Lady Doctors in Late Antiquity

Before lockdown began in the UK, a friend from work lent me a copy of one of her favourite historical novels, the Beacon at Alexandria, by Gillian Bradshaw. As someone who was first captivated by the Middle Ages by reading historical fiction, particularly the works of Frances Temple, Gerald Morris, Rosemary Sutcliffe, and Frances Mary Hendry, I have a soft spot for novels set in the ancient or medieval past. Most of the time, I don't care whether the story is historically accurate. As kid I wasn't interested in whether something 'really happened' and I continue to find this a profoundly uninteresting question as an adult. My disbelief is willingly suspended: a story is its own truth but it is not fact. Even so, I am always delighted when fiction writers trace their inspiration back to a medieval source: the story's truth and historical fact united.

Which is a long-winded way of saying that the story of the Beacon at Alexandria--that of a young woman from Ephesus, Charis, who runs away from home and disguises herself as eunuch in order to train as a physician in Alexandria--had me captivated from the first page. While novels which focus on the small world of a particular place (such as the Bronze Age farming community of Warrior Scarlet) are delightful, I particularly enjoy historical fiction where the characters travel widely. The Beacon at Alexandria gives a peak into the imagined worlds of fourth-century Ephesus, Alexandria, Noviodunum and other areas around the province of Thrace. Gillian Bradshaw, who has an MA in Classics from Cambridge, was explicit about what was and wasn't real:

Finally, I must state clearly that the central events and characters of this novel are entirely my own invention: I wrote it for fun and in the hope that others would enjoy it. The historical background, however, is tolerably accurate, and many of the characters are based on real people. For those who are interested in knowing more about them, let me recommend a few of the more obtainable books. The history of Ammianus Marcellinus (The Later Roman Empire, available in Penguin) is a fascinating work by a man who had witnessed many of the events he describes. Gibbon's Decline and Fall, though not always trustworthy, is still the best modern narrative of the period, and nearly available in various abridgements; as a corrective to this, The Decline of the Ancient World by A.H.M. Jones (an abridgement of his The Later Roman Empire) is magisterial and authoritative. These are only the beginning, of course: the later Roman period is a great foreign nation, full of people; a world which is an endless adventure to explore. (pp vi-vii)

Endless adventure--what better way to describe the fascination of late antiquity.

Footnote 27

The story of a woman who disguises herself as a man to practice medicine stuck in my head, and a few months ago, I was delighted to come across the following reference:

Women in Roman Gaul seem to have had a positive connection with education: Ausonius himself was brought up by his maternal grandmother and aunts (who included the interesting figure of his aunt, Aemilia Hilaria, so 'boyish' she was known by the masculine name 'Hilarius', vowed to perpetual virginity, and entirely occupied with medicine 'like a man'). Jane Stevenson, Women Latin Poets (Oxford, 2005), pp. 63-4.

I made a note to follow upon on the contents of footnote 27, which directed the reader to Ausonius' Parentalia, Poem 6. 

A word about the poet. Ausonius (c. 310- c. 395), was born in Bordeaux; he was the son of a physician and gained a good education in grammar and rhetoric, which he began teaching at his own school in around 334. About thirty years into his teaching career, he hit a high point, becoming tutor to the future emperor Gratian. His presence at the imperial court brought him and his family a number of prestigious appointments in late Roman bureaucracy. Ausonius returned to Bordeaux after Gratian was murdered in 383, and spent the rest of his life there. 

Throughout his life, Ausonius was a prolific writer, and some letters and a great deal of poetry still survive. I have had the pleasure of teaching a bit of the Professors of Bordeaux (Professores Burdigalenses), his set of biographies in poetry of the noteworthy teachers of his city, in a seminar on late antique education, but am sadly under-acquainted with most of his work. Late in life, Ausonius composed a series of thirty poems called the Parentalia, in memory of his relatives, including his aunt Aemilia. Literary production was a kind of bat signal for late Roman elites, enabling them to find and recognise one another as members of the same social class. Ausonius' literary output, although it contains personal matters such as family history, always had a public face.

VI. Aemilia Hilaria, my mother's sister, an avowed virgin

You too who, though in kinship’s degree an aunt, were to me a mother, must now be recalled with a son’s affection, Aemilia, who in the cradle gained the second name of Hilarius (Blithesome), because, bright and cheerful after the fashion of a boy, you made without pretence the very picture of a lad...busied in the art of healing, like a man. You ever hated your female sex, and so there grew up in you the love of consecrated maidenhood. Through three and sixty years you maintained it, and your life’s end was also a maiden’s end. You cherished me with your precepts and your love as might a mother; and therefore as a son I make you this return at your last rites.  

translated by Hugh G. Evelyn White, Ausonius Vol 1 (Cambridge and London, 1919), pp. 66-69

Tantalizingly, the ellipsis seems to indicate two lines are missing exactly where one wants to know more: could 'the picture of a lad' refer to cross-dressing, or some other form of masculine self-presentation? What does the name Hilarius tell us? Hilarius and Hilaria are the masculine and feminine forms of the same name. Ausonius' poem suggests the masculine form was deliberately used by the family, hence my use of Aemilia Hilarius to refer to her. Where did Aemilia Hilarius learn medicine? None of Ausonius' poems about his mothers' family mention physicians, but both his father, Ausonius Julius, and his brother, Avitianus, practiced medicine, so one possibility is that she learned from her brother-in-law.

One thing we can know for sure: she wasn't alone.  The research of Louise Cilliers and Francois Pieter Retief makes clear that there is evidence of female doctors throughout antiquity. Sources range from the philosophical writings of Plato, to the medical writings of the second century physician Galen and other medical writers, to offhand comments in the poems of Martial and Juvenal; to a matter-of-fact aside in the sixth-century legislation of the Byzantine empire Justinian, specifying that a particular law applied to doctors whether they were male or female. The only known surviving medical text written by a female doctor, Metrodora, is from the second or third century CE. Female doctors might also be mentioned in the dedications of medical texts--Gratian's personal physician, Theodorus Priscianus, dedicated a book on gynecology to a fellow doctor named Victoria. Female doctors are also attested in epigraphic sources--that is to say, the commemorative inscriptions which were ubiquitous around the Roman world. Particularly striking is a second-century inscription from Pergamum (modern-day Pergamos, Greece):

Receive, Pantheia, my wife, the farewell greeting of your spouse, who is cast into eternal mourning by the fate which caused your death. Because never before did Hera, patroness of marriage, see a spouse with such perfection of beauty, temperament and wisdom as you. You gave me sons, the images of myself. You watched in turn over your husband and children. You managed the household capably, and along with me you enjoyed fame as a medical practitioner because, dear wife, you were no less qualified than I in the art. Therefore Glykon, your husband, has buried you in this sepulchre, in which the body of the deceased Philadelphus also lies buried, and in which I myself will rest after my death; as I shared your marriage bed, so shall I lie beside you underground. (Cilliers and Retief, 'The Healing Hand: the Role of Women in Ancient Medicine', p. 175)

Women physicians even entered the realm of legend. One of the stories recounted in the Fables (Fabulae) of the first century Latin author, Gaius Julius Hyginus, is about the invention of obstetrics in ancient Greece.

The ancients didn't have obstetricians, and as a result, women because of modesty perished. For the Athenians forbade slaves and women to learn the art of medicine. A certain girl, Hagnodice [also translated as Agnodike or Agnodice], a virgin desired to learn medicine, and since she desired it, she cut her hair, and in male attire came to a certain Herophilus for training. When she had learned the art, and had heard that a woman was in labor, she came to her. And when the woman refused to trust herself to her, thinking that she was a man, she removed her garment to show that she was a woman, and in this way she treated women. When the doctors saw that they were not admitted to women, they began to accuse Hagnodice, saying that "he" was a seducer and corruptor of women, and that the women were pretending to be ill. The Areopagites, in session, started to condemn Hagnodice, but Hagnodice removed her garment for them and showed that she was a woman. Then the doctors began to accuse her more vigorously, and as a result the leading women came to the Court and said: "You are not husbands, but enemies, because you condemn her who discovered safety for us." Then the Athenians amended the law, so that free-born women could learn the art of medicine. (Hyginus, Fabulae 274, translated and edited by Mary Grant)

Bradshaw stresses that the events and characters of her novel are entirely fictional, so I want to conclude by emphasising that her heroine Charis is not Aemilia Hilarius or Pantheia or Agnodike. But without having read about Charis, I never would have been interested in reading about Aemilia Hilarius. The truth of the late antique world is even stranger than its fiction.

Further Reading

Interestingly, Aemilia Hilarius features in Judy Chicago's The Dinner Party, in the heritage floor underneath Hypatia's place setting--see here

Ausonius, Parentalia, translated by Hugh G. Evelyn White, in Ausonius Vol 1 (Cambridge and London, 1919). The latest and most reliable edition of Ausonius' works is Roger Green, Decimi Magni Ausonii opera (Oxford, 1999), which can be found in most research libraries.

Gillian Bradshaw, The Beacon at Alexandria (London, 1987).

Louise Cilliers and Francois Pieter Retief, 'The Healing Hand: the Role of Women in Ancient Medicine' Acta Theologica 7 (2005), pp. 165-188.

T.R. Heggestad, 'Women in Medicine', Women in Antiquity available from https://womeninantiquity.wordpress.com/2018/11/27/women-in-medicine/ [accessed on 30 August 2020].

Hyginus, Fabulae. Translated by Mary Grant, The Myths of Hyginus (Lawrence, 1960). Available from https://topostext.org/work/206 accessed on 30 August 2020.

Martin Nichols, 'Ausonius and his Aunt Aemilia Hilaria' Martin Nichol's Roman Blog http://martinnicholsroman.blogspot.com/2016/04/decius-maximus-ausonius-is-author-who.html [accessed 30 August 2020].