

Green sickness, red plants

By Helen King

I’ve been interested for a long time in green sickness, a condition affecting girls at puberty that involved menstrual suppression, often along with some sort of dietary ‘blockage’. The remedies for it, over the 400 or so years that it was recognised as a disease, raise all sorts of problems. For example, in the 19th century it was seen as a form of anaemia, so iron was prescribed. In the 17th century, before that level of knowledge of blood existed, ‘steel filings’ were often part of the remedy, and iron is a constituent of steel. So, how did they know to use steel? Or was this nothing to do with the iron content, but instead about steel being imagined as ‘cutting through’ the blockages?

Langham’s text. From . Copyright: Cardiff University, used with permission.

William Langham wrote ‘The Garden of Health’ in 1597. It was based on earlier recipe collections, and I came upon it when I was thinking about using recipes to tease out what exactly was supposed to be causing the symptoms – so, if the recipe involved plants that were clearly evacuative, then this could suggest that the cause of the disease was seen as a blockage. Langham arranged plants in simple alphabetical order, rather than arranging the material under the names of diseases; but, as part of his accessibility, he also gave a list of conditions with references to the different plant entries where the reader could find out more.

Langham gives a range of recipes for green sickness. One is packed full of ‘red’ plants –

‘seethe powder of the Keyes [i.e. the ash tree] with Betonie, red Sage, red Mynts, and Magerom [marjoram] in running water from a pottell [= 2 quarts] to a quart, and drink thereof a good draught with sugar warme morning and evening’

Elaine Hobby pointed out to me that this recipe also appears in 1677 in ‘The Accomplish’d Lady’s Delight’ by ‘T.P.’ (possibly Hannah Woolley), but with ‘red Fennel’ instead of ‘red Mynts’. There was a second edition of Langham in 1633, and maybe the author used this.
So what’s all this red about? Betony, sage and marjoram often appear together in later collections as a gentle sternutatory. Red sage and betony are used against bilious attacks. Ash keys feature today on ‘wild food’ sites with the warning that they are very bitter and need to be boiled several times before eating, but what was used here was the ripe seed, dried and then reduced to powder. The ash-powder is used elsewhere for the stone (by provoking urination), jaundice and dropsy.

So maybe there’s something here about getting rid of obstructions. But to me, all this redness suggests the colour of blood, and the use of running water also makes me think that this is aimed at restoring or establishing a normal menstrual flow. How do we balance the known effects of the plants chosen, with the symbolic power of red? Comments please!

Helen King is Professor of Classical Studies at the Open University, UK. Her book on green sickness is  The Disease of Virgins.