BMCR 2026.05.07

Aristotle’s gynecology: facts, evidence, and early medicine

, Aristotle's gynecology: facts, evidence, and early medicine. Oxford: Oxford University Press, 2025. Pp. 320. ISBN 9780197790397.

Preview

 

Did Aristotle really think that if women look into a mirror when they are menstruating, the mirror gets stained red? And if he did think this, what might have led him to believe it and mention it as if it is a fact in his On Dreams?

The book under review is not only an overview of Aristotle’s knowledge of women’s health and medical treatment, but also an analysis of how Aristotle came to hold the views he expresses on this subject matter in his writings. Throughout the book, the focus is as much on how Aristotle acquired and established facts related to gynecology as it is about the facts themselves. On almost every page of the book, the statements of Aristotle are not merely quoted, outlined, and related to other texts, but also examined and tested from a methodological perspective—his sources, his ways of evaluating information that he has received, and his processes of reasoning.

One of Leunissen’s main aims in the book is to understand why Aristotle might have made some mistakes about women’s biology, like the statement about menstruation and mirrors mentioned above, in spite of the fact that he was married to Pythias and after her death took a mistress called Herpyllis (some ancient sources actually call Herpyllis his wife) and also had two children (including a daughter named Pythias). Leunissen argues that these and similar odd statements come from the way in which he collected facts, especially from his reliance on expert opinions about women over and above personal observation, particularly when such expert opinions relate to matters which he himself may not have experienced personally or which were derived (or thought to derive) from what women themselves said or were claimed to have said.

In the first chapter of the book, Leunissen argues that Aristotle displays two standards for scientific inquiry. According to one standard, all results should be tested by authoritative perception; everything needs to be seen and verified before it can be accepted. According to a second standard, results can be tested by whether or not they are credible. This second standard, Leunissen argues, is what Aristotle applied to many facts that are not apparent to observation, and she suggests that because most facts about women were probably not able to be directly observed by Aristotle, he often used this second standard when deciding whether to include certain pieces of information about women as facts in his writings. As Leunissen indicates, many of Aristotle’s facts about women derive from earlier medical writings and from the (alleged) reports and opinions of expert women who are mentioned in them.

The remaining chapters of the book look in detail at specific facts about women that Aristotle includes in his writings. Chapter 2: Aristotle’s view that menses are to women what sperm is to men. Chapter 3: Aristotle’s view that menstruating women can stain mirrors red. Chapter 4: Aristotle’s view on women’s sexual pleasure. Chapter 5: Aristotle’s view on so-called “wind-pregnancies” and “wind-eggs” (i.e. air in the uterus causing false symptoms of pregnancy). Chapter 6: Aristotle’s knowledge of pregnancy and childbirth.

This is all difficult material involving difficult questions. Leunissen has done an excellent job of drawing together various threads of thought and weaving them together in a coherent and informative analysis. The sixth chapter is also of special note, as it will be of particular interest not just to scholars of ancient philosophy but also to historians.

My main complaint about the book is that sometimes Leunissen is drawn into debates about authorship that are difficult if not impossible to resolve. For example, in the case of the comment about menstruating women reddening mirrors in On Dreams, Leunissen devotes considerable space to the issue of whether this is an interpolation or an authentic statement of Aristotle. Unsurprisingly, she is unable to determine this conclusively either way, but she also doesn’t do much to address the further issue of who exactly the “Aristotle” in question is (the man himself, or his students, note takers, and editors?) and whether it makes any difference to her point about how knowledge about women is formed in the Aristotelian Corpus. If the question of the transmission and authorship of the Aristotelian Corpus had been treated in a small section in the introduction, Leunissen would not have needed to get bogged down in these issues later on, where they distract a bit from the main line of argument.

If, as many believe, these Aristotelian treatises are the product of lectures that have undergone a complicated and murky process of transmission, perhaps with many stages of revision by Aristotle himself or by his students and companions or by Aristotle and others, it would not be difficult to think that bizarre statements have crept into the text here and there without Aristotle’s genuine authority. Some modern scholars may be inclined to think here of Galen’s amusing words in his Commentary on the Epidemics about Hippocrates’ alleged claim that eating grilled octopus can make sterile women pregnant and Galen’s harsh words for doctors who not only believed this but actually performed this as a treatment:

I met many other people who kept doing other things like this that were smuggled into the works of Hippocrates, and they earned everyone’s scorn and laughter by it … Those teachers on the other hand deserve to be detested if they rely on defrauding these unfortunate students, even if they were so blinded by these statements that they (themselves) believed that they were by the (same) Hippocrates who wrote the books (On) Fractures, (On) Joints, the Aphorisms, (On) Regimen in Acute Diseases, the Prognostic and other such admirable works … I think that some malicious people added these statements to the works of Hippocrates with the intention of exposing and unmasking those unfortunate sophists with them and of revealing their ignorance ….

Aristotle’s treatises include plenty of bizarre facts, similar to the bizarre “fact” about menstruating women and mirrors, but how many of these did Aristotle (i.e. the man himself) believe or include in his writings, and how many were integrated by editors, followers or interpolators? Should we, like Galen with regard to Hippocrates, just assume that the idea that the great Aristotle said such things is simply absurd? It is a pity we do not know what Aristotle said about women’s health and medicine in the works that he did actually publish, his mostly lost exoteric works.

Leunissen’s book is full of interesting and challenging ideas. It is a major contribution to the field of ancient medicine, not only because of the value of its in-depth discussions, but also because it displays a fruitful method for unpacking the epistemic basis of ancient facts about health and medicine, a method which can and hopefully will be applied more widely to other aspects of the subject.