Fruit of the Womb: Prenatal Food in Renaissance Italy

Connecting the dots: humors, gender, fertility and health

Content warning- This presentation covers historical medical theory and practices and may include images not appropriate for all ages.

Introduction

By Raffaella di Contino, OP

Renaissance[1] physicians and midwives had many tools at their disposal; balms, tinctures, poultices, even rudimentary diagnostic testing and surgical procedures. However, most health maintenance was done by controlling the diet.  Proper humoral balance, achieved through proper diet and preparation, was central to classic medical theory, which became the basis for Renaissance dietary theory. During the time period under discussion there was a booming market across Europe for health manuals, reminiscent of today’s self-help, beauty, pregnancy and diet books.  This paper will examine some of the dietary recommendations for pregnant woman in one of these health manuals, Michele Savonarola’s Ad mulieres ferrarienses[2]It will categorize and compare entries in this extant manual with similar references in contemporary sources and modern medical research. Michele Savonarola’s Ad mulieres ferrarienses was addressed to the women of a specific region; however it was also printed outside of that region in several popular editions, and the advice it gives seems to be consistent with prevailing medical theory of the time. The edition I will be referring to here is the one printed in 1554.

One of the crucial tenants of humoral theory is the belief that females are of a colder and wetter disposition than the hotter, drier nature of males. To achieve optimal health the humors needed to be in perfect balance, as seen in all recommendations for food, drink, preparation and even environment.  Savonarola addresses each category of food, and details which to embrace or avoid. I will address each category of food, note where historical recommendations coincide, or deviate from modern recommendations and where our modern definitions of these categories may deviate as well.

1521 Berengarioda Carpi Note that she is pointing at what is clearly a single chambered uterus, and has her foot on older medical books that incorrectly stated that the human uterus was multi-chambered

Meats

The overall dietary recommendations show a preference for domestic meats over game meats, young animals over older ones, minimal exposure to most fruits and vegetables and avoidance of fish.

Domestic Meats:

“Especially good for pregnant women are veal, beef, kid, milk-fed lamb and young mutton.” These red meats would be high in both protein and iron, which would be beneficial to pregnant women. “Stay away from excessive salt and from salted meat products.” I find it interesting that both “excessive salt and from salted meat products” are prohibited and have some thoughts on why these might be two separate items for consideration. Excessive salt has been linked not only to unpleasant swelling, but hypertension, and an increased risk of cardiovascular disease in the child[3].  Meats that are cured instead of cooked have been found in modern European studies to be the principal contributing factor in toxoplasma infection in pregnant women[4].  

Game meats:

“Among gamier meats, wild boar is best; you can eat hare in small quantities- it is better if roasted even though it tends to make you urinate too much. Young roebuck is allowed, but eating the mature specimens will make you melancholic. Venison should be avoided completely because it is hard to digest and provokes melancholy.”[5] Historically, Melancholy is not the state of being sad or morose; it is a part of the humoral system wherein a temperament is assigned to a different point on the humoral compass, which in turn had various aspects. The humor “melancholy” is related to the qualities of being cold and dry, and to the characteristics of being despondent, sleepless, and irritable. We now know game meats are a bastion of a few food borne pathogens, like Trichinosis, that have been otherwise eliminated in the US diet. New studies also show a risk of low dose lead exposure from the ammunition used to harvest.[6]

XIV. Ciuiro overo sauore negro a cengiaro/ Ciuiro or sauce black to ash gray for boar (with boar, venison and rabbit)
Boar with sauce Ciuiro or sauce black to ash gray for boar

In addition to my research on historical Italian medical theory, gender relations, clothing and cultural norms, I have also worked on interpreting many of the recipes in Libro di cucina/ Libro per cuoco (14th/15th c.)  (Anonimo Veneziano)

https://allvenicechannel.dreamwidth.org/

Poultry/ Fowl:

Several forms of poultry are also addressed at length in Ad mulieres ferrarienses and as as we’ve seen in other forms of meat the recommendations are for young over old, and domestic over game.
“Most fowl is good for you, such as chicken, capon, pullet, young grouse, pheasant, partridge and pigeon.  Duck and goose are acceptable only if you have a strong stomach as these are hard to digest, especially the old birds, even for people who are not pregnant. Avoid completely the crane and peacock which are hard to digest and generate bad blood. A fat grey partridge is excellent for the blood.”  This is one instance where historical and current dietary theories agree. Domestic poultry, especially the lower fat options are considered to be one of the healthier forms of protein available to pregnant women.[7]

Savonarola also expounds on the social aspects of diet and notes those available specifically to the “rich and powerful” “And you readers who happen to be rich and powerful, when you’re pregnant seek out other delicacies that are good for your blood; go for the young, fat turtledoves and leave the old, skinny birds to others. Don’t eat too many quails, and if you want to get even with your physician, assuming you have one, present him with a plate of them. Skip over the little creatures, which have no meat on them anyway and indulge yourself with skylarks, thrushes and black birds. Let all aquatic fowl go their own way.”[8] I assume the reference to aquatic fowl comes back, at least in part, to the idea that being in or near the water they were considered to be a colder food as far as dietary humors were concerned.

XVII.   Caponi ouer polastri impliti/ Capons or hens stuffed

In addition to my medical, gender, and clothing research, I’ve also worked on cooking my way through Libro di cucina/ Libro per cuoco (14th/15th c.)  (Anonimo Veneziano) You can find my interpretations here: https://allvenicechannel.dreamwidth.org/

Notes on Seafood:

Current dietary recommendations are to limit to no more than two or three servings of fish per week including canned fish. Do not eat shark, swordfish, king mackerel, tilefish, or tuna. These fish sometimes have high levels of mercury, which could hurt your baby.”[9]

Whereas they were told to limit their fish consumption because according to humoral theory creatures that live in water have flesh that is cold and humid which would make the mother’s blood more phlegmatic, which they considered to be hazardous to both the mother and fetus. Women were warned that if they chose to eat fish that it should be roasted or cooked in wine seasoned with cinnamon to counteract its nature. However, even within the general guidelines that seafood is to be avoided in general, there are still suggestions on which types are better for pregnant women than others. “Eat only the best fish, such as sea bream, mackerel, cod or eel.” “Crustaceans generally are better for you than scaly fish. Some think prawns are especially good for preventing miscarriage and despite what Galen says to the contrary, shrimp also are fine. Be careful about oysters and clams, however, since for anyone they are hard to digest and will make you gassy, which is particularly bad when your enlarged uterus is pressing on your intestines in the last three months of pregnancy. “

Another point addressed specifically to the women of Ferrara is that eels are especially abundant in the region and have “long been known to be the best thing for clearing the bronchial passages, which in turn makes for a great singing voice. You wives who delight in singing can’t very well be expected to give up eating eels every time you are pregnant, so at least be sure to boil them first and then cook them in a good, spiced wine.’ I find it interesting that eels were considered to be good for clearing the lungs, and singing.

Cisame de pesse quale tu voy from Libro di cucina/ Libro per cuoco (14th/15th c.)  (Anonimo Veneziano)
XIII.    Brodeto de pessi/ Little broth for fish

Fruits, Vegetables and Grains:

Current prenatal dietary recommendations are two to four daily servings of fruit and  four or more servings of vegetables[10], which conflicts with the Renaissance Italian recommendations. “When you crave a piece of fruit, just think that the most noble and beautiful fruit in the world is the human creature in your womb, so surely you can resist the vituperative claims of your palate for a vile, ugly, bad piece of fruit that will harm what you carry inside yourself”. “If you must eat fruits, then choose cooked over raw and ripe over immature” “Fruits, like fish are cold and humid; moreover, many of them are gassy, so generally you should avoid them altogether or eat them only in moderation.” So here we not only have the instruction to limit fruit consumption during pregnancy, we have the humorally based medical reason that it is considered to be cold and humid and therefor would potentially cause an imbalance in the humors of the mother and child.

“Tubers are not good for you and neither are the seeds of fruits such as melons, squash, fennel, and cucumbers.” He had earlier in his introduction (directly following his recommendation to eat 3 meals a day) said “Base your diet on eating the finest bread, baked from kernels of pure wheat if possible” He acknowledges that not all women will be able to afford the best and encourages them to do the best they can within their means. It’s unclear as to whether his comment on basing a prenatal diet on bread means that the majority of bulk, or calories should be from that source, but that’s certainly in line with today’s prenatal guidelines of 6-11 daily servings of breads and grains[11].

The Renaissance division of grains/ fruits and vegetables can be hard to relate to modern definitions as is highlighted when he then seems to contradict his previous statement about bread being a staple by going on to say “Grains also cause problems. Although rice is tolerable, the larger grains and beans, especially red beans, provoke menstruation and are universally prohibited by physicians in recommended diets for pregnant women. Peas are not quite as bad as lima beans, especially if the peas have been allowed to dry out, but basically these things are not good for you and should be eaten only in moderation, if at all.

Certain green leaf vegetables, such as cabbage and rape[12] also should be avoided because they tend to provoke menstruation. Some of the noxious effects can be reduced by cooking your greens with plenty of meat fat, especially chicken. Lettuce is fine, even raw in a salad with some wine vinegar to stir the appetite. The local Po valley varieties of endive and radicchio not only are harmless but they are good for getting bodily fluids moving through the liver and blood flowing through the veins. Arugula eaten by itself will give you a wicked headache, but loses its negative qualities in a mixed salad. Spinach remains your friend even during pregnancy, as long as you do not have a cold stomach.”

Women today are told to eat a large variety of fruits, vegetables, and legumes to get a good balance of nutrients in addition to suggested prenatal supplements. Specific food recommendations that contrast with those here are consumption of at least one serving of oranges, grapefruits, strawberries, honeydew, broccoli, cauliflower, brussel sprouts, or mustard greens, for vitamin C as part of 70 mg suggest daily dosage. At least one serving 0.4 mg of folic acid daily – found in dark green leafy vegetables, veal, and legumes to help prevent neural tube defects such as spina bifida. Recommendations for vitamin A are at least one serving every other day of one of the following choices: carrots, pumpkins, spinach, turnip greens, beet greens, apricots, and cantaloupe. [13]

LXV. Rapa armata / Armored turnips

Savonarola indicates that other experts warn that thyme can cause menstruation, but does not agree, but that it should be used in moderation as with rue, marjoram, sage and Rosemary. Garlic, onions and leeks are said to be good for some digestive issues, but may provoke menstruation, so caution and moderation is advised. Modern traditional medicine is fairly mute on whether any of these will actually help or harm you during pregnancy, women are recommended to limit their consumption of herbal teas, especially those containing chamomile, licorice, peppermint and raspberry leaf.[14]

Dairy

“Milk products can cause stomachaches and a bloated feeling, especially the whey or ricotta from fresh milk, but if the milk is thoroughly boiled down so that it loses its watery properties, the remainder is less harmful. Eating ricotta can give you kidney stones”. “As to cheese, the best is one not to fresh but also not too aged, just in the middle.” Are those descriptions of symptoms potentially an indication of lactose intolerance?

There have been studies done on the regional prevalence of various degrees of lactose intolerance in what is now Italy, which found “A higher frequency of lactose malabsorption in the south of Italy than in the north”, and for further perspective “the frequency of primary adult lactose malabsorption in Italians is unusually high for a European population” in percentages they found that the frequency of lactose intolerance in northern Italy at the time of the study was likely to be between %45-57, and roughly 71% in Sicily, in relation to the 16% found in Switzerland, and 14-23% in Austria.[15] Milk processed into cheese would have a lower amount of digestible lactose available and therefore should have caused less of a reaction, and the differences in reaction would have been noticed.  Current guidelines are three- four servings of dairy products for Calcium, but to avoid soft cheeses such as feta, Brie, Camembert, blue-veined, and Mexican-style cheese.[16]

Vaginal pessary

 Fats and oils

“Avoid butter altogether and use virgin olive oil, which is much better for the stomach and does not interfere with the appetite.” In terms of modern health recommendations this would be beneficial to those trying to lower their fat and cholesterol as well as any potential lactose intolerance which would be even more unpleasant during pregnancy. Current guidelines are to decrease the total amount of fat eaten to 30% or less of your total daily calories. For a person eating 2000 calories a day, this would be 65 grams of fat or less per day.

Sweeteners

“Be on guard against honey, which is very gassy and likely to keep you up all night with sharp pains. Sugar is acceptable.” Sugar was considered to be a symbol of wealth, and was also seen used in medicine either for a perceived medicinal property itself, or to help balance the often bitter taste of medicines. (Reference – Maestro Iacopo da Furli wrote a prescription to Giovanni Corsini to cure worms and “mentioned in the recipe that more sugar could be added to make the pill easier to take for children” Current guidelines are to use sweets sparingly. [17]

CXXXIII. A ffare codogniato bono vantagiato/  To make marmalade of quinces good and fantastic.

Wine and other beverages

I find it interesting and amusing that white wine was apparently a fashionable choice as it was thought to “look better in your hand”, and was thought to dilate the uterus.  “The mother-to-be should drink wine that is subtle, aromatic, and well-aged.” “Stay as far away as you can from white wine, woman reader, even though it’s true that white wine looks better in your hand. In your ninth month however, start drinking white wine as it will open you up and facilitate child birth” “Cold water is not good at all- better to drink wine.” Current recommendations are to avoid alcohol during pregnancy. Alcohol has been linked to premature delivery, developmental issues, birth defects, and low birth weight babies, and is now considered to be generally off limits to pregnant and nursing women.
From another source, but along the same lines is a quote from Marinello:

“wine is beneficial for the stomach and generates good spirits and heat. A light red is best and if you mix it with water, then use water in which you have extinguished a hot iron” [18]

I found this quote particularly interesting as I’ve come across mention in several references from all over Italy, France and England recommending that pregnant women drink quench water, occasional specifically mentioned for those who are weak, or have lost blood, and that it should be taken with quince syrup. I plan to test quench water for iron content as these symptoms sound like a potential iron deficiency, and this sounds to me like the modern recommendation for anemic women to take iron supplements with vitamin C to help it bind and absorb better. A recent prenatal study stated that “Anemia is the most common nutrient-related problem of pregnancy, and is attributable to iron deficiency nearly 90 percent of the time, with the remainder due to folate deficiency.”[19] Which may be due to modern diet, but the physical demands of pregnancy still remain fairly constant.

Position for a woman with difficult paturation

Notes: preparation methods and food related care

“As to preparation, roasting is fine the first three months, after which boiling is best because it reduces constipation. For the same reason pregnant women should shift gradually to foods that are more humid or soupy, less of the dry and hard, to keep her uterus and lower abdomen light and lubricated. “This is especially advised in the last ten to fifteen days before her expected due date, when a good regimen should include lots of warm baths, ointments concocted from almonds, chamomile, and chicken fat to rub on the genitals and _consumption of fatty foods_, nothing that might cause constipation.” [20] (emphasis mine)[21]  “You understand me, woman reader, eat three meals a day, trying to space them out with ample room for digestion between one and the next” Current recommendations are to eat small, frequent meals throughout the day, rather than 3 larger meals to ease prenatal heartburn and nausea.[22]  

Woodcut images

Following are a selection of woodcut images taken from Renaissance medical texts which are interesting from the perspective of women’s anatomy and medical care.

Citations

[1] Renaissance

a. The humanistic revival of classical art, architecture, literature, and learning that originated in Italy in the 14th century and later spread throughout Europe.

b. The period of this revival, roughly the 14th through the 16th century, marking the transition from medieval to modern times.

[2] Savonarola, Michele. Ad mulieres ferrarienses de regimine pregnantium et noviter natorum usque ad septennium. Edited by Luigi Belloni. Milan. 1952

[3] High-salt diet during pregnancy and angiotensin-related cardiac changes Ding, Yanga,*; Lv, Juanxiua,*; Mao, Caipinga,*; Zhang, Huiyinga; Wang, Aiqinga; Zhu, Liyana; Zhu, Huia; Xu, Zhicea,b Journal of Hypertension: June 2010 – Volume 28 – Issue 6 – p 1290–1297

[4] Congenital and Perinatal Infections: Prevention, Diagnosis and Treatment by Marie-Louise NewellJames McIntyre pg. 315

[5] Savanarola, Ad mulieres ferrarienses, 118-19

[6] Health Effect of Low Dose Lead Exposure in Adults and Children, and Preventable Risk Posed by the Consumption of Game Meat Harvested with Lead Ammunition Michael J. Kosnett

[7] Pregnancy: Keeping Yourself and Your Baby Healthy Am Fam Physician. 2005 Apr 1;71(7):1321-1322.

[8] Savanarola, Ad mulieres ferrarienses, 119

[9] Pregnancy: Keeping Yourself and Your Baby Healthy Am Fam Physician. 2005 Apr 1;71(7):1321-1322.

[10] Pregnancy: Keeping Yourself and Your Baby Healthy Am Fam Physician. 2005 Apr 1;71(7):1321-1322.

[11] Pregnancy: Keeping Yourself and Your Baby Healthy Am Fam Physician. 2005 Apr 1;71(7):1321-1322.

[12] Rape, scientific name rape Brassica napus napus. Handbook of Medicinal herbs second edition James A. Duke p.147

[13] Evidence-Based Prenatal Care: Part I. General Prenatal Care and Counseling Issues Am Fam Physician. 2005 Apr 1;71(7):1307-1316

[14] Medicinal plants with potential antifertility activity- A review of sixteen years of herbal medicine research (1994-2010) Priya G.1, Saravanan K.2* and Renuka, C.3 PG & Research Department of Zoology, Nehru Memorial College (Autonomous), Puthanampatti-621 007, Tiruchirappalli district, Tamilnadu, South India.

[15] Prevalence of primary adult lactose malabsorption and awareness of milk intolerance in Italy G Roberto Burgio, Gebhard Flatz, Cristiana Berbera, Rosario Patane, Attilio Boner, Cinzia Cakozzo, and Sibeylle D Flatz American Journal of Clinical Nutrician 39:January 1984, pp100-104

[16] Pregnancy: Keeping Yourself and Your Baby Healthy Am Fam Physician. 2005 Apr 1;71(7):1321-1322.

[17] The Renaissance man and his children Lois Haas Pg. 163

[18] Marinello, Delle medicine, 250

[19] Reference: California Food Guide: Fulfilling the Dietary Guidelines for Americans pg.4 http://www.dhcs.ca.gov/dataandstats/reports/Documents/CaliforniaFoodGuide/7PrenatalNutrition.pdf

[20] Savanarola, Ad mulieres ferrarienses, 118-19

[21] Rudolph M. Bell How to do it, Guide to Good Living for Renaissance Italians, 20-21, 89-92, 94

[22] Savanarola, Ad mulieres ferrarienses, 66-8

Here’s a useful bibliography for medical and reproductive research in Renaissance Italy.

8 Replies to “Fruit of the Womb: Prenatal Food in Renaissance Italy”

  1. My goodness your research has such depth! We have spoken in the past about your interests and I already knew we found the same topics fascinating but when I read this presentation I found myself lost in the information as if I was learning it for the first time. Great work!

    -Giata Magdalena Alberti (called Giada)

  2. And to note that modern science has found the last 3 months of pregnancy to be when most of the development has been completed. In this time, the fat of the baby grows and absorbs as much of the mother’s iron and Vit D. A relaxed mother DOES tend to bring on the labour more smoothly, so I can understand their ideas back then that a small bit of watered wine would actually be beneficial.

    What I’m fascinated about, and indeed in confirms my suspicions, while their scientific confirmations had yet to be developed, they were very much trusting of their own eyes and observations. They may not have been able to explain the nutrients in each food and the cooking of it, they definitely were very much on the right track! Not stupid at all! Fascinating.

  3. Fascinating! And very well written; thank you! I love how you tied other lines of research you have done into this topic. I also had the same idea as you did about quench water and iron. I also wonder if the act of quenching boils the water enough to reduce dangerous micro-organisms which may have been present.

  4. I LOVE this!! So interesting! <3 I just started reading a late period English text on child birth and such. Sooo fun! Thank you for sharing!

    1. When I was still working at UWMC, I could have books sent from Suzzalo and the other libraries to their smaller periodicals library next to the medical center, and was able to get access to TONS of research about historical medical recommendations on my lunch breaks. Since more things have been made available digitally and I still have university library access, just let me know if you are having trouble getting your hands on a specific source document, and I can see if I can get my hands on it.

    1. Yes! I was researching this when I was pregnant myself, and I found it so fascinating when modern medical research and recommendations lined up with what I was finding in historical medical guidance.

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