‘Her body was masculinized (τό τε σῶμα ἠνδρώθη)’. This is one aspect of the description of Phaethousa of Abdera, who features in one of the Hippocratic ‘case histories’ from probably the fourth century BC. When her husband leaves, or goes into exile, this previously fecund woman stops menstruating and experiences a range of symptoms, including menstrual suppression, a deepening voice, excess body hair and a beard. But is the comment about being ‘masculinized’ a summary of these other changes, or something more?
Sixteenth-century readers sometimes presented Phaethousa as someone undergoing a spontaneous sex change, and read this comment to suggest that a penis emerged from inside her body. The sixteenth-century medical humanist Hieronymus Mercurialis, a brilliant and shrewd reader of ancient medical texts who held chairs of medicine at Padua, Bologna and the Pisa, disagreed. He linked the verb employed here to other examples of its use in the Hippocratic treatise On Joints, and concluded that it meant only that her body became stronger and more mature. I myself would read ‘her body was masculinized’ alongside the comments on the gendered texture of flesh in another Hippocratic passage, the opening section of Diseases of Women (1.1) to imply a change in the overall texture of Phaethousa’s body, from wet and spongy (= female) to firm and dry (= male). But even if we took this phrase to mean the appearance late in life of something that looks like a penis, would this make Phaethousa a man, or a hermaphrodite?
Historically, medicine has tried to categorise hermaphrodites out of existence. In 1839, James Young Simpson – who wrote a long entry on “Hermaphroditism” for The Cyclopaedia of Anatomy and Physiology – argued that true hermaphrodites were very rare, many so-called hermaphrodites really being women, with the confusion arising from the presence of an enlarged clitoris or a prolapsed womb. Sixteenth- and seventeenth-century writers, also resisting the possibility of true hermaphrodites, had explicitly attributed Phaethousa’s condition to something else: prolapse of the womb.
Jacques Ferrand, for example, quoted the sixteenth-century medical writer Luis Mercado, who regarded the condition of Phaethousa as being due to ‘the protrusion or descent of the matrix [i.e. the womb] that bore a certain resemblance to the male member’. In the surgeon Jacques Guillemeau’s Child-Birth or, the Happy Deliverie of Woman, published in 1609 in French and 1612 in English, the chapter on prolapse appeared in the section on what can happen after childbirth, which suggests that an early modern reader would also think about Phaethousa’s previous confinements here; the text describes her as ‘having given birth to children in the preceding time’. This could be seen as putting her at greater risk of this condition. When Guillemeau listed the ‘internal causes’ of prolapse in general, he included the desire of a woman to have sex, long-standing menstrual suppression, and having intercourse too soon after childbirth, while the lochia were still flowing. At least the first two of these could have been imagined to apply to Phaethousa, in the absence of her husband.
Some commentators in this period saw her as overwhelmed with desire for this absent husband; Jacques Ferrand, for example, proposed that the cause of the transformation was ‘passionate love’ because she ‘loved her husband dearly, but was not able to enjoy him due to his long absence’. In the original Hippocratic text, she was the victim of menstrual suppression causing blood to be diverted from the womb to other parts of her body. This condition too could be seen as causing prolapse. For example, in Guillemeau’s Child-Birth, the relevant explanation was ‘the long suppression of the naturall courses, which sometimes makes a woman grow Viril, or mankind [sic], as Hippocrates witnesses of Phaëtusa, wife of Pitheus, who became like a man, with a beard, and a man’s voice’. Becoming ‘like a man’ is not, however, the same as becoming a man, and here Guillemeau is denying that any real sex change occurred. For these early modern readers, Phaethousa may have experienced a prolapse, which was then misunderstood as the emergence of a male organ.
If you want to read some of the other theories about this Hippocratic story, or pick up on any of my references, I’ve written more here.