Menstruation and humoral medicine

Last updated October 13, 2023

Many beliefs amount menstruation in the early modern period were linked to humorism, the system of medicine introduced by Ancient Greek and Roman physicians. People believed that the human body contained four humours: blood, phlegm, yellow bile, and black bile.^[1] Illnesses and problems were understood as being caused by dyscrasia, or an imbalance in the four humours. Treatments for disease had the aim of restoring a balance, curing the patient. The humoral model was a continuity during the early modern period, despite the fact that new medical theories began to arise in the second half of the eighteenth century, because these new ideas which used different treatments involving new chemicals were not as trusted since they were not properly established.^[2]

In this way medical and popular beliefs about menstrual problems such as irregular menstruation, amenorrhea (absence of periods whilst fertile) or dysmenorrhea (painful periods) were thought of in relation to the four humours.^[3] In early modern western Europe, physicians believed that the womb could not be too cold, hot, moist or dry and that an excess in any of these could impact a woman's fertility.^[4] Significantly, people believed that warmth encouraged sexual pleasure and increased the probability of conceiving a child, meaning that the womb had to be warm during intercourse. If a woman was found to be having problems menstruating which would then impact their fertility, remedies which aimed to alter the humoral state of the body were used. Aphrodisiacs were a common remedy given to women with menstrual problems, since they were believed to have internal heating effects, stimulating menstruation by redressing the constitutional balance of a womb that was too cold.^[5]

Beliefs on menstruation and conception

The humoral model was not the only way menstruation was understood in the early modern period. The four humours helped guide physicians to give remedies for menstrual problems, but there were different understandings of what menstruation might be caused by. The two main beliefs surrounding menstruation were either that it was necessary to remove an excess of blood, or to purify blood.^[1] Some believed that women had an excess of blood which the body needed to get rid of in the form of a period. This excess was due to the belief that women's bodies could not use all of the blood in their body unlike men, making them weaker.^[2] Others believed in the Aristotelian model, which purifies women's blood. According to this model, after menstruation a purified substance is left which forms a foetus once mixed with the male seed.^[4] A further function of menstrual blood was proposed by the Galen model. This was the belief that after conception the foetus was nourished in the womb by menstrual blood.^[5] This shows that in early modern period menstrual blood and conception itself were linked together.

With this in mind, what can be perceived as a classic negative attitude towards menstruation can be re-evaluated. For example, in the Bible (Ezekiel) men are advised to not have sex with a woman who is menstruating. The passage states that "a good man" should "not to lie with a menstruous woman".^[3] This could be interpreted as an example of the stigmatisation of menstruation, and how menstrual blood was considered to be dirty and not pure. In a translation of a sixteenth-century text on the art of having beautiful children published early in the eighteenth century, the message that no procreation should occur while the woman is menstruating is very clear. This text can be used as an example of the disgust towards menstruation that may have been found at the time:

Press not your Wives, tho height'nd Lust incite The Soul to try the pleasurable Fight, While the Blood monthly rushing from the Veins, The Flowing Womb with foul Pollution stains ... But if by Chance the Seeds concurring fix, And with th'impurer Dross of Nature mix, What a detested, miscreated Thing From such ill-suited Principles must spring? Foul Leprous Spots shall with his Birth begin, Spread o'er his Body, and encrust his Skin; For the same Poison which that Stream contains, Transfer'd affects the forming Infant's Veins, Inbred it fixes deep, and radically reigns.^[3]

However, the conclusion that attitudes towards menstruation were completely negative is not certain. Some historians have argued that the advice followed by many men found in the Bible was not because of a stigma or a hostile attitude towards menstrual blood, but because sex during menstruation was thought to impact healthy conception.^[6] While it is hard to know exactly which theory is correct, it is important to examine the medical context, because the humoral model emphasised the need for balance between the four humours. This means that blood could be healthy or polluting depending on the humoral context in which blood was discharged and observed, in the same way that menstrual blood was viewed differently depending on certain situations.^[6]

Menstrual provocation and abortion

The use of emmenagogues (substances used to promote menstruation) was a key part of sexual health practices associated with fertility and humoral medicine in the early modern period. Aphrodisiacs and hot spices were used to warm up the womb, stimulating menstruation. This was believed to purge the womb of all its contents, including a foetus, as a means of abortion.^[7] Abortion was not the only function of emmenagogues. They were also used to provoke menstruation which was linked to conception and reproduction. In this way, by purging the womb menstruation would occur and depending on which model people believed in, the menstrual blood helped the formation of the foetus and its healthy growth.

Menstruation vs male forms of bleeding

The early modern belief in the humoral model and the need to maintain the balance between blood, phlegm, yellow bile, and black bile means that it has been argued that other forms of bleeding were considered to be similar to menstruation in women. People believed that menstrual blood represented an excess in blood that women had, however it is not completely clear whether menstrual blood was viewed in a different way to normal blood. In this way, a man who had a humoral imbalance may also need to get rid of excess blood. This means that male periodic emissions like nose bleeds, haemorrhoidal flux, blood-letting, and sweating were viewed similarly to menstruation, and were even considered to be a form of vicarious menstruation. As a result the humoral model does not necessarily make a distinction between male bleeding and female menstruation. While bleeding in men represented a re-balancing and for women it had a further role in reproduction, male regularity could also be implicated in reproductive potential because of the belief that the fertile potential of semen fluctuated. Interestingly in 1701 William Musgrave described a case where a man bled from his thumb every month from infancy until the age of 24. This monthly bleeding did not affect his health, however when he chose to sear his thumb with a hot iron to stop the bleeding, this changed. His health worsened and he began to cough up blood. His doctor concluded that this monthly bleeding in a man was similar to a woman's period, being nature's way of keeping bodies balanced.^[8] This is a very specific example of a rare case of male periodic bleeding, however it does shed light on the way that male blood was viewed in comparison to menstrual blood.

Menstruation and superstition

While there were some theories surrounding menstruation that were linked to beliefs in the humoral model in the early modern era, some beliefs were extremely superstitious. There are many tales that can be found in folklore that make a menstruating woman be a sign of good luck. Generally menstruation had a mysterious nature. For centuries people believed that the beginning of a woman's period was controlled by the moon or even by multiples of the number seven. Menstrual blood was believed to be a cure for animal bites or stop fevers. There are stories that recount that if a young menstruating virgin touched the posts of a house it would protect it and there could be no troubles there.^[3]

Related Research Articles

Calendar-based methods are various methods of estimating a woman's likelihood of fertility, based on a record of the length of previous menstrual cycles. Various methods are known as the Knaus–Ogino method and the rhythm method. The standard days method is also considered a calendar-based method, because when using it, a woman tracks the days of her menstrual cycle without observing her physical fertility signs. The standard days method is based on a fixed formula taking into consideration the timing of ovulation, the functional life of the sperm and the ovum, and the resulting likelihood of pregnancy on particular days of the menstrual cycle. These methods may be used to achieve pregnancy by timing unprotected intercourse for days identified as fertile, or to avoid pregnancy by avoiding unprotected intercourse during fertile days.

Menstruation is the regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina. The menstrual cycle is characterized by the rise and fall of hormones. Menstruation is triggered by falling progesterone levels and is a sign that pregnancy has not occurred.

Bloodletting is the withdrawal of blood from a patient to prevent or cure illness and disease. Bloodletting, whether by a physician or by leeches, was based on an ancient system of medicine in which blood and other bodily fluids were regarded as "humours" that had to remain in proper balance to maintain health. It is claimed to have been the most common medical practice performed by surgeons from antiquity until the late 19th century, a span of over 2,000 years. In Europe, the practice continued to be relatively common until the end of the 19th century. The practice has now been abandoned by modern-style medicine for all except a few very specific medical conditions. In the overwhelming majority of cases, the historical use of bloodletting was harmful to patients.

The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that makes pregnancy possible. The ovarian cycle controls the production and release of eggs and the cyclic release of estrogen and progesterone. The uterine cycle governs the preparation and maintenance of the lining of the uterus (womb) to receive an embryo. These cycles are concurrent and coordinated, normally last between 21 and 35 days, with a median length of 28 days, and continue for about 30–45 years.

<span class="mw-page-title-main">Four temperaments</span> Proto-psychological theory

The four temperament theory is a proto-psychological theory which suggests that there are four fundamental personality types: sanguine, choleric, melancholic, and phlegmatic. Most formulations include the possibility of mixtures among the types where an individual's personality types overlap and they share two or more temperaments. Greek physician Hippocrates described the four temperaments as part of the ancient medical concept of humourism, that four bodily fluids affect human personality traits and behaviours. Modern medical science does not define a fixed relationship between internal secretions and personality, although some psychological personality type systems use categories similar to the Greek temperaments.

Menarche is the first menstrual cycle, or first menstrual bleeding, in female humans. From both social and medical perspectives, it is often considered the central event of female puberty, as it signals the possibility of fertility.

Humorism, the humoral theory, or humoralism, was a system of medicine detailing a supposed makeup and workings of the human body, adopted by Ancient Greek and Roman physicians and philosophers.

Niddah, in traditional Judaism, describes a woman who has experienced a uterine discharge of blood, or a woman who has menstruated and not yet completed the associated requirement of immersion in a mikveh.

Concealed ovulation or hidden estrus in a species is the lack of any perceptible change in an adult female when she is fertile and near ovulation. Some examples of perceptible changes are swelling and redness of the genitalia in baboons and bonobos, and pheromone release in the feline family. In contrast, the females of humans and a few other species that undergo hidden estrus have few external signs of fecundity, making it difficult for a mate to consciously deduce, by means of external signs only, whether or not a female is near ovulation.

A menstrual pad, or simply a pad, is an absorbent item worn by women in their underwear when menstruating, bleeding after giving birth, recovering from gynecologic surgery, experiencing a miscarriage or abortion, or in any other situation where it is necessary to absorb a flow of blood from the vagina. A menstrual pad is a type of menstrual hygiene product that is worn externally, unlike tampons and menstrual cups, which are worn inside the vagina. Pads are generally changed by being stripped off the pants and panties, taking out the old pad, sticking the new one on the inside of the panties and pulling them back on. Pads are recommended to be changed every 3–4 hours to avoid certain bacteria that can fester in blood; this time also may differ depending on the kind worn, flow, and the time it is worn.

A menstrual disorder is characterized as any abnormal condition with regards to a woman's menstrual cycle. There are many different types of menstrual disorders that vary with signs and symptoms, including pain during menstruation, heavy bleeding, or absence of menstruation. Normal variations can occur in menstrual patterns but generally menstrual disorders can also include periods that come sooner than 21 days apart, more than 3 months apart, or last more than 10 days in duration. Variations of the menstrual cycle are mainly caused by the immaturity of the hypothalamic-pituitary-ovarian (HPO) axis, and early detection and management is required in order to minimize the possibility of complications regarding future reproductive ability.

There are many cultural aspects surrounding how societies view menstruation. Different cultures view menstruation in different ways. The basis of many conduct norms and communication about menstruation in western industrial societies is the belief that menstruation should remain hidden. By contrast, in some hunter-gatherer societies, menstrual observances are viewed in a positive light, without any connotation of uncleanness.

Childbirth and obstetrics in Classical Antiquity were studied by the physicians of ancient Greece and Rome. Their ideas and practices during this time endured in Western medicine for centuries and many themes are seen in modern women's health. Classical Gynecology and obstetrics were originally studied and taught mainly by midwives in the ancient world, but eventually scholarly physicians of both sexes became involved as well. Obstetrics is traditionally defined as the surgical specialty dealing with the care of a woman and her offspring during pregnancy, childbirth and the puerperium (recovery). Gynecology involves the medical practices dealing with the health of women's reproductive organs and their breasts.

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Modern understanding of disease is very different from the way it was understood in ancient Greece and Rome. The way modern physicians approach healing of the sick differs greatly from the methods used by early general healers or elite physicians like Hippocrates or Galen. In modern medicine, the understanding of disease stems from the "germ theory of disease", a concept that emerged in the second half of the 19th century, such that a disease is the result of an invasion of a micro-organism into a living host. Therefore, when a person becomes ill, modern treatments "target" the specific pathogen or bacterium in order to "beat" or "kill" the disease.

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Jewish male menstruation is the belief that Cisgender Jewish men experience menstrual periods, or periodic bleeding. This belief was popular among Christians across Europe throughout the late medieval and early modern period, including in Great Britain, Germany, and Spain. Common ways Jewish men supposedly menstruated were through nosebleeds, urination, and bleeding of hemorrhoids. The ability to menstruate was not associated with having a uterus. The first written mention of this phenomenon was in Jacques de Vitry’s Historia Orientalis in 1219. These attitudes have roots in both Humorism and religious, antisemitic Christian beliefs.

References

1 2 Hippocrates (1983). Hippocratic writings. G. E. R. Lloyd, John Chadwick, W. N. Mann ([New] ed., with additional material, repr. in Penguin classics ed.). Harmondsworth: Penguin. ISBN 0-14-044451-3. OCLC 10501704.
1 2 Read, Sara (2013). Menstruation and the female body in early-modern England (1st ed.). Houndmills, Basingstoke, Hampshire. ISBN 978-1-137-35502-7. OCLC 852225082.{{cite book}}: CS1 maint: location missing publisher (link)
1 2 3 4 Crawford, Patricia (2014). Blood, bodies and families in early modern England. Abingdon, Oxon. ISBN 978-1-317-87686-1. OCLC 927103701.{{cite book}}: CS1 maint: location missing publisher (link)
1 2 Evans, Jennifer (2014). Aphrodisiacs, Fertility and Medicine in Early Modern England. Woodbridge: Boydell & Brewer. ISBN 978-1-78204-368-3. OCLC 890980805.
1 2 Evans, J. (2012-02-01). "'Gentle Purges corrected with hot Spices, whether they work or not, do vehemently provoke Venery': Menstrual Provocation and Procreation in Early Modern England". Social History of Medicine. 25 (1): 2–19. doi:10.1093/shm/hkr021. hdl: 2299/11721 . ISSN 0951-631X.
1 2 McClive, Cathy (2016). Menstruation and procreation in early modern France. London: Routledge. ISBN 978-1-315-59499-6. OCLC 948602973.
↑ Gowing, Laura (2003). Common bodies women, touch, and power in seventeenth-century England. New Haven. ISBN 978-0-300-14288-4. OCLC 1255893736.{{cite book}}: CS1 maint: location missing publisher (link)
↑ Smith, Lisa Wynne (2011). "The Body Embarrassed? Rethinking the Leaky Male Body in Eighteenth-Century England and France". Gender & History. 23: 26–46. doi:10.1111/j.1468-0424.2010.01622.x. S2CID 70967914.

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[:0-1] 1 2 Hippocrates (1983). Hippocratic writings. G. E. R. Lloyd, John Chadwick, W. N. Mann ([New] ed., with additional material, repr. in Penguin classics ed.). Harmondsworth: Penguin. ISBN 0-14-044451-3. OCLC 10501704.

[:1-2] 1 2 Read, Sara (2013). Menstruation and the female body in early-modern England (1st ed.). Houndmills, Basingstoke, Hampshire. ISBN 978-1-137-35502-7. OCLC 852225082.{{cite book}}: CS1 maint: location missing publisher (link)

[:2-3] 1 2 3 4 Crawford, Patricia (2014). Blood, bodies and families in early modern England. Abingdon, Oxon. ISBN 978-1-317-87686-1. OCLC 927103701.{{cite book}}: CS1 maint: location missing publisher (link)

[:3-4] 1 2 Evans, Jennifer (2014). Aphrodisiacs, Fertility and Medicine in Early Modern England. Woodbridge: Boydell & Brewer. ISBN 978-1-78204-368-3. OCLC 890980805.

[:4-5] 1 2 Evans, J. (2012-02-01). "'Gentle Purges corrected with hot Spices, whether they work or not, do vehemently provoke Venery': Menstrual Provocation and Procreation in Early Modern England". Social History of Medicine. 25 (1): 2–19. doi:10.1093/shm/hkr021. hdl: 2299/11721 . ISSN 0951-631X.

[:5-6] 1 2 McClive, Cathy (2016). Menstruation and procreation in early modern France. London: Routledge. ISBN 978-1-315-59499-6. OCLC 948602973.

[7] Gowing, Laura (2003). Common bodies women, touch, and power in seventeenth-century England. New Haven. ISBN 978-0-300-14288-4. OCLC 1255893736.{{cite book}}: CS1 maint: location missing publisher (link)

[8] Smith, Lisa Wynne (2011). "The Body Embarrassed? Rethinking the Leaky Male Body in Eighteenth-Century England and France". Gender & History. 23: 26–46. doi:10.1111/j.1468-0424.2010.01622.x. S2CID 70967914.

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