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Medieval Feminine Hygiene
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Surprisingly, we do know a little about that certain time of the month thanks to medical treatices like those attributed to Trotula. An English copy from the early 15th century advises that:

Women have purgations from the time of twelve winters to the time of 50 winters, although some women have it longer, especially those with a high complexion who are well-nourished with hot meats and hot drinks and live very much in leisure.

The image above shows a woman in the setting of the zodiac with her menses flowing out of her, and holding in her hands what might be an extremely crude astrolabe for nagivating the heavens or her feminine hygiene product for navigating her monthly cycle.

It is unlikely that the fluid flowing from her body is urine, as in matters of urinary health, medieval imagery constantly shows the patient or doctor holding a urine flask, which this is visibly not.

Punishment from God
Some doctors called menstruation a sickness although it was generally agreed by most that it was a punishment from God. Women needed to pay for Eve's original sin in the Garden of Eden and menstruation was therefore deserved, part of God's plan and not in any way in need of medical intervention.

If a woman suffered with cramps or excessive flow, it was because God willed it. It was also seen as extremely significant that holy women were often found to not menstruate, thus substantiating the belief of regular women were sinners who deserved their lot.

In reality, the extremely frugal diets of very pious women were probably the underlying cause for the lack of menses. With a strict monastic diet and lack of proper nourishment, the body could not longer sustain a pregnancy or reproduce and the menses stopped. If a woman left the harsh religious life and returned to the secular world and diet, her menses would return.

Again, this was seen as an undisputed sign from God of the holiness of nuns and the worldliness of other women generally. Another possible reason for the lack of menses in holy women is that many wealthy women only turned to a life of religious contemplation very late in life and were possibly post-menopausal.

Either way, troubles associated with menstruation were seen to be something that was not in need of any medical intervention. To do so, was to place your own ideas above those which God had planned for you, and that was a bit risky. Nevertheless, medieval medicine offered herbal relief for painful periods.

The Tacuinim Sanitatus, Vienna, also known as The Four Seasons of the House of Cerruti, offers this advice:

Parsley: It is good for the health because it unblocks occlusions, helps the bladder to function properly and relieves the discomfort of the female period. It heats the blood and excessive use also causes headaches.

Medical beliefs
Those who were more medically minded believed that the menses bloodletting started at the head and traveled throughout the body collecting poisonous wastes and humors. This was because most medically minded doctors believed in the Theory of the Wandering Womb.

This particular theory was the cause for any number of female illnesses.

The theory of the wandering womb
Medical practitioners during the middle ages failed to agree on a rather unusual point connected to feminine complaints- whether the womb was stationary or whether it wandered around inside the body causing a variety of other ailments- including vomiting if it stopped at the heart, and loss of voice and an ashen complexion if it stopped at the liver.

The stress of a wandering womb was usually believed to be the cause of hysteria. Indeed the word hysterical translates loosely as madness of the womb. Even physicians who did not adhere to the theory of the wandering womb, agreed that hysteria was a solely female complaint and was probably caused by a lack of intercourse when uterine secretions built up and were not released, thereby causing the entire body to be poisoned.

Popular menstruation beliefs
There were a lot of what we consider today, to be ridiculous beliefs attached to medieval women and menstruation in the middle ages. One popular belief was that sex with a menstruating woman would kill or mutilate the semen and produce horribly deformed offspring or children with red hair or leprosy.

Just the gaze of an old woman who still had her periods was thought to be poisonous- the vapours being emitted from her eyes. It was also believed by some that the touch of a menstruating woman would cause a plant to die- a belief which was probably not shared by landowners who required women to work alongside men in the garden and would not have wished to lose days of productivity each month.

The Four Seasons of the House of Cerruti, a copy of the Tacuinum sanitatus, assures women that their gaze while menstruating will kill, quite specifically, pumpkins:

Take care that women do not come near because if they touch the pumpkins, they will prevent them from growing; they should not even look at them if it is the time of their periods.

Pliny the Elder, in the first century, declared that the menstrual fluid was most potent-

Contact with it turns new wine sour, crops touched by it become barren, grafts die, seeds in gardens dry up, the fruit of the trees fall off, the bright surface of mirrors in which it is merely reflected is dimmed, the edge of steel and the gleam of ivory are dulled, hives of bees die, even bronze and iron are at once seized by rust, and a horrible smell fills the air; to taste it drives dogs mad and infects their bites with incurable poison.

Pliny reported that the poisonous properties of menstruating women could be put to good use. If menstruating women go round the cornfield naked, it would act as a powerful insecticide, he wrote. Caterpillars, worms, beetles and other vermin were expected to be eliminated. During plagues of insects, Pliny had read, menstruating women had been instructed to walk around the fields with their clothes pulled up above their buttocks. He does not note whether this proved a successful remedy or not.

Premenstrual Tension
As with our modern society, premenstrual tension was not undiagnosed. Known as melancholia, very little effort was spent in seeking causes or cures as it was once again seen as God's natural design for the female and therefore not necessary of change.

In spite of this, many herbal remedies were widely known and used by medics who claimed that for every ill and suffering that God causes, so he also provides the cure in the natural world, and these were provided by God for our use.

Many herbal remedies, therefore might be utlisied.

The astringent leaves of Lady's Mantle, Alchemilla vulgaris, at left, were helpful with profuse menstruation.

Thyme, Thymus species, was used for 'women's complaints' and as an ointment for skin troubles.

Fresh leaves of Woodruff, Asperula odorata, (shown at right) made into tea and drunk was recommended for nausea.

Aldobrandino of Siena produced a work Regime du Corps which included advice on feminine hygiene, skincare and gynecology.

According to the 14th century manuscript, Tacuinum Sanitatis, fennel was particularly useful for menstruation. It also advises that acorns would prevent menstruation from occurring, but does not indicate how the acorns should be eaten. It goes on to say that this could be countered by having the acorns roasted with sugar.

Feminine hygiene products- the options

Free bleeding
I have seen any number of social media posts claiming that medieval women just bled into their clothes or bled into their red, linen petticoats or chemises. That's a myth. The idea may seem sound on the surface, but a look at what we know about medieval clothing seems to disprove this.

Firstly, medieval clothes were expensive and hand made. The poorer a person was, the more their clothes needed to last and were of value to them. The higher up a lady was, the more expersive her brocaded silks and cut velvets were. Allowing staining and smell to permeate the fabric time and time again, month after month seems to not sit well with the idea of looking after their clothes.

Red, linen underclothes to disguise the stains also falls apart as a theory. Chemises weren't red. Undergowns might be, but the linen chemises under them were not. A huge body of evidence points to white underclothes or perhaps naturally bleached linen for the lower classes. Red dye was extremely expensive. Wasting it on clothing that wasn't seen just wasn't done. And then there's the problem that linen doesn't hold red dye very well at all. It washes out fairly quickly which would leave a pale, pink linen chemise- not substantiated in either art or literature or particularly helpful in disguising blood stains.

As a theory, it just doesn't work.

There is very little information about what was used for a woman's monthly period written. Trotula mentions wads of cotton being used for the cleansing of the inner canals of the woman's vulva prior to sexual intercourse with her husband, but it is unlikely that a similar cotton wadding may have been used for a kind of medieval tampon as the belief in letting the menses flow and drain from the body prevailed.

Certainly tampons were known and used for keeping medicines in their proper place for ailments of a woman's privvy place, but should we then conclude that tampons were used for periods? No. To plug up the flow of menstrual blood would be seen as both dangerous and injurious to the woman when the blood was known to be extremely toxic.

Pads, sheets, rags and clouts
Obviously, some device was necessary, so this leaves the alternate as a stuffed sanitary pad or napkin of some kind as a logical conclusion.

Historian Rachael Case has discovered a written reference to period supplies, linen sheets, in the Sumpturay laws for the Nunnery at Sonneburg. Bishop Nicolaus of Cusanus wrote:

... each and every one is to be given a chorkutte (frock to wear in church), a frock for the day, a long fur (coat), a Kursten (fur frock or gown), two night gowns, a scapular for the day, a scapular for the night, veils and kerchiefs as they need; and if they have the female sickness, they need linen shirts and linen sheets as long as the sickness lasts. They may have bedclothes according to the rule and customs of the order...

The size of these linen sheets is not specified, but I feel these were less bed-sheets and more small, folded sheets of linen like a sanitary napkin.

My own thoughts turn to the stuffed pads we have available today and consider what might have been available to the medieval women.

A stuffed pad of linen fabric seems extremely possible, but when filled with linen wadding would make a pad which would be unlikely to launder well for reuse. A single sheet of linen folded repeatedly which unfolded for laundering might be quite workable, but a pad with linen filling would probably not wash well and dry badly in the winters. Since the lower classes also menstruate, it seems that when considering a reusable, washable pad, this was not the answer. It seems that due to wool's water-dispelling qualities, it is also an unlikely stuffing for a sanitary pad.

In the middle ages, sphagnum moss, Sphagnum cymbifolium, shown at right, was used for toilet paper and was also believed by surgeons to have antiseptic properties.

It was also known by the name Blood Moss and was used during the crusades by physicians to stem blood flow in battle wounds. It was renown for its sponge-like absorbent qualities and ability to be rinsed out and reused. A Gaelic Chronicle of 1014 relates that the wounded in the battle of Clontarf stuffed their wounds with moss, and the Highlanders after Flodden tended to their bleeding wounds by filling them with bog moss.

It occurs to me that this might make an exceptionally good filling for a sanitary pad- absorbent, reusable, washable, almost instantly driable and freely available to both wealthy and the lower classes alike in almost all geographic locations. The benefit of antiseptic properties from a woman's poisonous menstrual blood would possibly be seen as an added bonus.

Although there is no concrete proof, it is entirely possible that medieval women used moss-stuffed napkins as sanitary pads. We know that moss is very like a very fine sponge. It easily and quickly absorbs liquid and retains it. Water can be squeezed out and the moss does not collapse and is ready for reuse. A pad of sphagnum moss would absorb the blood in lateral directions well as above and retain it until fully saturated.

In a forum discussion in January, 2006, Robin Netherton discusses an interesting find from a burial at Herjofsnes. It concerns a pad, possibly used for incontinence. It is made of sealskin, wool and has traces of moss in the filling. Her conclusions are:

When the body was laid in the grave there must have been lying on the back of os coccygis ... a strip of sealskin to which was fastened a redbrown woolen cord to keep the sealskin in place, while in front on mons pubis it was also kept in place by a couple of woollen cords which probably passed up to a cord or belt about the hip-region, thus representing a kind of bandage passing from mons pubis between femora down before pudenda and anus and up between nates in the sacral region.

It shows that the possible use of a pad for both incontinence and other bodily fluids was known. Indeed, before the advent of the self-adhesive sanitary pad, napkins were similarly suspended, although from modern elasticised suspenders.

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