Sexual Difference and the Uterus in Luis Mercado, Rodrigo de Castro, and Zacuto Lusitano^[1]

Cristina Pinheiro^*

https://orcid.org/0000-0001-5223-0519
University of Madeira/
Centre for Classical Studies of the School of Arts
and Humanities of the University of Lisbon
cristinap@staff.uma.pt

La différence sexuelle et l’utérus chez Luis Mercado, Rodrigo de Castro et Zacuto Lusitano

Introduction

The authors of many of the sixteenth and seventeenth-century treatises on gynaecology often begin their works by explaining why they write about women and their diseases, providing the reader with a set of arguments that aim to justify the choice of such a subject. One of the reasons most frequently given is that women have specific diseases and, therefore, they need specific medical care. This idea seems to have been first exposed in the Hippocratic Corpus, in Diseases of Women 1.62, probably dating back to the fifth century BC: that women’s diseases are dangerous and especially difficult to treat because women do not know what causes them and sometimes, due to shame, ignorance, and lack of experience, women do not talk about these illnesses; that doctors treat them as men’s diseases and do not inquire correctly about them; and, finally, that the treatment of the diseases of women is different from those of men’s. Helen King called this set of Hippocratic ideas the “Hippocratic imperative” that, in the long run, originated the specialised medical field of gynaecology.^[2] Together or separately, these topics are often used to justify writing or publishing treatises on gynaecology, and they usually appear in introductory texts such as prefaces or dedicatory epistles or in the initial chapters, which constitute the main focus of this study.^[3] This seems part of the text’s rhetorical construction intended to solve a fault or problem identified in the medical tradition. As such, the author presents himself as someone dedicated to improving the status quo, in this case, women’s health or the state of medicine. There is, consequently, a social commitment related to the well-being of women and, ultimately, of the social fabric itself that we need to keep in mind when interpreting these treatises.

The difference between the sexes is thus one of the main arguments that justifies the need for this kind of endeavour. Asserting female nature as specific and especially difficult to understand is the starting point of many of these texts. Women have different physical, psychological, and social features and particular conditions, like menstruation, pregnancy, and childbirth, and so they need a specialised medical approach. Moreover, not only do women have organs and diseases of their own, which men do not have, but these female organs and diseases are particularly challenging for the physician and put medical knowledge and experience to the test. As a result, these texts often have admonitory content intended to warn the reader that this subject is particularly demanding and needs greater attention and much study. This also establishes the authorial voice as helpful, informed, and committed to the common good, a Leitmotiv in the prefaces of medical treatises. Therefore, the medical author offers his work as a valuable tool to aid others, be they other doctors, laymen, or women.

The three authors I study here constitute another link in this long chain that ultimately established gynaecology as an autonomous field. The differences between the sexes are thus an essential basis in the books devoted to gynaecological matters. Nevertheless, I argue that other concurrent, even if dissonant notions, such as complementarity and even, at times, equality or female superiority, combine, not, however, without tension, with this fundamental concept of sexual difference. This combination creates a nuanced framework encompassing complex and multi-layered images of women, aggrandising, at the same time, the subject of these treatises and legitimising the incursion of the learned male physician in a field traditionally reserved for midwives. The treatment of women and their diseases requires, thus, the intervention of a highly qualified doctor, prepared to face conditions that are peculiar and very difficult to diagnose and cure.

Luis Mercado (1532-1611), Rodrigo de Castro Lusitano (1546-1627/1629), and Zacuto Lusitano (1575-1642) share the same Iberian origins and the same academic background. They all graduated from Iberian universities, Mercado in Valladolid, Castro in Salamanca, Zacuto in Salamanca and Siguenza.^[4] Mercado was appointed physician of the king’s chamber by Philip II and, later, “protomedico general de los reynos de España.”^[5] Castro and Zacuto both fled Portugal due to religious persecutions, having publicly assumed themselves as Jews later in life, the first in Hamburg and the latter in Amsterdam.^[6] The three were well known and respected, not only in their country of origin but also, or even especially abroad, as is the case of the two Portuguese.^[7]

Mercado published his De mulierum affectionibus libri quattuor (Four books about Women’s Diseases) in Valladolid in 1579, with subsequent editions in Venice in 1587, Basle in 1588, etc. It was included in his Opera Omnia, edited in 1594 and also edited as part of a massive collection of treatises dedicated to gynaecology and obstetrics, the Gynaeciorum libri, in the fourth volume of the second edition in 1588, and its third folio edition in 1597.^[8] The international dissemination of the work was thus ensured, which is undoubtedly the cause of this treatise being one of the most important and well-known works of Luis Mercado. In it, Mercado articulated the medieval tradition on women with the Hippocratic texts, made available by the new humanist interest in the Hippocratic Corpus. The nearly five hundred pages of the 1579 edition organise the medical knowledge on gynaecology and obstetrics in four books: the first deals with diseases common to all women, the second with diseases of virgins and widows, the third with sterility and pregnancy, and the fourth with puerperal and wet-nurses’ disorders.

Castro’s De uniuersa mulierum medicina (On the Complete Medicine of Women) was printed in 1603 in Hamburg and underwent several editions in the seventeenth century.^[9] In this treatise, Castro synthesises the medical tradition concerning women’s conditions and diseases in two parts of differing lengths, organised in four books each. In Part 1, he explores what is “natural” to women, that is, what happens according to nature (female anatomy, conception, normal pregnancy and childbirth). Part 2 is a gynaecological and obstetric pathology manual, where Castro analyses the diseases that can affect the female reproductive tract.^[10] As he states in the Preface to the reader in Part 1, the main goal of his treatise is to bring order and clarity to a subject which, in his opinion, was scattered throughout multiple sources or confusedly organised in the specialised literature. According to Castro, the extension and diversity of the published material were challenging to handle and understand; therefore, as he asserts, the doctor could not read the texts before the illness reached its conclusion. His compositional method consists of an intricate process of selecting, compiling, interpreting and harmonising textual sources, sometimes combining them with his experience as a medical practitioner and frequently scrutinising medical practices and other authors’ opinions in his commentaries.^[11]

Zacuto’s medical work is extensive, and it was published in the last years of his life when he had already settled in Amsterdam after leaving Lisbon. It was compiled into two massive tomes, printed in Lyon following the author’s death. His major works are De medicorum principum historia (On the History of the Most Important Physicians), Praxis medica admiranda (Medical Practice to be Admired) and Praxis historiarum (Practice of Histories). In all three, Zacuto deals, at some point, with women’s diseases. Here, and for the sake of clarity and brevity, I analyse only Book 3 of Praxis historiarum, which is, in fact, Zacuto’s treatise on gynaecology, also printed in tome II of his Opera Omnia.^[12] I refer to this treatise as Treatment for Women’s Diseases (Curatio muliebrium morborum), the expression used as a subtitle in the book’s frontispiece. Comprising 23 chapters and a praefatiuncula, that is, a little preface, it explores conventional topics like menstrual blood, semen, and breastmilk, advancing then to female disorders and their treatments.

Sexual difference as a cosmological feature

As stated, the peculiarity of women’s condition is a common starting point for these three authors, but they elaborate more widely on the differences between the sexes. For Mercado and Castro, it is a cosmological characteristic, a feature of all things constituted by Nature. Both authors present this topic in the first chapter of their works, entitled “On the difference of sex” (De sexus differentia). In contrast, Zacuto gave his first chapter the title “On the excellence of the female sex” (De excellentia feminei sexus), evoking the title of Cornelius Agrippa’s controversial book on women, De nobilitate et praecellentia feminei sexus (On the Nobility and Pre-eminence of the Female Sex), and thus diverging from the other two authors.

Mercado’s chapter is extensive and much more complex than Castro’s, which, at some points, seems to be an abridgement of Mercado’s. The main argument of both is drawn from natural philosophy: sexual difference exists in all natural things. It can be identified in the four elements, in metals, in the zodiac signs, and, of course, in plants and trees. It is not something peculiar to human beings, but it goes far above and beyond. Mercado begins Chapter 1, Book 1, by stating:

Feminas in omnibus natura constantibus reperiri mille modis testatum esse apud omnes philosophos, haud difficulter quiuis reperiet. Nam cum per generationem, et nouam rerum propagationem continuo sucessu species conseruationem nanciscantur: ex necessitate naturae prodit, feminas esse in omni genere necessarias ad ipsius naturae perfectionem. L. Mercado, op. cit., 1579, p. 3.

Anyone will find without difficulty that it is attested in all the philosophers, in a thousand ways, that females are found in all things that are constituted by nature, for since species obtain conservation through generation and by the new propagation of things, in continual succession, it is said that by the necessity of nature, females are necessary, in all genera, for the completion [perfectio] of nature itself.

Besides the emphasis on proof – “all the philosophers attest to it, in a thousand ways” – and on necessity, which shows how important females are for procreation, it is imperative to understand the meaning of the Latin word perfectio and its compounds, much used in this type of discussion. It does not mean excellence or the absence of flaws or errors, but completion. It is reminiscent of the Greek word telos and its correlates used by Aristotle and Galen in their texts on sexual difference to distinguish the male from the female: the male is more complete/more perfect than the female.^[13]

Nature, so Mercado asserts, would not be complete without the female. This idea has an Aristotelian origin, but it was Galen who expanded this notion of the female as a necessity or, more accurately, a chreia, that is a utility or an advantage, not as a failure of nature, as he states in On the Utilities of the Parts, 14.6 (4.162 K) after explaining why women have the generative parts inside of their bodies, while men’s are outside. As women are colder, they do not have enough heat to project their parts.^[14] Notwithstanding, this inability does not imply, according to Galen’s teleology, a failure:

[…] οὔκουν θαυμαστὸν οὐδέν, εἰ τὸ θῆλυ τοῦ ἄρρενος εἰς τοσοῦτον ἀτελέστερον, εἰς ὅσον ψυχρότερον. ὥσπερ οὖν ἀτελεῖς ἔσχεν ὀφθαλμοὺς ὁ ἀσπάλαξ, οὐ μὴν οὕτω γε ἀτελεῖς, ὡς οἷς οὐδ’ ὅλως ἐστὶ ζῴοις οὐδ’ ὑπογραφή τις αὐτῶν, οὕτω καὶ γυνὴ τοῖς γεννητικοῖς μορίοις ἀνδρὸς ἀτελεστέρα· διεπλάσθη μὲν γὰρ ἔνδον αὐτῆς ἔτι κυουμένης τὰ μόρια, προκύψαι δὲ καὶ ἀνατεῖλαι πρὸς τοὐκτὸς ἀρρωστίᾳ θερμότητος οὐ δυνηθέντα τὸ μὲν διαπλαττόμενον αὐτὸ ζῷον ἀτελέστερον ἀπειργάσατο τοῦ πάντη τελέου, τῷ δ’ ὅλῳ γένει χρείαν οὐ σμικρὰν παρέσχεν, ἔδει γὰρ εἶναί τι καὶ θῆλυ. μὴ γὰρ δὴ νομίσῃς, ὡς ἑκὼν ἄν ποτε τὸ ἥμισυ μέρος ὅλου τοῦ γένους ἡμῶν ὁ δημιουργὸς ἀτελὲς ἀπειργάσατο καὶ οἷον ἀνάπηρον, εἰ μή τις καὶ τούτου τοῦ πηρώματος ἔμελλεν ἔσεσθαι χρεία μεγάλη.

[…] and so it is no wonder that the female is less perfect than the male by as much as she is colder than he. Just as the mole has imperfect eyes, though certainly not so imperfect as they are in animals that do not have any trace of them, the woman is less perfect than the man regarding the generative parts. For the parts were formed within her when she was still a foetus, but could not because of the defect in the heat emerge and project on the outside, and this, though making the animal itself that was being formed less perfect than one that is complete in all respects, provided no small advantage for the race; for there needs must be a female. Indeed, you ought not think that our Creator would purposely make half the whole race imperfect and, as it were, mutilated, unless there was to be some great advantage in such a mutilation [trad. May, 1968, p. 630].

This excerpt demonstrates the theoretical relationship between heat, completion, and sexual difference: the female is certainly defective in what concerns vital heat, and this makes her different from the male. However, this difference is instrumental to generation, as it allows her to have internal organs where the seed can be conceived and the foetus can grow. Males and females must be different in order to complement each other in generation.^[15]

The causal nexus that Mercado and Castro establish between the need for the propagation of the species and sexual difference combines arguments taken from ancient authors with theological issues. Very frequent in this matter is the evocation of Eve’s creation. Usually, the emphasis is on Eve’s role as Adam’s helper because the first man was incapable of begetting on his own. Hence, God created Eve to complete Adam and guarantee the human species’ continuity. The source of this idea is undoubtedly Thomas Aquinas’ exegesis in Genesis. It was elaborated in the Middle Ages and was still very important in the sixteenth and seventeenth centuries, when it was articulated with new scientific and social trends.^[16]

Sex difference is thus a requirement for generation, but must be performed in complementary roles. One provides what the other lacks. As such, concludes Mercado, on the one hand, even if the male has the efficacia, he does not have the place where the foetus can be engendered, and, on the other hand, even if the female has the proper place to contain and form the foetus, she does not have the principium of generation. The difference is, as such, an essential feature for procreating, and it lies in genital parts differing in function, form, structure, and mainly, since Galen, in location. It is, nonetheless, more comprehensive as it also includes a distinction in temperament (the male being hotter, the female colder), in strength (the male being stronger, the female weaker), and an association, going back at least to the so-called Epicurean table of opposites, of the male to the right side and the female to the left. Mercado accepts all these dissimilarities while asserting that they do not prove female inferiority, despite what all the philosophers say, but that “woman is as complete as man” (feminam aeque uiro esse perfectam).

Castro states something similar at the beginning of Chapter 1, thus setting the tone for his thoughts on the subject throughout the treatise, but, as he promised in the preface, with more clarity and conciseness. According to him – or, more precisely, according to Galen, whom he is paraphrasing here – a sagacious and very clever Nature created females for procreation because it was impossible for beings composed of corruptible matter to be immortal.^[17] Thus, by guaranteeing the replacement of the individual, it was possible to preserve the continuity of the species.^[18] This is, indeed, the purpose of sexual difference. We have, then, the acceptance of difference as – literally – natural. Castro explores differences and similarities in Book 1, Part 1, devoted to anatomy. In Chapter 1, he analyses differences, but in the last chapter, Chapter 11, he highlights similarities and ends by reinforcing Galen’s isomorphism.

However, Castro’s statement in Chapter 8, Book 3, Part 1 is more important. After analysing an extensive series of opinions of philosophers and physicians on the determination of the sex of the child and the vexata quaestio of female imperfection, he concludes by advocating the equality of women:

[…] siue igitur feminarum uim in propaganda sobole intueamur, siue utilitatem mulierum ad bene beateque uiuendum spectemus, siue copiam ipsarum consideremus, siue formam, hoc est, animam rationalem, siue materiam, non monstrum sane, ut plerique falso rentur, neque resultatione natam, aut quippiam deficiens, sed potius primo a natura spectatam et alteram naturae humanae partem feminam esse palam intelligamus (R. de Castro, op. cit., 1617, p. 131).

[…] whether, therefore, we look at the strength of women in the propagation of offspring, or observe the usefulness of women for living well and with beatitude; whether we consider the quantity of them, or the form, that is, the rational soul, or the matter; we shall understand evidently that she is by no means a monster, as most falsely judge, nor was she born owing to a retrogression or lacking in anything, but rather that woman was esteemed by nature in the first place and is one of the two parts of human nature.

Women’s difference

Despite these claims of complementarity or equality, a common feature in several texts on gynaecology, as stated, is that they evoke the difference of women and the peculiarity of their diseases as a motivation for writing about these matters. Before proceeding to this topic, Mercado, however, devotes a few lines to enumerating the ailments that are common to men and women. The repetition of words such as uterque, ambo, and communis (meaning “one and the other,” “both”, and “common”) shows precisely the understanding that men and women have similar ailments: mental (deliramenta, amentia, stultitia, memoriae uarii defectus, that is “delirium, insanity, different types of memory failings”) and sensitive (stupor, conuulsio et in quouis sensuum alia pene innumera accidentia, “numbness, convulsion and other almost innumerable accidents in any of the senses”) disorders, for instance, are the same. Men, however, not only have diseases that are peculiar to them but are also affected differently by diseases that are common to both sexes. Difference is, thus, a central tenet in Mercado’s argumentation. But he strives to deny the devaluation of women. Difference does not mean inferiority or deficiency. Sexual difference is a necessity. Women’s dissimilarity lies in a set of features that allow them to play a specific and essential role in generating, and it is within this scope that the medical author must intervene.

In the epistle that precedes the 1603 edition, addressed to Benedikt von Ahlefeldt, a counsellor of the Danish king, Castro elaborates thus on the utility of his work:

Quod certe opus idcirco medicis utilius erit, quoniam mulieres, cum natura sint uiris debiliores, in eis saepius acerrimae abundant aegritudines, maxime circa membra operi naturae debita: reliqui etiam uiri docti habebunt, unde possint multis affectionibus opitulari, quas feminei sexus uerecundia raro aliis, quam propriis uiris detegere audet (R. de Castro, op. cit., 1603, unpaginated).

This work, for that reason, will certainly be most helpful to physicians because women, since they are by nature weaker than men, have very often a great number of severe infirmities, especially connected with the organs destined for the work of nature. Also, the other learned men will have from whence they can aid the many ailments which the shame of the female sex seldom dares to reveal to others than their husbands.

By focusing on sexual difference, and mainly on women’s frailty and their vulnerability to diseases described as complex to diagnose and to treat and often fatal, these authors, as Stolberg and King show, established for themselves a privileged position as skilled professionals.^[19] Thus, even if they strive to counter the idea that women are inferior, they elaborate an image of a vulnerable woman who desperately needs the doctor’s help. These authors are thus motivated by a feeling of pity and mercy for the misfortune of women. Castro states that in the first words of the preface to the reader: Subit omnino misereri femineae sortis (“One must surely have mercy on the fate of women”). In Mercado’s 1579 edition, the idea is explicitly referred to by Pedro de Sousa, professor of Medicine, as Mercado himself, at the University of Valladolid, in the epistle dedicated to Mercado: he pitied them when their health care was considered by most doctors as something alien to the medical profession and was left to midwives and superstitious old women. He did this by revealing the obscurities of Hippocratic doctrine so that no physician could refuse to help women afflicted by a thousand diseases.

Dealing with organs such as the uterus or with physiological processes like menstruation and childbirth is thus assumed to be particularly challenging and requires specific knowledge. The sexual organs that define the difference between the sexes “are an inexhaustible source of diseases which,” says Mercado, “hardly anyone, even with the utmost diligence, would be able to enumerate.” The stress on difficulty and the repetition that women’s diseases are countless demonstrate precisely how these authors understand their craft to be above what an ordinary doctor can do. To make things worse, ignorant and superstitious midwives usually control this area of medicine. The medical author comes to women’s aid, equipped with the knowledge acquired from a new understanding of the Hippocratic and Galenic texts. The severity of women’s illnesses thus makes it necessary for the knowledgeable physician to intervene in opposition to a group of lay people associated with women’s medical care, but who are characterised in a negative way as incompetent or superstitious.^[20]

Sexual difference, thus conceived as a necessity of nature and not limited to human beings and animals, although extending to other features, focuses mainly on the body and, in the female case, on the uterus. A word about what sixteenth and seventeenth-century medical authors called uterus or matrix. Helen King has already shown, to explain the much-debated Figure 27 of Vesalius’ Fabrica, that the uterus was not only the internal reproductive organ, as we conceive it today, but it also included the external genitalia.^[21] André du Laurens clearly states in his Anatomical History (Historia anatomica) that by the word uterus, he understands all that extends from the external pudendum to the fundus.^[22]

In these texts, two different perspectives combine in the descriptions of this organ: on the one hand, the Hippocratic view, sustained by Aretaeus, of a movable, unstable, even unruly organ originating “countless” diseases;^[23] on the other, the Galenic perspective that its form, its functions, its location are the admirable work of a wise nature that does nothing in vain. This combination created a conflicting polychromatic image of the organ; in Book 2, Mercado begins Chapter 1 on the nature of the uterus and the diseases that can affect it by clearly stating this organ’s importance to women’s health. The uterus, he says, is one of the many remarkable organs with which nature endowed the human body. The uterus is also so efficient that, as is the opinion of all physicians, asserts Mercado, women’s well-being depends solely on it.^[24] It is the most important organ in women and has such dignity and excellence that Plato considered it a living animal. This is how Mercado understands the much-debated description of the uterus as a wandering living being in Plato’s Timaeus, 91a-d, to which Castro devotes Chapter 6, Book 1, Part 1, where he considers downright laughable the idea that the uterus can wander freely throughout the entire body, in search of moisture and angry for not being pregnant.

The function of the uterus as a regulator of women’s health is frequently associated with its comparison to a sewer. Even if this seems to have negative implications, as Helen King rightly noted, it can be interpreted more positively^[25]. In truth, the image of the cloaca sums up the ambiguities surrounding these authors’ views on the uterus: a feeling of wonder for the craftiness of nature that made this organ precisely as it should be mixed with a sense that it has a pathological inclination that lies behind women’s vulnerability to disease. “The womb is the cause of all diseases,” reads the Hippocratic Places in Man, 47 (6.344L), a passage much repeated in sixteenth and seventeenth centuries gynaecological treatises.

Castro’s perspective on the uterus in Part 1 is more favourable than in Part 2. As in Part 1, Castro deals with women’s natural condition, that is, with what happens according to nature (secundum naturam), he describes, in Vesalian terms, the organ’s excellent location, protected by the bones of the hip and how it allows the stretching of the uterus in pregnancy and childbirth. Another perspective arises when the subject is uterine pathologies, which are always considered especially dangerous and very difficult to identify and treat. Castro’s two references to the uterus as a sewer appear in Part 2, concentrating thus on the abnormal functioning of the organ.^[26] The separation established between Part 1 and Part 2, with the latter’s focus on disease, creates a division between the woman on the one side and her illnesses and her diseased organs on the other.

The structure of Zacuto’s Treatment for Women’s Diseases emphasises the negative connotation of women’s diseases. Even if in the praefatiuncula, as we will see, he has much to say about women’s superior qualities, after nearly two pages of praise, the question arises: “(…) why are women exposed to so many and such serious diseases?”. The diseases caused by menstrual suppression are classified as funesti, diri, inmedicabiles (“deadly, horrible, non-treatable”); those originating by the retention of the lochia are said to be monstrosi, lernaei, insuperabiles (“monstrous, related do the Lernaean hydra (?), invincible”); women’s diseases, in general, are perardui, periculosi et graues (“very difficult, dangerous, and severe”) and, as he asserts at the end of Chapter 2, they all have something divine, inasmuch as he claims, Galen defined that the divine element in diseases was something difficult and extraordinary residing in them.

Zacuto’s Chapters 2 and 3 discuss the danger and the number of female diseases.^[27] To sum up, women have more and more dangerous diseases than men, originating from the retention of semen or menstrual blood, two substances that, if putrefied in the uterus “as if in the sewer of the whole body,” inflict diseases described as uenenosi, ferini et letales (“poisonous, savage and lethal”). In the preface to Book 3 of On the History of the Most Important Physicians, Zacuto’s ambivalent perspective on the uterus is evident:

Vterus est ueluti hortus feracissimus, excipiendo muliebri, et uirili semine ad sobolis generationi comparatus. Est nobilissima, ac prope diuina fauissa, ex qua naturae thesauri conditi depromuntur. Est quasi animal errabundum, quod nunc mouetur sursum, nunc deorsum, nunc ad latera, ad praecordia, ad coxas. Ex hoc inordinate motu, uaria, eaque grauissima symptomata emergent, dira, et terroris plenissima. Insuper mirabilis est huius partis cum omnibus nostri corporis partibus consensus, ob quem eleuata uenenosa, et deleteria aura ab uteri ergastulo ascendente, superioraque membra feriente, et dira labe foedante, miri et ferini propulant affectus, qui sedulam medici opem praerequirunt: quare non inscite dicebat Hippocrates libro De locis in homine, 59: Vteri omnium muliebrium morborum causa sunt (Zacuto, op. cit., 1649, p. 439).

The uterus is like a most fertile garden, prepared to receive the feminine and virile seed for the generation of progeny. It is the noble and almost divine cellar from which the hidden treasures of nature are drawn. It is like an erratic animal that moves upwards, downwards, sideways, to the entrails, to the thighs. From this disordered movement emerge various and severe symptoms, horrible and full of terror. Besides, it is admirable the sympathy of this part with all the parts of our body, a sympathy due to which, as a poisonous and deleterious aura rises from the prison of the uterus, injuring the upper limbs and polluting them with terrible disease, ferocious affections abound, requiring the attentive aid of the physician. For this reason, Hippocrates said in a not ignorant way in Places in Man, 59: “The uterus is the cause of all women’s diseases.”

Here, we can see the multi-layered approaches that accumulate in these authors’ theories about women: the Hippocratic stress on women’s vulnerability combined with the Galenic sense of wonder at the works of nature. The therapeutic function of the uterus, which guarantees a woman’s health, is described here not as that of a cloaca but as a prison (an ergastulum) that prevents the pathological vapours emanating from putrefying matter from reaching other parts of the body. As we proceed from Mercado and Castro to Zacuto, the seriousness of women’s illnesses seems to become immeasurable, and the role that the uterus plays in them is hyperbolised.

The superiority of women?

When we compare Castro’s statement in the Epistle to Benedikt von Ahlefeldt quoted above that women only reveal their diseases to their husbands with Diseases of Women, 1.62, the obvious subtext of this passage, it immediately strikes us as odd that the Greek text, at least as we know it, makes no reference to husbands. The content of the Hippocratic subtext seems to have been redefined by Castro to make sense to an audience that probably had different expectations related to marriage and women. The underlying notion of an ideal of companionate marriage must certainly be at the core of this reference in Castro’s epistle, confirmed, for instance, by his mentions of his late wife, Catarina Rodrigues, who died after childbirth.

According to Lorna Hutson, the Renaissance social construction of the housewife as an equal companion owes much to the influence of Xenophon’s Oeconomicus, in which Socrates interrogates his newlywed friend Ischomachus about how he taught his wife to perform her domestic duties.^[28] The valorisation of the wife’s role as manager of the oikos contextualises the natural differences between the sexes: men and women possess distinct characteristics that enable them to perform different tasks and occupy different spaces – women indoors and men outdoors – both working for the prosperity of the household in a relationship based on cooperation.

Zacuto states clearly in the preface to the reader printed in the 1642 edition of his Treatment for Women’s Diseases that men should dedicate themselves more to female health so that they might “have at home a faithful but healthy guardian and to ensure that the rest of the work that must be managed at home is done properly.”^[29] It is relevant, however, that Zacuto, more than Mercado and Castro, insists on valuing women and their abilities. In Chapter 1, he has nothing to say about the cosmological or natural differences between males and females. He goes much further: he offers a different interpretation of the creation myth. Adam and Eve are no longer each other’s complement, as they were in the medieval exegesis of Genesis and Castro’s and Mercado’s texts. In what relates to the materia creationis, that is the “matter of creation,” Adam is a crude and primary creation, whereas Eve is an elaborate and more worthy product. Zacuto says Eve was not created from something inanimate, lifeless as vile clay, but from animate, purified matter. As such, “man is a work of nature, woman a work of God.” He copies these words, as much of the assertions in this chapter, from Cornelius Agrippa’s On the Nobility and Pre-eminence of the Female Sex, printed in 1529 and with several subsequent editions and translations, a significant milestone in the literary polemic known as Querelle des femmes.^[30] Zacuto introduces Agrippa’s controversial interpretation of Genesis (never mentioning Agrippa’s name), justifying the panegyric content of this chapter:

Magnum opus molior, meo rudi ingenio indignum: nam curationem praescribere, muliebrium morborum, tam difficile est, quam esse medicum. Illud uero in limine praefari opus est, deque praestantia feminarum aliquid mentione dignum commentari, ut earum laudibus lectores allecti, ad curandos morbos, quibus ipsae assidue premuntur, accelerant, et auxiliis strenuis muniti, illorum furiosos impetus, symptomatum multiplicem struem, dolorum ineffabiles cruciatus retundere, ac refrenare possint (Zacuto, op. cit., 1642, p. 4).

I undertake a remarkable work, of which my rude talent is undeserving: prescribing the treatment of women’s diseases is as difficult as being a doctor. It is necessary to say this at the beginning of the work and to comment something worthy of mention about the pre-eminence of women so that the readers, attracted by the lauds to them, may hasten to treat the diseases by which they are assiduously oppressed, and armed with strenuous aids, may restrain and curb the furious impetus [of diseases], the manifold heap of symptoms, the unspeakable excruciations of their pains.^[31]

One cannot help but wonder what is, for Zacuto, more important: whether it is the difficulty of this branch of medicine or the superiority of the sex afflicted by such a problematic set of ailments. Immediately afterwards, he introduces the doubt: “whether women are superior to men in pre-eminence and excellence” (utrum feminae praestantia, et excellentia sint superiores uiris). Part of the answer is that there is consensus among doctors that males and females only differ in the location of the parts of the body that, because of generation, were required to be different. God gave men and women the same form of the soul, without distinction, and the same intellectual qualities (mens, ratio, sermo, that is, “mind, reason, language”). Nevertheless, women are superior in moral qualities like pudor, mansuetudo, animi candor, pietas, patientia (“pudor, mansuetude, candour of spirit, pity, patience”) and other virtues that are rare in men but common in women. He continues, following very closely Agrippa’s arguments, his explanation of why Eve is a superior creation to Adam: God began by creating a noble being but ended in the one that was the noblest; He rested after creating woman because there was nothing more worthy than she that He could create; God created man in a rural field among irrational animals, while she was created, together with the angels, in Paradise.

In the praefatiuncula, Zacuto lavishly praises women’s beauty and elegance as something imbued with divine splendour:

Cum elegantissimum, et pulcherrimum mulieris corporis contemplor, in eo maiestatem quondam supranaturalem adesse non dubito, cum pulchritude ipsa nihil aliud sit, quam diuini uultus, atque luminis splendor in rebus insitus, per corpora formosa relucens (Zacuto, op. cit., 1642, p. 1).

When I contemplate a woman’s most elegant and beautiful body, I do not doubt that it contains a majesty above what is natural, since beauty itself is nothing more than the splendour and light of the divine face situated in things that shine through beautiful bodies.

Then he goes on to describe body part after body part, female beauty, until he concludes that there is no spectacle more admirable than the corporeal beauty of women. Zacuto’s perspective is, in fact, somewhat disconcerting because, alongside a stylised and exuberant valorisation of women, he remains very dependent on the Aristotelian model of the hierarchical organisation of the sexes. When commenting, in On the History of the Most Important Physicians (Book 3, Historia 8, Quaestio 16), on the case of the bearded woman known by the name of Brígida de Penharanda, whom he claims to have seen in a painting,^[32] he states that women can transform themselves into men, but not the other way around, since it is only very rarely that evolution happens from what is complete to what is incomplete. However, in the following chapters that constitute the treatise on gynaecology, Zacuto focuses on women’s diseases: their diagnosis, symptoms, and treatments. This is the challenge the doctor has to face. Like a Herakles facing the Lernaean hydra…

Conclusion

The notion that women are different from men, not only in the organs dedicated to procreation, but in their whole body, in temperament, or in the type and degree of morbidity to which they are subject, thus becomes a legitimising element of the treatises on gynaecology. Mercado, Castro, and Zacuto, like many other authors, took for granted, without hesitation, the assertion of Diseases of Women, 1.62, that women are different and, whether they are inferior, equal, or superior to men, need specialised care. One of the consequences of these differences is the consolidation of the image of women as fragile creatures oppressed by pathology. By helping them, these authors fulfil a certain sense of duty towards the community, consolidating the role of women in generation and valuing their contribution with theological and philosophical arguments. Nevertheless, at the same time, they create for themselves an exceptional role as interpreters of a medical tradition that justifies the specific treatment of women. Even if some contemporaries dedicate their works to female patrons, the three authors studied here imagine their readers not as female but as a challenging and demanding male audience that they must seduce into a problematic area of medical expertise. I want to emphasise these texts’ immense complexity and richness: at the crossroads of diverse disciplinary conventions and principles, they try to create from divergent ideas a congruent image of the physician and his role as a member of a social and professional community, striving, at the same time, to dignify the subject of their texts. The complex appropriation of traditions from diverse authors, genres, and times thus creates ambiguous perspectives. Women and their differences, however, impose themselves as a theme worth studying, dependent upon a male fantasy of female vulnerability.