medical history

Aristotle in the Sex Shop and Activism in the Academy: Notes from the Joint Atlantic Seminar in the History of Medicine

By Editor Spencer J. Weinreich

Four enormous, dead doctors were present at the opening of the 2017 Joint Atlantic Seminar in the History of Medicine. Convened in Johns Hopkins University’s Welch Medical Library, the room was dominated by a canvas of mammoth proportions, a group portrait by John Singer Sargent of the four founders of Johns Hopkins Hospital. Dr. William Welch, known in his lifetime as “the dean of American medicine” (and the library’s namesake). Dr. William Halsted, “the father of modern surgery.” Dr. Sir William Osler, “the father of modern medicine.” And Dr. Howard Kelly, who established the modern field of gynecology.

1905 Professors Welch, Halsted, Osler and Kelly (aka The Four Doctors) oil on canvas 298.6 x 213.3 cm Johns Hopkins University School of Medicine, Baltimore MD

John Singer Sargent, Professors Welch, Halsted, Osler, and Kelly (1905)

Beneath the gazes of this august quartet, graduate students and faculty from across the United States and the United Kingdom gathered for the fifteenth iteration of the Seminar. This year, the program’s theme was “Truth, Power, and Objectivity,” explored in thirteen papers ranging from medical testimony before the Goan Inquisition to the mental impact of First World War bombing raids, from Booker T. Washington’s National Negro Health Week to the emergence of Chinese traditional medicine. It would not do justice to the papers or their authors to cover them all in a post; instead I shall concentrate on the two opening sessions: the keynote lecture by Mary E. Fissell and a faculty panel with Nathaniel Comfort, Gianna Pomata, and Graham Mooney (all of Johns Hopkins University).

I confess to some surprise at the title of Fissell’s talk, “Aristotle’s Masterpiece and the Re-Making of Kinship, 1820–1860.” Fissell is known as an early modernist, her major publications exploring gender, reproduction, and medicine in seventeenth- and eighteenth-century England. Her current project, however, is a cultural history of Aristotle’s Masterpiece, a book on sexuality and childbirth first published in 1684 and still being sold in London sex shops in the 1930s. The Masterpiece was distinguished by its discussion of the sexual act itself, and its consideration (and copious illustrations) of so-called “monstrous births.” It was, in Fissell’s words, a “howling success,” seeing an average of one edition a year for 250 years, on both sides of the Atlantic.

It should be explained that there is very little Aristotle in Aristotle’s Masterpiece. In early modern Europe, the Greek philosopher was regarded as the classical authority on childbirth and sex, and so offered a suitably distinguished peg on which to hang the text. This allowed for a neat trick of bibliography: when the Masterpiece was bound together with other (spurious) works, like Aristotle’s Problems, the spine might be stamped with the innocuous (indeed impressive) title “Aristotle’s Works.”


El Greco, John the Baptist (c.1600)

At the heart of Aristotle’s Masterpiece, Fissell argued, was genealogy: how reproduction—“generation,” in early modern terms—occurred and how the traits of parents related to those of their offspring. This genealogy is unstable, the transmission of traits open to influences of all kinds, notably the “maternal imagination.” The birth of a baby covered in hair, for example, could be explained by the pregnant mother’s devotion to an image of John the Baptist clad in skins. Fissell brilliantly drew out the subversive possibilities of the Masterpiece, as when it “advised” women that adultery might be hidden by imagining one’s husband during the sex act, thus ensuring that the child would look like him. Central though family resemblance is to reproduction, it is “a vexed sign,” with “several jokers in every deck,” because women’s bodies are mysterious and have the power to disrupt lineage.

Fissell principally considered the Masterpiece’s fortunes in the mid-nineteenth-century Anglophone world, as the unstable generation it depicted clashed with contemporary assumptions about heredity. Here she framed her efforts as a “footnote” to Charles Rosenberg’s seminal essay, “The Bitter Fruit: Heredity, Disease, and Social Thought in Nineteenth-Century America,” which traced how discourses of heredity pervaded all branches of science and medicine in this period. George Combe’s Constitution of Man (1828), an exposition of the supposedly rigid natural laws governing heredity (with a tilt toward self-discipline and self-improvement), was the fourth-bestselling book of the period (after the Bible, Pilgrim’s Progress, and Robinson Crusoe). Other hereditarian works sketched out the gendered roles of reproduction—what children inherited from their mothers versus from their fathers—and the possibilities for human action (proper parenting, self-control) for modulating genealogy. Wildly popular manuals for courtship and marriage advised young people on the formation of proper unions and the production of healthy children, in terms shot through with racial and class prejudices (though not yet solidified into eugenics as we understand that term).

The fluidity of generation depicted in Aristotle’s Masterpiece became conspicuous against the background of this growing obsession with a law-like heredity. Take the birth of a black child to white parents. The Masterpiece explains that the mother was looking at a painting of a black man at the moment of conception; hereditarian thought identified a black ancestor some five generations back, the telltale trait slowly but inevitably revealing itself. Thus, although the text of the Masterpiece did not change much over its long career, its profile changed dramatically, because of the shifting bibliographic contexts in which it moved.

In the mid-nineteenth century, the contrasting worldviews of the Masterpiece and the marriage manuals spoke to the forms of familial life prevalent at different social strata. The more chaotic picture of the Masterpiece reflected the daily life of the working class, characterized by “contingent formations,” children born out of wedlock, wife sales, abandonment, and other kinds of “marital nonconformity.” The marriage manuals addressed themselves to upper-middle-class families, but did so in a distinctly aspirational mode. They warned, for example, against marrying cousins, precisely at a moment when well-to-do families were “kinship hot,” in David Warren Sabean’s words, favoring serial intermarriage among a few allied clans. This was a period, Fissell explained, in which “who and what counted as family was much more complex” and “contested.” The ambiguity—and power—of this issue manifested in almost every sphere, from the shifting guidelines for census-takers on how a “family” was defined, to novels centered on complex kinship networks, such as John Lang’s Will He Marry Her? (1858), to the flood of polemical literature surrounding a proposed law forbidding a man to marry his deceased wife’s sister—a debate involving many more people than could possibly have been affected by the legislation.

After a rich question-and-answer session, we shifted to the faculty panel, with Professors Comfort, Pomata, and Mooney asked to reflect on the theme of “Truth, Power, and Objectivity.” Comfort, a scholar of modern biology, began by discussing his work with oral histories—“creating a primary source as you go, and in most branches of history that’s considered cheating.” Here perfect objectivity is not necessarily helpful: “when you make yourself emotional availability to your subjects […] you can actually gain their trust in a way that you can’t otherwise.” Equally, Comfort encouraged the embrace of sources’ unreliability, suggesting that unreliability might itself be a source—the more unreliable a narrative is, the more interesting and the more indicative of something meant it becomes. He closed with the observation that different audiences required different approaches to history and to history-writing—it is not simply a question of tone or language, but of what kind of bond the scholar seeks to form.

Professor Pomata, a scholar of early modern medicine, insisted that moments of personal contact between scholar and subject were not the exclusive preserve of the modern historian: the same connections are possible, if in a more mediated fashion, for those working on earlier periods. In this interaction, respect is of the utmost importance. Pomata quoted a line from W. B. Yeats’s “He wishes for the Cloths of Heaven”:

I have spread my dreams under your feet;

Tread softly because you tread on my dreams.

As a historian of public health—which he characterized as an activist discipline—Mooney declared, “I’m not really interested in objectivity. […] I’m angry about what I see.” He spoke compellingly about the vital importance of that emotion, properly channeled toward productive ends. The historian possesses power: not simply as the person setting the terms of inquiry, but as a member of privileged institutions. In consequence, he called on scholars to undermine their own power, to make themselves uncomfortable.

The panel was intended to be open-ended and interactive, so these brief remarks quickly segued into questions from the floor. Asked about the relationship between scholarship and activism, Mooney insisted that passion, even anger, are essential, because they drive the scholar into the places where activism is needed—and cautioned that it is ultimately impossible to be the dispassionate observer we (think we) wish to be. With beautiful understatement, Pomata explained that she went to college in 1968, when “a lot was happening in the world.” Consequently, she conceived of scholarship as having to have some political meaning. Working on women’s history in the early 1970s, “just to do the scholarship was an activist task.” Privileging “honesty” over “objectivity,” she insisted that “scholarship—honest scholarship—and activism go together.” Comfort echoed much of this favorable account of activism, but noted that some venues are more appropriate for activism than others, and that there are different ways of being an activist.

Dealing with the horrific—eugenics was the example offered—requires, Mooney argued, both the rigor of a critical method and sensitive emotional work. Further, all three panelists emphasized crafting, and speaking in, one’s own voice, eschewing the temptation to imitate more prominent scholars and embracing the first person (and the subjectivity it marks). Voice, Comfort noted, isn’t natural, but something honed, and both he and Pomata recommended literature as an essential tool in this regard.

Throughout, the three panelists concurred in urging collaborative, interdisciplinary work, founded upon respect for other knowledges and humility—which, Comfort insightfully observed, is born of confidence in one’s own abilities. Asking the right questions is crucial, the key to unlocking the stories of the oppressed and marginalized within sources created by those in power. Visual sources have the potential to express things inexpressible in words—Comfort cited a photograph that wonderfully captured the shy, retiring nature of Dr. Barton Childs—but must be used, not mere illustrations. The question about visual sources was the last of the evening, and Professor Pomata had the last word. Her final comment offers the perfect summation of the creativity, dedication, and intellectual ferment on display in Baltimore that weekend: “we are artists, don’t forget that.”

What was life like as a female singer 3400 years ago?

By guest contributor Lynn-Salammbô Zimmermann


A singer and a musician on the royal standard of Ur.

In the mid-14th century BCE, a group of young female singers contracted an unknown disease. A corpus of letters from Nippur, a religious and administrative center in the Middle Babylonian kingdom (modern-day Iraq), tells us about the medical condition of these young females, who learned to become singers sharing the same quarters (cf. BE 17, 31, 32, 33, 47, N 969, and PBS 1/2, 71, 72, 82).

The letters about these girls’ medical conditions were exchanged between the physician Šumu-libši (and his colleague Bēlu-muballiṭ) and the governor of Nippur, Enlil-kidinnī. Šumu-libši provides the governor with meticulous reports of the girls’ symptoms, as well as his attempts to cure them. The symptoms include an inflammation of the chest, fever, perspiration and coughing. The girls are treated with poultices on the chest. Thus it is likely that Šumu-libši was an asû, a physician, and not an exorcist. An asû would have concentrated on the natural causes of symptoms, applying drugs and using the scalpel when dealing with the physical side of the disease, while an exorcist would have also spoken incantations (Geller, 2001: 27-33, 43-48, 56-61). So far the focus of research has unfortunately only been on the sender and recipient of these letters, but not on the female patients, due to the lack of information and their passive role in the narrative. This article aims to shift the perspective.

Unfortunately, we really do not know much more about these girls. We do not even know their names. They are all called “the daughter of NN” with the exception of a woman named Eṭirtu, who may have been in a higher position, such as that of a supervisor or a teacher.

The girls were most likely trained to become singers in a palace or a temple complex (Sallaberger, Vulliet, 2005: 634). Every report by Šumu-libši begins with the greeting: “Your servant Šumu-libši: I may die as my lord’s substitute. The male and female musicians, Eṭirtu and the house of my lord are well.” The governor, who is inquiring after the girls’ health, was not only responsible for the provincial administration of Nippur, but also for its temples, as he also held the position of the highest priest in the city (Petschow, 1983: 143-155; Sassmannshausen, 2001: 16-21). Additionally, he owned large estates, so we cannot exclude the possibility that he would employ singers for his private entertainment there. Since the kingdom had a patrimonial structure, and the concept of “privacy” separate from an official’s public role did not exist until later, “the house of my lord” could apply not only to the various official households under Enlil-kidinnī’s command, but also to his own estates.


Musicians and singers in Girsu. Louvre Museum, Paris. Photo by Lynn-Salammbô Zimmermann.

In general, musicians, both male and female, had a high status at the royal courts of the Old Babylonian period. This is consistent with the fact that the governor, who held the most important office of the Middle Babylonian kingdom, made inquiries about the young singers’ health. Despite the fact that the girls are rather passive in the letters, they can apparently give orders to the healing specialists, as is reported in the letter BE 17, 47, ll. 4-5: “they bandaged her with a poultice as (she) requested” (Sibbing Plantholt, 2014: 180).

During the Middle Babylonian period, Elamite and Subarean singers can be found at the royal court in Dūr-Kurigalzu (Ambos, 2008: 502). Foreign singers were exchanged as precious diplomatic gifts. Young female musicians often ended up in the royal harems (Ziegler, 2006: 247, 349). Nonetheless, in Mesopotamia—and especially in the “international” Middle Babylonian period—the ethnicity of a person cannot automatically be deduced from the language of their name. That being said, the majority of the names of the fathers of “our” girls appear to be Babylonian, one father bearing a supposedly Hurrian name (Hölscher, 1996: 85).

We can find out more about Šumu-libši’s patients by comparing their situation with that of other female singers in Mesopotamia. This unfortunate case of an epidemic infecting apprentice musicians is reminiscent of another disease among female singers at a royal court, some 400 years earlier (Ziegler, 1999: 28-29). The archive of this royal court, that of king Zimri-Lim (1775-1762 BC) in the city state of Mari (modern-day Syria), documents a large number of female musicians present (Ziegler, 1999: 69-82; Ziegler, 2006: 245). Many of the female musicians at court were actually concubines. We know this because some of them received oil after successfully giving birth, and since they were “unmarried”, we can conclude that they got pregnant by the king as members of his harem. One of Zimri-Lim’s favourite wives actually supervised a number of female musicians, who must have been very young, since according to the oil accounts they only received small allotments. We can see in the accounts of oil for their toilette and for the lighting of the palace quarters that there existed a strict hierarchy among these women (Ziegler, 1999: 22-24, 29-30; Ziegler, 2006: 346). According to their rank, the women received larger or smaller rations. The female singers were among the lower classes of the harem, being supervised by a governess (Lafont, 2001:135-136). In the Middle Babylonian letters, Eṭirtu might have been such a governess.


A model of the royal palace of Mari. The women’s quarters are in the lower right corner. Louvre Museum, Paris. Photo by Lynn-Salammbô Zimmermann.

Contrary to our imagination of an oriental harem, it is attested that these women could move beyond the scope of their quarters (Lafont, 2001: 136; Ziegler, 1999: 15-20). In the younger Middle Assyrian harem edicts, however, which were issued in Assyria during the Middle Babylonian period, the freedom of the women at court was much more limited, rendering them completely dependent on the king and palace officials (Roth, 1997: 196-209). If we assume that the Middle Babylonian patients were singers at court, then—according to the contemporary Middle Assyrian harem edicts—they were kept under strict surveillance by palace officials.

In both cases we see that the apprentices apparently shared the same quarters and had close daily contact with one another. This might have not only lead to the spread of a contagious disease, but also to conflicts: quarrels between women at court were addressed in the Assyrian edicts (Roth, 1997: 201-202). While “our” Middle Babylonian singers’ lives were valuable enough to their employer to receive medical care, the king of Mari ordered his queen in two letters to isolate sick women from the rest of the harem (Lafont, 2001. 138-139). In one of these letters (ARM X, 129), Zimri-Lim writes that a sick woman had infected other women in the palace. Therefore he orders his queen: “[G]ive strict orders that no one is to drink from the cup from which she drinks, or sit on the seat where she sits, or lie on the bed where she lies, so that she does not infect many women by her contact alone” (Lafont, 2001: 138). In the second letter (MARI III, 144), Zimri-Lim orders his queen to let the isolated woman die (illnesses were believed to be a divine punishment, cf. the arnu principle in Neumann, 2006:36): “So let this woman die, she alone, and that will cause the illness to abate” (Lafont, 2001: 138-139).

Where were Zimri-Lim’s concubines from? Apparently the king had his pick among the women whom he had brought back as booty from campaigns to the north. In the Middle Babylonian letter, however, nothing implicates that “our” girls were booty—not even the fathers’ names. It is also possible that the girls’ families wanted them to become singers, because it was a prestigious position at court or in a temple.


Heads of votive figures of priestesses or ladies of the court at Mari. Louvre Museum. Photo by Lynn-Salammbô Zimmermann

How did the young women in Mari become singers? Since they were not only used for entertainment and/or the cult, but also functioned as concubines, physical attributes were the main criteria, rather than artistic or musical talents. Thus the king orders his queen to pick the prettiest ones (ARM X, 126): “Choose some thirty of them […] who are perfect and flawless, from their toenails to the hair of their head.” Only afterwards does the king want them to learn how to sing. Once the concubines were picked, they should also keep their weight according to the king’s orders: “Give [also] instructions concerning their food, so that their appearance may not be displeasing” (Lafont, 2001: 138). Such appearance-related pressure presumably applied to “our” girls as well. Even if they worked in temple premises at Nippur and not in a royal harem, the religious cult would have required an immaculate body due to purity regulations.

The Middle Babylonian (14th century BCE) letters themselves do not offer much information about “our” young female patients. This is consistent with the patriarchal nature of Mesopotamian society, resulting in the textual evidence mostly being written from the male perspective, reporting about women referring to their looks, their fertility and use as workforce (Note, though, that women had some legal rights, i.e. appearing at court and as contracting partners, and especially in the Middle Babylonian period as single heads of their families, cf. Paulus, 2014: 240-245). Research, focusing on the available information, has consequently followed this perspective. However, drawing parallels to the conditions of female singers at court 400 years earlier offers us a plausible glimpse into the possible living conditions of “our” female patients.

Lynn-Salammbô Zimmermann is a D.Phil. candidate in Assyriology at the University of Oxford, writing her thesis about the Middle Babylonian/Kassite period administration. She completed her undergraduate and graduate studies in Egyptology, Assyriology and Religious Studies in Münster, Germany.