Trotula de Ruggiero (Trota of Salerno), lived in the eleventh century, was the most important “physician” of “mulieres Salernitanae“, a student and then teaching of the Salerno Medical School, she founded modern gynecology, she realized the importance of hygiene in medical treatments and in life everyday, in a time where hygiene was unknown, or rather, opposed.
Salerno was the capital of an important principality from the tenth century that, in some periods, had supremacy over southern Italy territory with the exception of Calabria and Puglia in the hands of the Byzantines.
During the Middle Ages (year 850) Salerno broke away, along with part of Longobardia Minor, from the Principality of Benevento forming an autonomous principality. Siconolfo, opponent of Radelchi, Prince of Benevento, became the first ruler of the Tyrrhenian part of the former Longobardic territory, he was confirmed in his possessions by Emperor Ludwig. Over time different dynasties ruled the principality, which grew and became stronger, reaching the height of its power with the Norman family Altavilla.
Robert Guiscard was one of the founders of the Altavilla (Hauteville) family, Norman “dani” originating in northern France, came to southern Italy and established in Melfi. In 1059 he married Sichelgaita, daughter of the Prince of Salerno. The strength of this relationship, after a few years Robert moved war to half-brother of his wife for the conquest of the principality. After an eight-month siege of Salerno Guiscard seized the principality and in a few years built a Norman kingdom that included the whole of southern Italy, Sicily, Malta and the coastal part of North Africa.
It was a happy time for Salerno, because it, as capital city, had a good time with a widespread prosperity and it had a develop economic and cultural. It was particularly important the Medical School of Salerno.
The origin of the medical school is unknown, the founding date should be positioned between the ninth and tenth century. A legend says that a traveler of Greek origin named Pontus, who took refuge from the rain under the arches of Arce in Salerno, saw a pilgrim, Latin Salernus, who also was avoiding the rain, dressed himself for some wounds to his leg. Pontus approached him to offer help. At that same time other two travelers took shelter under the arches, the Jew Helinus and Arabic Abdela. Speaking about the wounds of Salernus, the four discovered that all of them were experts of medicine, then they decided to found a medical school in the nearby Salerno.
The Medical School of Salerno was a real university avant la lettre and in his first bout, between the ninth and tenth centuries, it gave a practical teaching of medicine. The science of medical care was transmitted orally by the masters, it was based on empirical experience, putting particular emphasis on the prevention and prophylaxis of diseases.
In the second period of its existence, between the eleventh and thirteenth century, the school had the contribution of teachers of culture Greek and oriental, thanks to the Salerno position which had become a center of reference for the culture of the time, facilitated in this by traffic of its port that welcomed ships from Africa and from the Middle East. A number of texts from Greece, Egypt and the Far East arrived at the school: the writings of Hippocrates, Galen, Rhazes and Isaac Israeli the Elder, which were translated by the Carthaginian Constantine the African, one of the school teachers, along with books of Averroes and Avicenna. The translated books were then transcripts in several copies by the Benedictine monks of the nearby Abbey of Cava, where also the abbot Desiderius of Monte Cassino lived at that time, who became pope under the name of Victor III.
It was during this time that the school of Salerno reached its peak welcoming in its faculty medical teachers from various backgrounds with students from all over Europe. Patients came from all over to be treated by those who were considered the best doctors at the time. In 1241 Frederick II established in Edict of Salerno that the medical profession was reserved for graduates of the Salerno School of Medicine, officially recognized as a Medical University (Studium).
In the Salerno school, women were also accepted, first as students, then also as teachers. The most famous woman of the graduates doctor was Trotula (aka Trocta, Troctula, Trotta) de Ruggiero (or Trota of Salerno). Trotula lived in the second half of the eleventh century, she is considered the founder of gynecology as a medical science. Trotula was born in Salerno, she belonged to one of the noblest families of the kingdom, with Longobardic origins but with strong ties to the Norman conquerors, The de Ruggiero became over the years one of the most powerful Norman families with its feuds in southern Italy. The family de Ruggiero promoted the construction of the Cathedral of Salerno procuring funds with the sale of several its properties. The family palace, which still exists today, is just opposite the entrance of the cathedral. Trotula had married John Platearius, one of the medical teachers of the School of Salerno, she had two children, John (said the young) and Matthew both students and teachers to medical school of Salerno.
Trotula became a famous “mulieres Salernitanae” first student and then “Magistra” of the school. The legendary aura, that took her person in the Middle Ages, have made to doubt his very existence, also because of alleged impediments to access the medical profession to women. But the Longobardic culture did not include foreclosures against women, in fact, with regard to medical practice, women were usually treated by other women; however Trotula was not the only woman to graduate from the school of Salerno, since there is evidence of numerous other female figures graduated “doctor” in Salerno. Orderic Vitale makes mention in his “Ecclesiastical History” of a cultured matron who in 1059 managed to talk about medicine with Rodolfo Malacorona, she was later identified in Trotula de Ruggiero, the only Salerno cultured woman who could discuss with the famous Norman physician.
Trotula de Ruggiero chose to devote his knowledge to alleviate the suffering of women who often died in childbirth. She put emphasis on the need for women of proper hygiene of intimate parts of the body, as a prophylaxis to prevent venereal diseases that were widespread and difficult to treat with remedies then available. She was the first to study the menstrual flow of women, and the connection of the same with the fertility. Trotula was the first to support the male infertility existence, which at that time was not considered possible. She is credited with writing the treatise “De mulierum passionibus ante et post partum” (also called “Troctula major”) by which the guidelines of obstetrics and gynecology were indicated. This treatise was later printed in Venice in 1544, in Italian, within the work “Doctors Antiqui Omnes”. Other studies of de Ruggiero concerned the cosmetic “De ornatu mulierum” (also called “Troctula minor“) and the physician profession “Practica secundum Trotam“.
Her husband John Platearius and his sons Giovanni the young and Matteo (said Arcimatteo), who continued the medical profession of the parents, are remembered as “Magistri Platearii“. John the young was author of “Circa istans“, summa of knowledge of the time botanical, and “Regulae urinarum” and Matthew was the author of “Practice” guide on the cures to be applied in various clinical situations. Matthew Platearius was one of four inventors of “pills of four masters“.
Trotula was present in the literature of the Middle Ages. She is cited in the “Canterbury Tales” by Geoffrey Chaucer under the name of “dame Trot“, and she is recognizable, in the satirical book of Rutebeuf “Dit de l’herberie”, in the teacher named Trotte of a charlatan who sells his herbal remedies at people. In 1840 a bronze medal preserved in the Provincial Museum in Salerno was dedicated to her.
Between the fifteenth and nineteenth century the medical school of Salerno gradually lost importance, supplanted by the University of Naples and Bologna. It was suppressed in 1811 by Joachim Murat part of the reorganization of the Education in the Kingdom of Naples. The school had over time various locations, the first is supposed to be the castle of Arechi, then the classes were held in the chapel of St. Catherine, and also in the atrium of the Cathedral, in theaters now called St Thomas and St Lazarus; most recently the school had as headquarters the building was later occupied by the District Court, in via Trotula de Ruggiero, and also the former Archbishop’s seminary near the Cathedral.
The American writer and poet Henry W. Longfellow (1807-82), confirming the international notoriety that in the Middle Ages enjoyed the medical school of Salerno, reported an old German legend called the “poor Henry“. It told the story of the young German Prince Henry who, engaged to the beautiful Princess Elsie, he was suddenly taken ill with leprosy. A night he dreamed that the devil told him to go to Salerno where doctors would heal him, after a bath done in the blood of a virgin. The young girlfriend Elsie offered her life in sacrifice but the poor Henry refused indignantly. He still went to Salerno, where, before meeting the doctors, entered the cathedral to pray to St. Matthew. Miraculously he healed from leprosy and married in the same church his girlfriend Elsie.
Another legend tells that Robert of Normandy, injured during a crusade by a poisoned arrow, on his way back he stopped in Salerno for treatment. The doctors prescribed that the poison had to be sucked from the wound, warning that the person sucking poison would be died poisoned; Roberto refused treatment. During the night, while Roberto slept, his wife Sibilla da Conversano sucked the poison saving the life of her husband, but dying soon after. A thumbnail of the “Canon of Avicenna” brings this legend depicting Robert of Normandy who thanked the doctors of Salerno, while other medical succor his wife dying Sibilla.
In 2005 the faculty of medicine at Salerno was restored; in 2013 the school was reconstituted by creating university company San Giovanni di Dio e Ruggi d’Aragona – Scuola Medica Salernitana.
Trotula de Ruggiero: De passionibus mulerium, Medici Antiqui Omnes, Venezia 1547
Trotula de Ruggiero: De ornatu mulierum – L’armonia delle donne, a cura di Piero Manni, San Cesario di Lecce, Manni 2014
Andrea Sinno: La scuola medica salernitana e i suoi mestieri, a cura di Marcello Napoli, Avellino, Edizioni Ripostes, 2002
La regola sanitaria salernitana, premessa storica di Cecilia Gatto Trocchi, introd. di Roberto Michele Suozzi, Roma, Newton Compton, 1993