The Disease of Virgins

Green Sickness, Chlorosis and the Problems of Puberty

Helen King

• Publisher: Routledge
• Year: 2004
• ISBN:
  9781134589081
• Edition: 1
• Topic: History
• Subtopic: Ancient History
• Index: History

From an acclaimed author in the field, this is a compelling study of the origins and history of the disease commonly seen as afflicting young unmarried girls.

Understanding of the condition turned puberty and virginity into medical conditions, and Helen King stresses the continuity of this disease through history, depsite enormous shifts in medical understanding and technonologies, and drawing parallels with the modern illness of anorexia.

Examining its roots in the classical tradition all the way through to its extraordinary survival into the 1920s, this study asks a number of questions about the nature of the disease itself and the relationship between illness, body images and what we should call'normal' behaviour.

This is a fascinating and clear account which will prove invaluable not just to students of classical studies, but will be of interest to medical professionals also.

1
THE NATURE OF GREEN SICKNESS

In sixteenth-century England, there was a disease known as ‘green sickness’. In this chapter I will be discussing how ideas about this condition developed during the sixteenth century, examining in particular the relationship between lay ideas of disease and ‘official’ medical versions of the female body. Although I have already mentioned the role of Johannes Lange as the ‘creator’ of the precise symptom picture of the disease of virgins, I have deliberately chosen to start, not with him, but with green sickness in English vernacular sources. There are two reasons for this strategy.

First, there are chronological considerations. Lange’s letter, in which he describes the disease of virgins, was published in 1554 but, as I will show here, green sickness was described both before and after this date. In this and the following chapter, I will be arguing that Lange’s ‘disease of virgins’ may have reinforced the transformation of the English green sickness from a digestive disorder affecting all ages and both sexes to a condition found only in young women.

Second, starting with green sickness means giving priority to popular, vernacular medicine rather than elite Latin medicine. Lange’s contribution, although important, distorts the image we have of sixteenth-century medicine; when we accept his letter as the ‘first medical description of this syndrome’ (Crosby 1987:2799), the tendency is to privilege technical literature written in Latin, and to regard vernacular works as being merely derivative from Latin texts. However, in early modern Europe, while some Latin medical texts were translated into several different languages, vernacular medical texts were also translated into Latin in order to make them more easily accessible to the European medical elite; this two-way movement meant that early modern European medical knowledge was increasingly cross-cultural. I am also not convinced that medical ideas begin with a university-trained physician’s reading —or, as I shall show in chapter 2, misreading—of the classical sources and are then imposed on a population to whom they were previously unknown. The connections which Lange drew between his ‘disease of virgins’ and the classical medical writers have been very influential, but they do not represent the whole story. The speed with which this condition gripped the imaginations of European medical writers, becoming, within a generation, something which ‘occurs in a large number of virgins’ (Mercado 1579:201), and its appearance in case notes and in popular literature, suggest that it was embraced by patients as much as by physicians. Indeed, in his letter to Anna’s father, Lange himself said that his ‘disease of virgins’ was already known under other names to ordinary people, being ‘what the women of Brabant usually call “white fever”, on account of the pale face, as well as “love fever”’.

Which came first: the technical terms or the popular terms? Guggenheim (1995:1822) states that ‘ chlorosis’ ‘led to the popular English term “green sickness”’, but this is simply an error: the vernacular term predated the coining of the technical label ‘ chlorosis’. It is one of the many peculiarities of the disease of virgins that its history, in many ways so opaque, nevertheless contains several events which can be clearly dated. The first use in print of the term ‘ chlorosis’ is one of these events; it occurred in 1619, in the Latin edition of the work of Varandal of Montpellier published by his students two years after his death, where a list of alternative names for the condition is given, ending with ‘the disease of virgins, which we, from Hippocrates, call Chlorosis’ (Varandal 1619: 4–5; 1620:1).² Varandal very consciously separated this allegedly ‘Hippocratic’ name from the other labels he gave, all of which were classified as the terms used by the ‘common people’ (Latin vulgus ). One of the few women of the early modern period to write about the condition, the midwife Jane Sharp (1671:256– 70; Hobby 1999:194–204), continued to prefer to use ‘green sickness’ over fifty years after Varandal, but the Vulgar’ label survived well beyond this date; for example, in the Glossary to Ruddock’s homeopathic manual for ladies, first published in 1869, ‘ Chlorosis’ is explained as ‘Green sickness’ as late as the tenth edition of 1892, while Stengel’s 1896 encyclopaedic essay on diseases of the blood gave green sickness as ‘the popular name’ and chlorosis as ‘the technical name’ (1896:343).

For Varandal to be ‘the godfather’ of the condition (Schwarz 1951:14), he must have been using the word ‘ chlorosis’ in his lectures some years earlier. This could push back the origin of the term to the 1590s, when he was teaching at Montpellier.³ It is clear that the label ‘green sickness’ was already in use in English medicine at this time. In his study of the casebooks of Richard Napier, an English astrological priest-physician working in the south-east Midlands in the early seventeenth century, Ronald Sawyer suggested that one of the earliest uses of ‘green sickness’ to denote a condition specific to women aged between 17 and 22, with the absence of menstruation as a defining symptom, occurs in Napier’s records for 1603 (see Sawyer 1986:591 in conjunction with Loudon 1984:29).⁴ Work published subsequent to Sawyer’s dissertation pushes back even further the earliest reference to this term in doctors’ case notes; in her work on the physician Dr Barker of Shrewsbury, Lucinda McCray Beier found that green sickness was one of the gynaecological disorders named in his case notes, which date from 1595–1605 (Beier 1987:120, 122); specifically, it appears in the notes from 1596.⁵ Outside doctors’ case notes, where the label seems to have been established as uncontroversial, at least by the first years of the seventeenth century, ‘green sickness’ already appeared as a cause of death in the records of the London parish of St Botolph without Aldgate in the late sixteenth century (Forbes 1971: 100–1); as the ‘searchers of the dead’ were ordinary women, who decided on the cause of death in their neighbours (Munkhoff 1999), this suggests that the label was familiar outside medical texts. So does its use in Shakespeare’s Henry IV Part 2, first performed in about 1597; there, Falstaff says

There’s never none of these demure boys come to any proof; for thin drink doth so over-cool their blood,⁶ and making many fish-meals, that they fall into a kind of male green-sickness; and then, when they marry, they get wenches. They are generally fools and cowards

(Henry IV Part 2, IV.iii.90)⁷

But green sickness appeared in English writing, both medical and lay, considerably earlier than the 1590s. Timothie Bright mentioned green sickness so casually in a list of diseases that the reader gets the impression that it was the common cold of its day:

Hath God so dispensed his blessings, that a medicine to cure iawndies, or the greene sicknes, or the rheume, or such like, should cost more oftentimes then one quarter of the substance that the patient is worth?

(Bright 1580:23)⁸

In Shakespeare, the joke depends on green sickness normally being a condition of young women: in Bright, there is no suggestion that it is gendered. However, if it was already known as an exclusively female disorder, then Bright would not need to spell out ‘or the green sickness in women’, just as we would not need to specify ‘or period pains in women’. In a romance licensed in the Stationers’ Register in the same year as Bright’s book was published, and which appeared in print only three years later (Newcomb 2002:42), Robert Greene’s Mamillia. A mirrour or looking- glasse for the ladies of Englande (1583; Grosart 1881–3: II. 36), green sickness was not only gendered as feminine, but also linked to virginity. Gonzaga realised that his daughter Mamillia was ‘marriageable, knowing by skill and experience, that the grasse being ready for the sieth [scythe], would wither if it were not cut; and the apples being rype, for want of plucking would rotte on the tree; that his daughter beeing at the age of twentie yeeres, would either fall into the green sicknes for want of a husband, or els if she scaped that disease, incurre a farther inconvenience [i.e. illegitimate pregnancy]’. He therefore found her a suitor.

In 1583 Walter Cary also discussed green sickness in chapter 15 of his A Brief Treatise called Caries Farewell to Physicke. He continued to regard the condition as a digestive disorder, attributing it to a weakened liver, which led to water rather than blood being made, to the extent that ‘if they chance to cut a finger, no bloud, but water will rather followe’. He noted that ‘It is found most in maidens’ and suggested that they bring it on themselves by an inadequate diet because they ‘desire to abate their colour, and to be over fine’. He included headache, difficulty in breathing, faintness and absence of menses as symptoms (1583:40–1).⁹ For him, green skin colour was part of the absence of ‘good blood’, patients being ‘ verie pale and greenish’.

Letters from the early modern period demonstrate that green sickness was something experienced by women, and expected by men. In her late thirties Margaret, Countess of Cumberland, described how she had been affected by green sickness in the second seven-year period of her life; she was born in 1560, and appears to have been ill between the ages of about thirteen and sixteen, the condition ending with her marriage, at nearly seventeen years old, in 1577 (Williamson 1920:11, 286). She attributed the affliction to ‘ unbrotherly dealing [which] pierced my thoughts’ (Williamson 1920: 285).¹⁰ Another case of the condition, this time occurring over twenty years before Bright, Greene and Cary, is described in a letter written in June 1558, in which Sir William Pagett describes his daughter Jane as ‘still troubled as she was before her going thither with the greine sicknes’. ¹¹ Jane was not, like Mamillia or Margaret, in ‘want of a husband’; like other aristocratic women of the Tudor period, she married in her middle or late teens and, rather than setting up a new household, lived with her husband Thomas Kitson at the home of his mother, the countess of Bath (Harris 2001:249). Her father was writing to her mother-in-law to explain why, having visited London to see her parents and to attend her sister’s lying-in, she was unable to return; he announced that he was keeping her in London, ‘where there is the best remedy to be had therfore, for which purpose I do use the advise of the best learned in Englande, not doubting but that she shall be remedied thereof. At the time of her London green sickness, Jane had been married for a year, or even less. Her father suggests that she had suffered from green sickness before her move to Hengrave (‘before her going thither’), and it is possible either that the marriage had not yet been consummated (Harris 2001:248 n. 11), or that she had not yet reached menarche.¹² She was ill again in late 1559—this time, her mother thought that she had consumption—and died before November 1560.

How can we combine the hint that Jane had green sickness before her marriage, the possibility that the marriage had not yet been consummated at the time of her green sickness in 1558, and her mother’s fear of consumption in 1559? Both disorders were associated with weakness, difficult breathing, and paleness; in 1559, at least, we know that Jane’s appearance was the subject of discussion, with her mother thinking her unwell, but her father considering that she had never looked better (Harris 2001:249).¹³ It may be valid here to compare the shift in label with one which occurred fifty years later, in the casebooks of Richard Napier. Here, case histories in which the diagnosis ‘green sickness’ was given were subsequently emended to ‘obstruction of the spleen’ if the patient menstruated (Sawyer 1986:491 n. 41). For Napier, ‘green sickness’ was always a diagnosis dependent on the absence of menstruation. The evidence—flimsy as it is—could be read to suggest that Jane reached menarche later in 1558 or in 1559, making green sickness no longer a possible label for her weakness. Her father’s claims that the learned physicians of London could provide the best remedy could indicate that he had been hoping that they could bring on her menstrual flow.

flow. Returning to published medical texts, the earliest use of ‘green sickness’ for a distinct condition which I have been able to trace in English writing dates back ten years before Jane Kitson’s illness, to 1547, when Andrew Boorde’s Breviary of Helthe used ‘ grene sicknes’ as the direct equivalent of ‘ grene Jawnes’, one of three types of jaundice mentioned: yellow, black and green.¹⁴ The green variant was seen as the result of the corruption of blood from a mixture of yellow bile and phlegm. Like Bright, however, Boorde did not state that this condition is specific to any age/sex group, nor did he regard it as in any way ‘new’ (1547:75r; see Norri 1992:336); on the contrary, he gave it an Arabic origin, saying that the ‘ grene sicknes’ is ‘named Agriaca’ in Arabic texts (1547:74r).¹⁵

The humoral body

The causation of green jaundice/green sickness was thus originally understood in the context of ‘the seductive coherence of Galenic humoral theory’ (Schoenfeldt 1999:3). As Gail Kern Paster has argued, ‘whenever the early modern subject became aware of her or his body…the body in question was always a humoral entity’ (Paster 1993:10). To understand green sickness, it is necessary to appreciate some of the implications of such a body. Based on the work of the Hippocratic writers and Galen, and serving as the dominant model of the body through the middle ages up to at least the eighteenth century, the humoral system concentrated on what Galen made into the canonical four humours: blood, phlegm, yellow bile and black bile.¹⁶ In its most complete form, the humoral body linked these constituent fluids to the four elements, the four qualities—hot, cold, wet and dry—and the four seasons, placing the human body within the wider cosmos and explaining its reactions to changes in the environment, while classifying people by their dominant humour, or ‘temperament’.¹⁷ Unlike a system in which the same pill—perhaps in different doses—is valid for the same condition, regardless of the individual in whom that condition is found, humoral medicine requires knowledge of the many individual features leading to illness in a specific person: this means that, ideally, the physician needs an extensive training, a detailed knowledge of the patient, and a lengthy—and expensive— consultation (Wear 2000:42). Yet, in a diluted, over-the-counter form, humoral medicine could also be easily understood by lay people. In the absence of books or doctors, they could discuss their predominance of phlegm or blood with family and friends, attempt self-treatment or decide on the best sort of healer to consult (Wear 2000:108–16).

The humoral body was, above all, a place of fluids, not of organs.¹⁸ When studying the female patients of an eighteenth-century German physician, Johannes Pelagius Storch, Barbara Duden speculated on the impact of writing on perceptions of the body. In pre-literate cultures, such as that of ancient Greece before the Hippocratic corpus, knowledge too is ‘fluid’, and ‘reality does not solidify’ (Duden 1991:33). But, even in the Western medical tradition of text-based medical education (Bates 1995), this lessthan- solid body persisted in medical thinking and popular knowledge into the modern period alongside a body made of organs. The role of the organs in the humoral bodily economy was, however, secondary: to collect, transform and transmit the humours. The four humours could accumulate to cause blockages anywhere in the body or, as in ‘green jaundice’, could form inappropriate mixtures. But other fluids, too, because they derived from blood, needed to be taken into consideration by the patient and her physician. Blood, according to Aristotle, was cooked or ‘concocted’ into breast milk and, in men, whose g...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Preface
• Abbreviations
• Introduction
• 1: The Nature Of Green Sickness
• 2: A New Disease?
• 3: The Menstruating Virgin
• 4: Dietary Factors
• 5: ‘The Laboratory Came To The Rescue’
• Conclusion
• Appendix
• Notes
• Bibliography