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Churchill, Wendy D., Female Patients in Early Modern Britain: Gender Diagnosis and Treatment.

Churchill, Wendy D., Female Patients in Early Modern Britain: Gender Diagnosis and Treatment (History of Medicine in Context), Farnham, Ashgate, 2012; hardback; pp. xiv, 281; R.R.P. 65.00 [pounds sterling]; ISBN 9781409438779.

With Female Patients in Early Modern Britain: Gender Diagnosis and Treatment, Wendy Churchill adds a new dimension to the study of early modern medical history. Her objective is to throw light on the relationship between female patients and male practitioners in order to understand the extent to which sex and gender were factors in diagnosis and therapy. Were women treated differently from men as a result of contemporary theoretical concepts of the body and the existence of disorders peculiar to women?

Churchill employs a wide spectrum of records to explore 'the extent to which women's health was, or was not, subsumed within a restricted range of female-specific complaints that were predominantly of a gynaecological or psychological character' (p. 1). Her sources range from physicians' casebooks and medical consultations to personal correspondence and diaries. Perhaps inevitably, physicians' records dominate over those of other practitioners and correspondence of patients themselves. Her sources are predominantly English and they have to some extent defined her choice of period. Nonetheless, the time frame, 1590-1740, covers a period when medical theory was undergoing change and the 'professional' practice of medicine was under challenge.

While her study is in part based on a quantitative analysis of the records, Churchill gives no indication of the total number of cases she has examined. If the number is indeed as substantial as it appears to be, enumeration would have added further authority to her arguments. Investigations of early modern medical history often run into problems that arise from the inconsistent nosology and diagnosis of disease of the period. To the extent that she has exemplified specific illnesses, notably venereal disease, smallpox, and tertian fevers, she has arguably minimised these problems. In the field of 'psychological' disorders, however, these problems are exacerbated, as Churchill herself recognises.

In Chapter 1, Churchill discusses the relationship between female patients and their male health providers. She considers not only the sort of conditions that were of concern, but also the dynamics of the relationship between the two parties including such issues as privacy and trust.

Chapter 2 focuses on female-specific physiology, lifecycle stages, and health issues, particularly those related to menstruation and breast disorders. Her treatment of female lifecycles, essentially an age-based model, is well constructed. While Churchill has provided a new way of looking at women's health, the chapter is stronger on the signs, symptoms, and diagnosis of women's specific complaints, than it is on treatment.

In Chapter 3, Churchill turns to the issue of prescribing for the sexed body. (She takes into account the shift in the early modern period from a one-sex to a two-sex model of the body, a core consideration, which appears throughout the book as she develops her arguments that women's physiological differences, in relation to men, had pathological consequences, which in turn led to sex-specific diagnoses and treatments.) Treatment proposed by contemporary medical practitioners could be considered as falling into two categories: paying attention to the Hippocratic non-naturals, and the use of therapeutic substances. The latter is admittedly a complex and difficult area, but one that might have been given more analysis considering the extensive sources she has employed.

Churchill suggests that in the cases of her selected contagious diseases, treatment proffered to men and women appear similar if not identical (pp. 144-45). She then sets out to demolish this by arguing, quite convincingly, that treatment for men and women was different. Her strongest argument is that treatment varied according to where a woman was in her individual life stage. Her section on race and through this on climate--in effect tropical medicine--adds an interesting and new aspect to the topic.

The final chapter focuses on what Churchill terms psychological disorders--'diseases of the head nerves or spirits' (p. 195)--principally hysteria, hypochondria, and melancholia. She points out that these disorders represented an important category, yet one that appeared in the casebooks far less frequently than contagious illnesses. The claim would have been strengthened had she provided quantitative data across her whole set of case studies. Notwithstanding this criticism, Churchill has argued well that women were treated differently from men in diseases of a psychological nature and that physicians of the period took account of not only sex and lifecycle, but also cultural variables.

Overall this is a useful addition to the genre and will be appreciated by historians working in the fields of early modern medical practice and gender studies.

Robert Weston

School of Humanities

The University of Western Australia
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Author:Weston, Robert
Article Type:Book review
Date:Jul 1, 2013
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