Doctor's Review: Medicine on the Move

October 27, 2021
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The art and artifice of Agnodice

Did a lady doctor in drag transform obstetric care in Ancient Greece?

Some medical historians say the story of Agnodice — the beloved gender-bending gynecologist of Ancient Greece — is merely myth. Others classicists firmly believe that this determined trailblazer did exist and that her contribution to medicine marked her as a pioneer in both obstetrics and women's rights. But whether her tale is fact, fiction or a combination of the two, the story of Agnodice is undoubtedly a fascinating one.

The field of gynecology didn't really come into its own as a distinct medical discipline until the 18th century. Until that point, barring a few notable exceptions, midwives had a virtual monopoly on all reproductive matters. Beginning in the mid-1700s however, things slowly began to change. Forceps, anesthesia, caesarean section and antisepsis became tools and techniques well guarded by the doctors who developed them. The traditional practice of midwifery was pushed to the sidelines, an option relegated to those who could either not afford doctors or, more recently, for those women who prefer it as an alternative to more "medicalized" approaches.

The practice of midwifery has been around since the beginning of recorded history. In Ancient Egyptian texts, there are numerous references to great midwives and their techniques. Later, during the Greek civilization, midwifery was

also considered to be an honourable profession. Socrates' (470-399 BC) own mother, Phaenarete, was a celebrated midwife, and the philosopher himself is sometimes venerably referred to as the "Midwife of Souls." He famously described his own role as the "midwife of men's thought, helping to give birth to the truth."

It was into this world — a progressive community which valued art, science and philosophy — that Agnodice was born. However, when young Agnodice decided she wanted to help women through the painful yet miraculous process of childbirth, she found her efforts thwarted. Not long before Agnodice's time, women actually were permitted to study and practise medicine. Socrates' most famous contemporary, Hippocrates (460-380 BC), the father of modern medicine and the first to practise the science as separate from religious superstition, was of course quite forward thinking. Though he wouldn't admit women to his primary medical school on his home island of Cos, he did allow them to study obstetrical and gynecological topics in his other teaching facility.

Upon Hippocrates' death, however, Athenian big-wigs revoked this right after they discovered that some women performed abortions and taught contraceptive techniques. The men feared that informed women would be able to use their knowledge about sex, reproduction and, supposedly, gender determination, to sabotage the production of heirs. Thereafter, any woman found practising either medicine or midwifery was subject to the death penalty. As a result, Agnodice found herself backed into a corner.

Whereas before Hippocrates, medical expertise was passed on through apprenticeship, Hippocrates and his followers began writing things down — the first medical textbooks, actually. These texts suggest that women of the day were extremely uncomfortable with even the most basic physical examinations performed by male doctors, let alone having men assist with labour and delivery. When male doctors tried to co-opt the midwife's role, women patients shunned them completely.

Several Hippocratic documents bemoan the general lack of cooperation on the part of women, who were therefore seen as obstacles to their own treatment. What it all boiled down to was that Greek women -- denied the expertise of midwives and refusing the services of the men who replaced them — began to suffer. The death rate of both mothers and children during childbirth began to rise.


One of Hippocrates' followers was a physician named Herophilos of Chalcedon (335-280 BC), a co-founder of the legendary medical school at Alexandria. Herophilos was the first anatomist, as well as the first to use the pulse for diagnostic purposes. He was also allegedly the one who unwittingly imparted his medical wisdom to a very unlikely student.

With all avenues shut to her — both the study of medicine and the practice of midwifery were no longer options — Agnodice decided to take matters into her own hands. She chopped off her hair, put on whatever passed for a suit and tie back in Ancient Greece, and showed up in Alexandria in the hopes of studying with the very best. Fortunately for Agnodice, Herophilos remained oblivious to her disguise. She graduated and went back to Athens to make her way in the world of obstetrics.

A mere century after Hippocrates, his followers had gradually hijacked the practice of delivering babies from fuming midwives despite the desires of their patients. Agnodice, somewhat ironically, was therefore forced to pretend to be a man not only in order to study medicine, but also to do what she'd wanted to do in the first place — deliver babies.

The story goes that the new graduate was called in to attend to a particularly difficult birth. When the labouring mother saw that a male doctor had been summoned, she modestly refused to let "him" help her. Either out of the sincere desire to help the agonized woman, or perhaps unable to contain her own frustration, Agnodice threw back her own robes to reveal her breasts, and so her relieved patient allowed her to help. Word of Agnodice's secret spread quickly among women and her practice grew.

Other more experienced physicians grew jealous of Agnodice's success and set out to ruin her practice by making vague accusations of "him" seducing and even raping patients. Some of Agnodice's patients were even accused of faking illness in order to be "treated" by the rogue doctor. Why else would all these formerly unwilling women be eager to let a male doctor treat them? Left with no choice but to defend her honour and prove the alleged indiscretions impossible, Agnodice pulled her skirt over her head and revealed her big secret. Of course, the crime of rape paled in comparison to that of being a woman doctor and so she was arrested, charged and a date was set for her execution.

Once her grateful patients learned of Agnodice's imprisonment and the plans to kill her, they were outraged. An angry mob of wealthy Athenian women whom Agnodice had helped — even some wives of the doctors and politicians originally determined to bring her down — stormed the legislature and demanded her release. Without her, they claimed, many of them would be dead or would surely die in the future. According to Roman author Hyginus (64 BC-17 AD), the mob of Agnodice's supporters shouted: "You men are not spouses, but enemies since you are condemning her who discovered health for us." If Agnodice were executed, they argued, "Then we shall all die with her." The enlightened Greek men heard the women's pleas — or feared their wives would divorce them — and freed Agnodice.

Not only that, but they rescinded the law that banned women from practising medicine, provided only female patients were treated by them. Instead of executing Agnodice or proclaiming her a witch, which is what surely would have happened if she had been born a millennium or so later, her medical and legal contemporaries agreed that she was indeed worthy of practising medicine. It was a right guaranteed to women until the fall of the Roman Empire.

Other women would follow in Agnodice's gender-bending footsteps. The most famous of these was Dr James Barry (1795-1865), the renowned Scottish army surgeon who turned out to be a woman. Amazingly, it was only upon Barry's death that the truth was discovered, after she'd spent 45 years practising medicine in the Queen's army. We may never know if Dr Barry took any inspiration from her legendary predecessor.


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