Following Agnodike and Phaethousa: gender and transformation in the reception of ancient medicine

My research investigates why stories from classical Greece and Rome continued to be so popular in medical writing from the late sixteenth century up to the nineteenth century, despite the revival of human dissection providing an alternative way of understanding the body. I explore how the content of these stories was adjusted to fit new explanatory frameworks, and how they can help us to consider the relative importance of different parts of the body in defining sexual identity, in cases where this was disputed. I focus on two classical stories, and analyse the different versions of them told by medical and other writers across Europe.

One is the story of Agnodike, the 'first midwife', told by the Latin writer Hyginus: the other is the story of Phaethousa, who grew a beard when her husband left her, told in one of the case histories of the Hippocratic 'Epidemics'. In an imagined Athens in which women are forbidden to be midwives, the virgin Agnodike disguises herself as a man, trains, and returns to become so popular that the male practitioners lose work. Accused of seducing her patients, this apparently male Agnodike reveals her true sex in court, then being accused of breaking the law preventing women from entering medical practice. Phaethousa is described as having ceased to menstruate after her husband was exiled; she became masculine in appearance and grew a beard and, despite medical intervention, she died. As part of the 'Epidemics' collection, this story comes with the authority of Hippocrates, whose influence in medicine increased after the Hippocratic corpus was translated in full into Latin in 1525.

I will focus on the early modern period, using these stories to uncover the complexity of medical views on sex and gender, but will extend my study to the nineteenth century, when they were still cited; for example, in the 1830s, James Young Simpson quoted the story of Phaethousa in discussing ovarian failure. Both stories were so fundamental that the early modern reader would expect to find them in any histories of midwifery or in discussions of sex change. Both concern the extent to which external appearance is a reliable guide to the realities of the body; they were used to support arguments about the medical profession, the proper role of women, and the body. But who told them, why, and how did the content of these stories differ as they were retold in the context of different ideas about disease causation and different models of the body?

This is not simply a linear narrative in which changing views of sex characteristics were imposed on ancient accounts. By looking at how far the visible body was thought to be an accurate reflection of the hidden interior, and demonstrating the coexistence of contradictory models of the body, my work challenges a number of current orthodoxies, in particular Thomas Laqueur's still-influential model of a pre-modern 'one-sex body' - in which the organs of generation are the same in men and women, merely differing in location - being replaced by a 'two-sex body' in the late eighteenth century. Concentrating on these two stories and their different interpretations also makes it possible to assess how far the vernacular medical literature of the early modern period deviates from established models of the body found in Latin treatises.

Who will benefit?

The story of Agnodike is one with a long history of use in debates about the proper role of women in medicine, and as such has resonances today. It is of interest to midwives and nurses, and also to other women in the medical profession, as it illustrates how a classical precedent can be reworked to fit different professional and political agendas, either promoting women's professional medical practice or being used as an argument against it.
The changing understandings of Phaethousa's illness will be of particular interest to those working on intersex, a growing field internationally and one which is well aware of the power of history in affecting policy and practice.
The wider public is very interested in issues of gender and sex change; for example, in early 2010 the Wellcome Collection hosted The Identity Project, part of which was a major exhibition exploring 'the tension between the way we view ourselves and how others see us', featuring the experience of April Ashley, one of the first people in the UK to undergo gender reassignment.

How will they benefit?

As a result of recent changes in their professional training, there are now a number of midwife-historians whose work would benefit from considering the different ways in which Agnodike was used historically; the sheer range of different uses of her story acts as a warning against taking earlier histories of medicine outside the context in which they were written.
The intersex community will be interested in seeing the variety of responses among earlier medical writers to the story of Phaethousa, which continued into nineteenth-century discussions of hermaphrodites. As an example of how medical 'orthodoxy' changes over time, her story will help those currently considering the relationship between the visible body and the identity of the person.
The wider public will be able to use both stories to think about the politics of medical treatment.

What will be done to ensure they benefit?

I will use my established links with practising midwives and with nurse education, writing pieces for relevant journals and websites, and speaking to medical groups (see Impact Plan). In particular, I will write an article on Agnodike aimed at practising midwives, and I will contact the national and international Intersex Associations and offer to write a summary of my argument for their websites.
Reaching the wider public will be done in conjunction with the University of Reading Press Office and also through my personal contacts with radio producers and through my external talks to groups such as the Classical Association, the University of the Third Age, and schools. I am already talking in 2010 to a Classical Association group in Bristol (on Phaethousa) and to St Paul's Girls' School (on Agnodike), in each case because they requested this topic. St Paul's Girls' School identified Agnodike as a relevant topic because they perceived her as a link between Classics and science, and also as a way of understanding women in the history of medicine.