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Remembering Trotula, the first female physician in Europe

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Trotula De Ruggiero was the first female physician in Europe. She was probably the most famous and important member of the so-called Mulieres Salernitanae (Women from Salerno), a group of women physicians who studied at the Medical School of Salerno and practiced the art of medicine at the end of the fi rst millennium, a time when the role of a woman in society was sadly not highly regarded.

It is hard to believe that more than 1,000 years ago, this medical school was also open to women who could attend, study, become physicians, and teach medicine to others.

She was born around 1040-1050 to a noble family, the De’ Ruggiero, who probably moved to the Salerno area from the North of Italy. She married Giovanni Plateario, who also was a physician and a teacher in the Medical School of Salerno. They had two sons, who both later became physicians. She died probably around 1097-1100, and because she was so famous and loved by the people, chronicles of the time describe that her funerary procession was many kilometers long of mourners.

Although we do not know a lot about her life, her legacy lives on not only as a physician, but also as a teacher and scientist. There are two major written works that have been attributed to her.

The first one, also known as Trotula major, is focused on women’s illnesses, and is entitled: “De passionibus mulierum ante, in et post partum” (On the diseases of women before, during and after delivery). This book describes different clinical conditions affecting women’s health and by most is considered as the fi rst textbook of obstetrics and gynecology. The second book, also known as Trotula minor, is called “De ornatu mulierum” (On women’s cosmetics) in which the focus is cosmesis, beauty and well-being.

Her impact in the medical field is enormous considering that for more than 500 years her works were used as textbooks throughout Europe by the various medical schools.

Undoubtedly, Trotula was ahead of her time. She had a holistic approach to human health. Thus, besides suggesting specific “remedies” for a disease, she would often talk about the importance of what today we would define as “healthy lifestyle.”

Trotula was not only a great physician, but most importantly an innovator and a ground-breaking scientist for her time. She did not practice general medicine, but women’s medicine focusing on health issues and diseases that until then were totally ignored or had very little chance to be considered with a woman’s mind.

Interestingly, in the preface of her major work she explains the reasons why she wanted to focus her work specifi cally on women’s health: “When comes to health, women are very unfortunate since they need to talk and describe symptoms that concern their most intimate body parts with a male doctor. This fact easily creates embarrassment and almost shame in the woman but often results in avoiding the doctor with serious health consequences for women.” She decided to work in this specifi c area of medicine so “women can talk openly and frankly without modesty and embarrassment sensitivity, and this will certainly facilitate the diagnosis and the cure for that particular illness.”

Undoubtedly, Trotula was ahead of her time. She had a holistic approach to human health. Thus, besides suggesting specific “remedies” for a disease, she would often talk about the importance of what today we would define as “healthy lifestyle.”

For her, the basis of a harmonious and healthy life were three major things: practicing good hygienic measures, daily physical activity, and a well-balanced diet (Mediterranean diet?).

Let’s recognize and celebrate Trotula De’ Ruggiero, a central fi gure, and a female pioneer in the history of medicine.

Dr. Domenico Pratico

Dr. Domenico Pratico is the director of the Alzheimer’s Center at the Lewis Katz School of Medicine at Temple University, Philadelphia.

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