First, I will tell you that a female philosopher named Trotula—
very beautiful in youth, who lived a long life and from whom ignorant doctors
drew great authority and useful lessons—revealed to us part of the nature of women.
One part she was able to reveal because she experienced it herself;
the other because, as a woman, women more willingly opened up to her than to a man and revealed their every secret thought.
C. A. Thomasset, “Placidius and Timaeus or the Secrets of the Philosophers”
[“Placides et Timéo ou Li secrés as philosophes”]
(Geneva-Paris: Librarie Droz, 1980)
in Women in the Middle Ages [Medioevo al femminile]
(Roma-Bari: Laterza, 1989)
I encountered Trotula De Ruggiero in 2005, while conducting research for a historical novel that I intended to write and that perhaps I will someday complete. I needed to write about the experiments of a fourteenth-century doctor and could do other than turn to the work of the Scuola Medica Salernitana, a prominent medical school in Salerno, Italy, during the late Middle Ages. Trotula’s name appeared among others. I knew of the existence of the Mulieres Salernitanae, the female medical practitioners of Salerno, and their expert use of herbs, but in the nineteenth-century book by Salvatore De Renzi, Storia documentata della scuola medica di Salerno (Documented History of the Medical School of Salerno), this woman stood apart from the rest due to her wisdom, importance, and fame. The author devoted many pages to her, explaining that she was regarded as the wisest woman in Christianity. I realized that I had discovered one of the many examples of history’s amnesia about great female figures.
Moreover, instinctively, I felt that this chance encounter would destroy the foundation of my prejudices, as happens when one encounters a genius: many of our previous ideas are swept away and replaced.
Something made me feel very close to her. Both of us had experienced the start of a millennium, both had focused our lives on passions so strong that they obscured all else, and both had risked being forgotten by the world. Nevertheless, I could not ignore the differences. She was a doctor, I am a writer; she was from Salerno, I am from Florence; she was the mother of two children, I am the child of many mothers; she lived in the first millennium, I live in the second. But as happens with great loves, distance served only to make her seem more attractive, more desirable.
What is love if not the voyage that is taken to know the other?
The voyage to reach Trotula appeared long and full of obstacles. I am not a doctor, even though I know illness, as it has complicated my mother’s life and now also my own. I am not a historian and I am not from Salerno. The only way in which I could hope to get close to her was through that spark that I had felt ignite at the sound of her name, while reading the few existing texts about her life. That spark would start the engine, the engine that would allow me to reach her. So, with the recklessness of a lover from another time, I hoisted the anchor and set off for her world.
After a year of intense, feverish study, which kept me from every other commitment and literary project, I decided it was time to write about her. I had never thought that my work would lead me to write a novel. How could I expect such an immense figure to submit to my imagination? The only thing that I felt entitled to write was a theatrical monologue. The stage seemed the best way. I would capture a moment in her life, letting her voice flow from my fingers to sound again in the mouth of an actress. Only her words—without a body, without a location. During the first performance, when she appeared before me in skin and bones, I understood that she was not yet finished. I realized that the character still had so much more to teach me, and so I found the courage to start over.
Once again, I threw myself into books and for two years did not touch a pen. In the same way one prepares for an appointment, I had to be ready and at my best the next time I was in her presence.
The more I read, the more astonished I became at how little attention had been paid—until now—to this fundamental figure in the history of women and medicine. Besides the work of De Renzi, there were some translations of her work and some scientific articles, but little else.
It was not just about studying her story and her work. I had to know that city, which, at the beginning of the millennium, shined above the others like an evening star. A city where Greeks, Arabs, and Jews joined in the great effort to understand the human body. I had to understand Salerno, the so-called Town of Hippocrates (Hippocratica Civitas), which was passing from Lombard to Norman rule; in which, in the mild air of the gulf, the innovative thought of Archbishop Alfano and Constantine the African progressed and spread; and which welcomed the exiled Pope Gregory VII, a reformer of the Catholic Church, during his final days.
In book after book, discovery upon discovery, I confronted a luminous, scholarly Middle Ages and a woman who perceived the value of hygiene eight hundred years before Ignaz Semmelweis—who was condemned to spend his final years in a mental hospital only because he had insinuated that illness spread to patients because doctors did not wash their hands. I had always thought that the Middle Ages was an era populated by dirty and bigoted people and that the little knowledge then in circulation was held and controlled within monasteries. Instead I found an eleventh-century city in which the texts of Greek philosophers were translated, centuries before what would later become known as humanism. Knowledge was, for the most part, in the hands of the laity, and a woman born in the first half of that century advised how and when to bathe, listed the herbs with which to cleanse teeth and freshen the breath, and transcribed recipes for the elixirs developed by the Saracens for shiny hair. A woman who, above all, spoke about other women, about their sexuality, their pleasure, and the ways to make childbirth less painful, identifying those characteristics in the female body that even today wait to be recognized by the academies.
The personal and private love that led me closer to her deepened with every new discovery. I understood that in her story was much of what I and others had been seeking for some time. I knew from experience that one of the greatest difficulties women encounter, when approaching the so-called intellectual professions, is not having role models. Looking back through history, one is confronted by an army of educated men, which every new male student knows he can count on as a fraternity, a family that legitimizes and sustains him. And the family of women? It does not exist and, if it does, it is buried in history. Until a century ago, Trotula was believed to be a man.
Like the archeologist who discovers traces of the writings of a people overlooked for centuries as illiterate, I began to dig with ever-increasing ardor to excavate this illustrious and fascinating ancestress from the debris of the centuries. And she emerged from the fog of history powerful and intact, fulfilling her destiny. Her life seemed completely imbued with the spirit of medicine, as if Aesculapius had personally blessed her with the caduceus. She not only practiced medicine, she also married a great doctor—Giovanni Plateario—with whom she gave life to generations of healers and scholars: her two sons, Matteo and Giovanni, both authors of important works; her grandchildren; and the children of her grandchildren. And yet the little information about her was not limited to describing her as “the mother of,” or “the wife of”: she succeeded in entering into history with her own name, with her own ideas, and with texts written in her own hand.
In the meantime, in the real world, in my present time, the debate between medical science and religious morality has become increasingly bitter. A millennium has passed but things do not seem to have changed much. Trotula was limited by the Church to the study of the internal organs of animals, because at that time human autopsies were considered desecrations. For this reason, until the seventeenth century, people died of appendicitis—a pig does not have a similar organ at the end of its intestine. I was sure that Trotula’s feelings would have been very similar to those of our doctors today regarding the impeding of experimentation that could save many human lives. Therefore, I added to my reasons of personal fascination and general principle the desire to immerse myself until I reached the heart of the matter and untangled the knot that still binds hands and minds.
At this point I had read dozens of books, spent days in the library, spoken to scholars and scientists, and clarified for myself the reasons for my journey. The time had arrived.
I left my house, full of objects, electronics, and modern innovations. That place was not suitable for Trotula. I rented an old mill in a forest far from civilization and moved there. The mill is large and old, and part of its structure dates to the first centuries of the last millennium. There are no human traces around it. What better place in which to turn all of these notions into a story?
Wandering around the great stone structure, I noticed an enormous door fastened with a metal bar.
I opened it and realized I had arrived: the barrel-vaulted ceiling, the deep light from the basement window, the wood of that unyielding door that seemed to divide the present from the past.
After a while she came. She was not the wise and revolutionary woman I had found in the books, but a child sitting in a field, under the southern Italian sun. Nothing about her foretold her future, but I knew that I was finally in front of my character, who was happy and willing to let me tell her story.
Chapter I: Of Fire and Time
During the first half of the eleventh century, Trotula was born into the noble De Ruggiero family of Salerno, of Lombard ancestry, praised by many of Salerno’s distinguished men.
Health Regimen: Flower of the Salerno Medical School
There is a period in everyone’s life in which time flows with imperceptible movement, like a cart or a horse that sidles into a race.
As I think back to the first years of my life, I recall pale hands ready to welcome my first steps, tepid and fragrant water, black-rimmed fingernails, grazed knees, the far-off night stars, rust-colored leaves, speckled stones, reflections in puddles. Every fragment is lucid, floating fixed in my mind, illuminated by traces of my mother’s face, suspended in the lightness I felt when lifted in my father’s arms. These images, however, do not have any particular order; I cannot say whether I first discovered rain or pain, fireflies or lizards.
Even though I surely must have learned many things in those years, I do not remember when and where the world revealed its wonders to me. There certainly must have been a time when I did not know the difference between summer and winter, male and female, love and war, or between a dog and a cat, cow, or horse. Day after day I must have learned names and skills, experienced feelings, discovered boundaries, but the memory of that fundamental learning is enclosed in a shell that is impossible to crack.
Then suddenly, metamorphosis.
I was about six years old. Beneath my tongue I could still feel the rough texture of my gums, newly abandoned by my baby teeth, which I lost at about that age, as happens to every child. Freeing myself from those weak and impermanent teeth was a torment. As soon as I felt one wiggle, I would start to pick at it with my tongue until it was attached by only one bloody filament. Then, I bravely finished the act and broke it off, spitting out the blood that the small trauma produced.
Like the water of a pond that you discover is a torrent at its mouth, my memory, moving away from that period, begins to run straight and lucid; the moments preceding those days are marked by uncertainty, just like those temporary teeth that one day disappeared from my mouth, leaving space for those with which I would chew each future mouthful.
It was vital for me to avoid the ever more ingenious method devised by my nanny, Iuzzella, who would attach a string inside my mouth to a chair and pull, in an attempt to yank the tooth from its bed. Not that my technique was less painful: on the contrary, her brusque and definitive method quickly resolved the problem once and for all, while my method, requiring tenacity and steady work, only prolonged the pain. The sight of that string, that chair, that room—all of them tied to my tooth—made the experience terrifying for me. It seemed that the whole world hung from my gums.
I knew that those teeth would never return. I felt the substitutes pressing below my gums, and my mind began to form its first rudimentary thoughts, the first simple musings about the ability of time to make familiar things give way to replacements we could not have imagined. After that, I began to notice the changing of the seasons, the fact that flowers became fruit, and that fruit fell to the ground and the earth ate it, making it disappear just like those teeth in my mouth had disappeared. Time had the power to turn leaves yellow, to make hair grow, to bruise the heart.
Whenever Iuzzella was away for the entire day, I noticed that I felt serene in the morning, but then, as the day passed, her absence became more acute, just as thirst and hunger increase as the hour of the last meal grows more distant. Iuzzella was the youngest daughter of my wet nurse. Her mother nursed me until the age of one, and she never forgot to remind me that, of all of the babies that had attached to her breast, none had ever extracted so much precious liquid and for such a long time. Usually girls are weaned earlier than boys, but they had to make an exception for me. “Ya drank this world an’ the other,” Iuzzella would say in her dialect, pinching my cheek between two rough and callous fingers. I do not remember the name of the woman who so generously gave herself to me. She died when I was still too young to keep a name in my memory. Iuzzella was hired by my family and assigned to my personal care. She was the one who dressed me in the morning and undressed me at night before bed, who tried to braid my hair as I ran from room to room, who prepared the mint leaves I chewed each morning to freshen my breath, and who always assembled those weapons to rip the teeth from my mouth. She was just a few years older than me, but I do not think that she had ever owned a doll in her life, of cloth or wood. I was her doll. A doll who would never stay still and who forced her to run around from morning to night. She ran, played, and even fought with me, for as long as Heaven let her—until the day came for her to know the power of pain and for me to know the ravenous power of fire. Later in life, I would appreciate the beneficial properties of fire. That first time, I met it in all its devastating power.
The event that so drastically upset the life of my nanny and my family coincided with the period in which I was losing my baby teeth. I have often asked myself if the change in my perception of the passage of time resulted from that transformation of my body or from the memory of that apocalyptic scene.
Certainly both fire and time had the capacity to destroy, crush, turn dust again to dust.
In winter, a fire burned in the fireplace of every room in the Salerno palace, secured on stone andirons and well tended by the servants. As often as I tried to wake up early, I never saw any one of the fires extinguished. Someone rose before dawn to revive the embers and someone retired after the moon set to bury them.
I was fascinated by the flames and amused myself watching whatever I had on hand vanish within the orange tongues: tiny animals, pieces of dried bread, apple skins, chicken bones, fat drippings, scraps of yarn—even the chewed-off tips of my fingernails and the tiny locks of hair that I sawed off with a knife when I was sure no one was watching. I paid close attention to the combustion time, to the altered appearance after the heat’s destruction, and, above all, to the changed odor. I preferred the smell of hair and nails, which I discovered were similar. The similarity intrigued me so much that if one of the servants had not discovered me in time, to satisfy my curiosity I would have cut enough of my hair to leave a bald patch.
All children, new to life, tend to be curious. They ask questions, dig holes, pull up flowers to dismantle the petals, torture insects to find the line between convulsive agitation and the stillness of death. My curiosity was methodic and almost ritualistic. I had a sort of sacred attitude toward the world I was encountering. So the first time I saw a bolt of lightning, I stood staring into the air in which that miracle occurred. I usually tried to analyze for myself the hows and whys of things that I could touch. That time, however, I had to turn to my father.
“Father, why has the sky split?”
He was alone, eating lentil soup at the large table where we usually had our meals. The weather was turning stormy and so he had returned early from his morning hunting trip.
“It is the work of God!”
Anything he did not understand had necessarily to be the work of God, especially anything that happened in the sky. I bowed my head to thank him for the information, which, in reality, had left me with my question intact. I focused again on the sky. Thick clouds moved, propelled by an invisible force. I imagined God blowing them, like a child determined to keep a leaf floating in the air.
That day I discovered that I preferred my mother’s responses. She at least launched into great flights of fancy, where there was never only one God, but as many gods as there are things on earth. So every night, before I fell asleep, she would tell me about the Goddess of the Moon and during the day about the Goddess of Earth. There was a God of the Sea and one of sleep. Although Iuzzella was always available to take care of me, my mother did not mind devoting some of her time to me, especially in summer, when the isolated life that we lived in the castle made the days slow and empty, free of the worldly commitments that kept her busy in the palace in Salerno. My father was often out: hunting, fishing, meeting important nobles, checking on faraway properties. For four months, I, my mother, Iuzzella, the servants, and the guards stayed out of the city and instead remained in the castle, surrounded by orchards, stuffing ourselves with seafood, clams, and glistening shrimp. I ran in the fields, playing sheep-and-wolf with Iuzzella. We had fun skipping pebbles on the pond. Iuzzella carried me on her shoulders, and I circled her waist with my legs, feeling more courageous than a knight.
Then came the fire, and nothing was as it had been before. We were in Salerno the day the fire struck. The entire family lived through an event that would forever unite us in its memory. The bolt of lightning entered through the open door like a hurried guest and exited through the window on the opposite side, dragging its fiery tail. The deafening sound traveling with it was not humanly comprehensible; in just a short time, the flame it left in its wake destroyed a great part of the building. Iuzzella ran outside with her leg on fire. Two guards died, and my father suffered a head wound. The stable boys heard only the earsplitting sound, and when they burst out of the stable they found a tower of flames instead of a palace. The horses kicked and whinnied, the chickens in the henhouses squawked, the cow burned to death in the barn.
I escaped unhurt, blackened with smoke. I saw Iuzzella rolling around on the ground in terror, her leg on fire. I fell on top of her, trying with my bare hands to put out the flames that blazed from her flesh, the acrid odor similar to that of my hair, which I had thrown playfully into the fireplace. Someone threw a wet blanket on Iuzzella, and the pain-filled grimace on her face melted into tears. My nanny closed her eyes as if she were ready to succumb to death.
In the days that followed, we had to live in one of the palace’s cellars while waiting to leave for the castle in the countryside.
Those were strange days, in which we all slept in the same bed, like poor families do.
I experienced an uneasiness that I would never forget. Until then, I had never thought that light could have such great importance. The palace of Salerno and the castle of my summers were always luminous. In those days that we spent in the cellar I realized that darkness and sadness go hand in hand, that sunlight is of divine origin and brings health to people on earth. Beyond the discomfort of living in those conditions, we also had to come to terms with the fact that all of the family—some more, some less—had been touched by the fire and suffered consequences. Iuzzella was the most affected: she had to drag her injured leg behind her for the rest of her life. My mother had not suffered any immediate physical injuries, but after that day, her sleep was always ravaged by images of fires, which awakened her in the dead of night. My father had had his wound treated immediately by one of the best doctors in the city and returned wearing a white turban that made him look like a sage from Africa. No one thought to bother a doctor for Iuzzella, however; she cured herself with the remedies that she knew and, while she was at it, she also took care of healing the small burns that I had caused while trying to extinguish her leg. I watched my playmate carefully prepare pastes and ointments as if she had done nothing else her whole life. I was amazed at her skill in dosing and choosing the materials that would save her from gangrene. I thought that such knowledge was the prerogative of religious people or of the rich.
I saw her leave the cellar, hopping on one leg like a strange bird. She returned several hours later, with a bunch of fresh lilies and baskets of small packets wrapped with fig leaves. She washed the lilies, boiled them with their roots, and crushed them. She added various powders that she extracted from the packets. She murmured, in her dialect, “This’s the paste, here’s the incense, two scruples o’ camphor, an’ a bit o’ white o’ lead.”
She opened another packet and took out pork fat. From a sack that was lying on her straw mattress, she removed a clay vial, where I knew she kept the rose water she washed my face with in the morning. “With water o’ roses red, girls become wed!” She melted the pork fat over a flame, poured it onto the ground lilies, and then added the mixture to the rose water. She put several mint leaves into her mouth, chewed them for a long time, and then mixed them with the rest of the ingredients. She let the preparation cool and then spread it on her calf, which had turned purple from the burn. Then called me over and did the same with my hands. Unfortunately, she had also broken her leg while fleeing the fire, and even as often as she splinted it, her foot remained crooked for the rest of her days.
Poor Iuzzella, crippled as she was, would never find a husband or even a family willing to take her into their home. If she had ever lost the benevolence of my parents, she would have had to beg from one monastery to another, hoping for the monks’ generosity. And maybe on a winter night, one of those nights in which the monastery guest rooms are packed with people seeking shelter from the cold, we would have found her curled up in a corner, frozen to death. The world would have never known one of the most gentle, docile souls that God had sent to earth.
Iuzzella never complained. She did not cry, and she was not capable of becoming irritated. She was jovial and cheerful. Her eyes—a strange color, between green and blue—were always curved into a smile that often also spread to her lips, transforming her round face into a full moon. Her square hands had fleshy fingers, like a child’s. Her neck was short, and her arms and legs stocky. Everything about her was round and solid. Even though her right foot was turned completely inward, so much so that it was perpendicular to her calf, she could walk fast. When she quickened her pace to chase me—as fleeing her kindly supervision was my goal each day—her plodding gait resembled that of a little chicken forced to run on its claws. She staggered, her gaze straight ahead, attentive to my every turn. These trips usually ended on the threshold that separated our rooms from those of the servants, the outer boundary of my independence. Overstepping it without the permission of an adult moved me from Iuzzella’s jurisdiction directly into my dear father’s, who felt compelled to correct me with long lectures on discipline and decency.
When we were in the city, the palace’s front door served as the moat separating my childhood world from the city. When we left Salerno to spend the summer in the castle, however, I was allowed to venture into the great garden, protected by high walls, to run among the fruit trees. I could walk and somersault through the fields as I liked, because guards armed with iron clubs and sharp swords protected the estate day and night, stationed there by my father to keep away thieves, Saracens, wolves, and every other species of wild animal. Those strongmen struck a holy terror in me with their unshaven faces and all the rusty iron they wore. Their presence, together with the impassable threshold of the city house, made me realize that beyond the boundary of my world of games and play, there was another very dangerous world. A world it was best to enter armed and uniformed, or at least fully clothed.
At around age seven, I was thrown out of my Eden and taken to that punishing land where no one laughed, where it was rare to see anyone run, and where beggars with crooked arms and legs stood along the roadsides like the branches of olive trees.
