By the middle of the 15th century, women’s healthcare had begun to shift from a field dominated by women to one monitored and controlled by men. Following the classical Aristotelian schema, the female body was perceived as biologically inferior, intrinsically weak, and predisposed to disease. Unlike the male reproductive organs, which could easily be presented for study, the female reproductive system proved frustratingly inaccessible and could only be seen in the event of a dissection or a uterine prolapse. In dealing with pregnancy, male physicians, limited in their empirical knowledge of gynaecological and obstetrical matters, relied heavily on texts and images for information on the pathology and physiology of the pregnant female body, a frighteningly foreign form.
Despite the absence of a standardised depiction of the visceral organs and internal systems of the female body, several illustrative traditions developed that depicted the female anatomy, but were indicative of a limited understanding largely centred on reproduction. Of these images, the ‘disease woman’ is the only one that illustrates the entire female body. Shown as pregnant, the ‘disease woman’ perpetuated an understanding of pregnancy as a disability or dysfunction. By qualifying it as such, male practitioners were able to impose restrictions on and exert control over the female form.
Of the twelve or so extant representations identified by Monica H. Green, all of which date from the 15th and 16th centuries, the ‘disease woman’ of the Wellcome Apocalypse (MS. 49), a 15th century German miscellany, is one of the most frequently reproduced. Situated amidst a collection of 25 medical and scientific illustrations in the medical section of the manuscript, the ‘disease woman’ appears on folio 38r alongside several other obstetrical and gynaecological images.
Dated around 1420, the Wellcome Apocalypse as a whole contains nearly 300 drawings and more than 100 different Latin and German texts, which pertain to a variety of medical, scientific, theological and moral topics. Rather large in size, the manuscript is composed of 69 vellum leaves, each leaf measuring approximately 300 mm x 400 mm. Despite the impressive amount of attention the manuscript has received since its acquisition by Sir Henry Wellcome in 1931, a full edition of MS. 49 is still yet to be published.
Preserving the binary structure of the living cadaver, the ‘disease woman’ of MS. 49 stares directly out at the viewer, oblivious to her body’s subjection to the rigours of anatomical dissection. Squatting with arms raised and legs bent, the woman appears completely naked with only the exception of a cloth headdress, which was traditionally associated with married women and nuns. Her head and limbs remain undissected, while her chest and abdomen are opened to reveal a simplified rendering of Galenic anatomy.
While the internal anatomy of the ‘disease woman’ closely resembles that of the manuscript’s male figures (the ‘wound man’ on folio 35r is shown above), there is one organ in particular that clearly distinguishes the sex of the figure on folio 38r as female. Incised on the left side of the figure’s distended abdomen, the uterus is represented by an inverted flask-shaped form, an image type commonly found in 12th and 13th century representations of the womb. There is no visible foetus inside the womb; instead, the pregnant condition of the figure is indicated by the word ‘embrio’ inscribed on the uterus. With the uterus opening downward into the lower abdominal cavity, there appears to be no viable path for the foetus to exit the body by way of a vaginal delivery.
In examining the ‘disease woman’ of MS. 49, it becomes clear that the illustration was not intended as a scientifically accurate representation of the female anatomy, but rather as a simplified diagram that left much to the imagination. Like many other medieval anatomical drawings, the ‘disease woman’ was not based on first-hand observation, but rather on the physician’s imaginative conception of the internal workings of the female body.
The schematic depiction of the internal organs reflects the persistence of atavistic ideas despite the growing practice of dissection during this period. Although dissections of the female body occurred in the West as early as 1315, the objectives of these procedures were usually instructive, rather than investigative. In MS. 49’s ‘disease woman’, the diagrammatic rendering of the viscera is contrasted by the more naturalistic realisation of the figure’s face, feet and hands. This ‘two-tiered mode of representation’ may have resulted from the inability to reconcile Galenic theories with real-life observations.
Unlike most medical illustrations of the Middle Ages, the ‘disease woman’ does not appear to have been derived from a written medical treatise, but instead seems to have generated its own text, particular to each image. With the female body serving as a generic framework, the ‘disease woman’ may have functioned as a practical reference, or ‘crib sheet’, on the pathology and physiology of the pregnant female body.
Inscribed with Latin labels, the figure in MS. 49 lists and localises various diseases and afflictions. Most of the ailments described, like diabetes and gout, or running eyes and foul breath, are not particular to women. However, there are a few afflictions, such as ‘closed’ womb, that are specific to the female body. Various remedies are prescribed in the surrounding text, including a treatment requiring the decoction of various herbal and animal materials in wine that promises to induce the flow of menstrual blood.
To the medieval physician, the pregnant body was a mysterious, problematic, and potentially dangerous form. The ‘disease woman’ presented a way in which that body could be contained, classified and controlled within the safe context of a masculinised medical framework.
Author: Rachel Wertheim was a placement student at the Wellcome Library from February to August 2014. She completed a Master of Arts degree at the Courtauld Institute of Art in 2014. Her research interests include pre-modern medical illustrations, relics and reliquaries, as well as medieval illuminated manuscripts.
Almuth Seebohm, Apokalypse, ars moriendi, medizinische Traktate, Tugend- und Lasterlehren: die erbaulich-didaktische Sammelhandschrift London, Wellcome Institute for the History of Medicine, Ms. 49 Farbmikrofiche-Edition (München: H. Lengenfelder, 1995).