Bulletin of the History of Medicine

Eve’s Herbs is both a summary of and a sequel to Riddle’s earlier study, Contraception and Abortion from the Ancient World to the Renaissance (1992). As in the earlier volume, Riddle puts forward a large and, in many respects, radical thesis that chemical means of limiting fertility (by both contraceptives and abortifacients, though he gives the latter category far more attention here) have been known and used throughout Western history. Beginning with a riveting summary of the landmark Roe v. Wade Supreme Court decision in 1973, Riddle moves back all the way to ancient Egyptian sources to find evidence that healers of the past were continually discovering the fertility-limiting properties of herbs. From this central assertion, he suggests that knowledge of these plants, and the later suppression of that knowledge by religious and legal forces (and even witchhunts), accounts for both the containment of population growth in premodern Europe and its manifold expansion in the modern period. This is a “big book” in the truest sense of the term, in that it offers interrelated causal explanations for the whole course of Western history.

Let me say at the outset that I find Riddle’s general argument about the potential of herbs to affect fertility plausible, if not yet fully conclusive. Critical to his thesis are modern chemical assays of various plant substances that show them to be effective on lower-order mammals in curtailing fertility. It remains to be seen whether these substances really have all the properties in humans accorded to them here. The amounts needed to produce effects are often huge: a dosage of 1.2 g/kg in a rat (the effective amount of rue extract) would mean that a 50 kg [End Page 308] woman (about 110 pounds) would have to ingest 60 grams of the substance in order to achieve a similar effect. Still, research on phytoestrogens has confirmed plants’ powers to affect human hormonal physiology, and it is likely that Riddle’s work will bring more plant substances back into the modern pharmacopeia.

Some of my criticisms pertain to minor inaccuracies: foreign words are often misspelled, mistranslations are unnervingly common, items are omitted from the index, and so forth. My real concerns, however, lie in Riddle’s handling of the “big questions” of the history of gynecology and the social history of women. His thesis hinges on his belief that women understood the code that substances labeled “menstrual regulators” and “emmenagogues” were really contraceptives and abortifacients in disguise.” He ignores the fact that premodern theories of female physiology were premised on the belief that menstruation was a vital purgation. Waste matter from the entire female body built up over the course of the month, and if it was not purged regularly, it would cause disease. Moreover, there was a belief that conception was best accomplished in the period right after this purgation; the menstrual purgation was thus necessary for conception. As one of the so-called Trotula treatises explained in the twelfth century, menses were called “women’s flower,” because just as trees did not bear fruit until they flowered, neither did women. “The flowers” is found in almost all European vernacular languages as the common medieval term for menstrual blood. Thus, it is in no way surprising that the authentic writing of the female practitioner Trota should begin its section on emmenagogues with the explicit claim that these render the woman ready for conception: “Secundum Trotam ad menstrua provocanda, propter quorum retentiones mulier concipere non potest [(a remedy) according to Trota for provoking the menses, because of whose retention the woman is unable to conceive].” ¹ Also typical was the description in the Circa instans (the principal twelfth-century Salernitan herbal) of the properties of balm (Melissa officinalis L.): “it provokes the menses, cleans and comforts the womb, and aids in conception.” ² Riddle is nonplussed by the, to him, illogical references to emmenagogues as fertility enhancers (which continue as late as the nineteenth-century advertising claim of Lydia Pinkham’s Compound that “There’s a Baby in Every Bottle”)—but there is no illogic here whatsoever.

What this means, of course, is that we must be very cautious in assuming, as Riddle does, that every substance identified as an emmenagogue was used with the intention of preventing pregnancy or aborting one already begun. Infertility was and remains a problem for a considerable number of women. For example, recent studies suggest that somewhere between 5 and 10 percent of modern American women suffer from polycystic ovarian syndrome, which is characterized by irregular ovulation. Irregular ovulation means irregular menstruation. The principal therapy, not surprisingly, is to use oral contraceptive pills to [End Page 309] reestablish a regular menstrual cycle. If irregular menstruation plays such a significant role in infertility problems in a modern, well-nourished population, might it not have played an even bigger one in the medieval world? Yes, of course we must dig beneath the surface of the euphemisms and discursive rhetoric (often unconscious) of medical writings of the past, but to do so while ignoring their own systems of understanding and explanation borders on positivism.

Perhaps the most surprising limitation of this book is how little it contributes to women’s history. Although the topic so obviously calls for engagement with the ever-growing wealth of empirical studies and analytical techniques in the field, Riddle cites only a handful of books and articles that reflect this new scholarship. Instead, he has borrowed heavily from dated and, in some cases, discredited pronouncements on the “causes” of the witchhunts. Given the numerous contradictions and unsupported assertions of much of this literature, Riddle never quite seems to make up his mind whether he believes all these conspiracy theories or not. In search of “women’s voices,” he tries to make much of a few female medical writers (“Trotula,” Hildegard, and the seventeenth-century midwife Jane Sharp), but it is only by significantly distorting or misreading his evidence that he can claim them as proponents of fertility limitation.

Riddle conveniently sidesteps scholarly evidence that the text he attributes to the authoress “Trotula” is not a single text but three works of different authorship fused together. He suggests (in a footnote buried in the back of the book) that for his purposes all that matters is that medieval readers believed that the author was female. Yet if our concern is to learn about the medical practices and knowledge of women, then it matters very much whether this information is coming from a woman with her own empirical knowledge of the effects of these herbs or from a man, who may simply be passing on information he has gleaned from earlier texts. Typical of the kinds of distortions that plague this book is Riddle’s assertion that “Trotula” “provides no details about birth control devices, either of the contraceptive or abortive variety” (p. 32). This is patently untrue, for one of the texts has a group of remedies explicitly identified as contraceptives for women whose small pelvises make it unsafe for them to bear children. Riddle presumably omits mentioning these remedies because they are all amulets, and so have only the placebo effects of magical medicine that so embarrass him because they complicate his claims about the knowing reliance on chemical substances.

Hildegard’s authorship is not in doubt, but she is hardly the advocate of fertility control that Riddle makes her out to be. On pp. 90, 105, and 189, Riddle claims that Hildegard recommends tansy as an abortifacient; in truth, she mentions only its utility in cases of obstructed menses. In both cases where this twelfth-century nun does mention plants with abortifacient properties, she identifies them as extremely dangerous drugs: oleaster “is noxious” (nocivus est) to healthy people, while asarum “ought to be feared” (timenda est). Riddle mistranslates (and so tones down) the Latin passage on asarum “et si praegnans mulier eam comederit, aut morietur, aut infantem cum periculo corporis sui abortiret, aut si eo tempore cum menstrua non haberet, plus indoleret,” rendering [End Page 310] it as “A pregnant woman will eat it, either on account she languishes or she aborts an infant with a danger to her body or if she has not had a menstrual period for a time period so that it hurts” (p. 59). Correctly, the passage should read “If a pregnant woman eats it, either she will die, or she will abort the child with danger to her own body; if at any time [she eats it] because she does not have her menses, she will suffer more.” These dire consequences hardly constitute a “recommendation” of abortifacients.

What women knew about fertility-controlling drugs and what they did with that information thus remains to be determined. Riddle has made no use of female-compiled recipe collections, which became quite common in the sixteenth century and after (cf. the splendid exhibition held early in 1998 at the Wellcome Institute in London, “A Lady’s Closet Opened: Women’s Recipe Books and Lay Medical Culture in Stuart England”). Of the primary sources he does use (mostly from legal cases), many contradict rather than confirm his assertion that it was women who primarily traded in knowledge of fertility-limiting drugs. From the fourteenth-century Beatrice of Montaillou, whose story opens Chapter 1 up through cases from the eighteenth century, most of the women who enter the historical record have obtained their birth control information or substances from men, whether lovers, apothecaries, or physicians (e.g., pp. 181, 200, 208, 209).

Because of its obvious relevance to both sides of the current political debates about contraception and abortion, Eve’s Herbs is likely to have an impact not only on the direction of future historical and medical research but, more immediately, on public policy. It is regrettable that these interested parties have not been better served by the skills that exacting historical scholarship has to offer.