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By Gabriella Zuccolin[caption id="attachment_2342" align="alignright" width="207"] Yarrow. From Dioscorides, De medicinali materia.Credit: Wellcome Library, London.[/caption]Before starting my research on anomalous bleeding and vicarious menstruation in medieval and Renaissance medicine, I was already well aware that according to Hippocrates, Aphorism V.33, “in a woman when there is a stoppage the menses, a discharge of blood from the nose is good”. What I did not know then is that the absence or irregular flow of menstruation puzzled physicians and their patients until the beginning of the twentieth century.Cases of compensatory bleeding – even in men suffering from hemorrhoids or nosebleeds -- are so common in old medical literature that a comprehensive list would include endless instances. And the list does not end, as one might expect, when a clear link between menstruation and ovulation was finally drawn in the first half of the nineteenth century, that is to say when the ancient theory of menstruation as primarily having a cleansing and purifying function was finally dismissed in favour of a straightforward connection between menstrual flow and reproduction.Only the identification of endometriosis, where endometrial tissue is found in abnormal situations outside the uterine cavity, nasal mucosa included, finally transformed the theory of vicarious menstruation into popular folklore in the 1930s.[1] Hence the idea of turning back to the past and trying to study gendered differences through the lens of the nosebleed, often seen as the supreme example of the compensatory bleeding theory. What were thought to be the causes of nosebleeds? Do the remedies used vary between men and women, or between menstrual and other bleeding? And in which cases did physicians provoke nosebleed as a therapy? What might this study tell us about gendered medical theories and practices in the Renaissance?While looking for answers to my research questions in collections of recipes, which as far as I can see do not include any gendered difference in the omnipresent recipe “ad sanguinem de naribus sistendum/to staunche blode of thy nose”, and only rarely tackle the issue of provoking a nosebleed, I was especially fascinated by the recurrence of one herb with many names: Yarrow-Achillea millefolium. This also was known as Nosebleed, Sanguinary, Soldier’s woundwort, Military Herb, Knight’s Milfoil, Thousand-leaf, Thousand-seal, Thousand-weed, Bloodwort, Staunchweed, Venus’ eyebrow, Carpenter’s Weed, Seven Year’s Love, Snake’s Grass, Sneezewort, Devil’s nettle, Devil's plaything, Bad Man's plaything, Old man’s pepper... The herb is drying and binding, and renowned of old for quickly halting any bleeding when applied to external wounds.Homer recounts that the centaur Chiron taught Achilles to use yarrow on the Trojan battlefield when staunching wounds, hence the name of the genus, Achillea; its specific name, millefolium, is derived from the many segments of its foliage.To provoke a nosebleed, one might inhale a pinch of powdered yarrow or push a rolled up yarrow leaf into the nostrils. A poultice of yarrow applied to the neck or temples could stop a nosebleed. As a wash, it was used to stop bleeding from piles, but as a drink it would help their pain. A cataplasm treated cold fits, sores and bruises. Yarrow was also used for toothache and internal bleeding (including excessive menstrual flow), either as a tea or by chewing the leaves.Yarrow's many uses were attested by an army of ancient and medieval medical authors, as well as by renowned early modern physicians and naturalists -- Girolamo Fracastoro, Konrad Gesner and Leonardo Fioravanti. In his Considerations touching the Usefulness of Experimental Natural Philosophy (1663), Robert Boyle discussed the different effects of substances “inwardly given or outwardly applied”:And Mille-folium or Yarrow, besides the vertues it hath inwardly against diseases of quite other natures, being worn in a little bag upon the tip of the stomack, was the secret against agues of a great Lord, who was very curious of receipts and would sometimes purchase them at very great rates; and a very famous physitian of my acquaintance did since inform me that he had used it with strange success (p. 212).Other evidence of yarrow's medical success emerged in 2010, after the analysis of plant DNA in Greek-made pills from a 130 BC shipwreck revealed the presence of yarrow.[2] Recent pharmacological studies of medicinal plants mentioned in Anglo-Saxon medical works also confirmed that yarrow may well have been effective for treating wound and bacterial infections and as a febrifuge[3].But the most detailed description of the virtues of this herb I have found so far is the one given by the botanist and surgeon John Gerard (1545-1612) in his Herball or Generall historie of plantes (1633). The Cambridge Library's copy contains a funny anecdotal note on Cambridge student life:The leaues of Yarrow doe close vp wounds, and keepe them from inflammation, or fiery swelling. It stancheth bloud in any part of the body, and it is likewise put into bathes for women to sit in. It stoppeth the laske, and being drunke it helpeth the bloudy fluxe. Most men say that the leaues chewed, and especially greene, are a remedy for the tooth-ache. The leaues being put into the nose do cause it to bleed, and ease the paine of the megrim. It cureth the inward excorations of the yard of a man, comming by reason of pollutions or extreme flowing of the seed (…) the juice be injected with a syringe, or the decoction. This hath been prooued by a certain friend of mine, sometimes a Fellow of Kings Colledge in Cambridge, who lightly brused the leaues of common Yarrow, with Hogs-grease, and applied it warme vnto the priuie parts, and thereby did diuers times helpe himselfe, and others of his fellowes, when he was a student and a single man liuing in Cambridge.I am not sure how and if this advice could be of any use to today's students. Browsing the many volumes of medical consilia, observationes and curationes of the late Middle Ages and the Renaissance, I still have not found examples of therapeutically induced nosebleeds in women. After all, cupping, bloodletting and leeching were considered more handy and controllable options of intervention to interfere with a missing or irregular menstrual flow.But please do let me know if you spot one!For some cases of vicarious menstruation, see these posts by Helen King (ear hemorrhage), Lisa Smith  (tongue ulcer) and Sarah Read (leg ulcer). For a case of a menstruating man, see Lisa Smith's post on "Manly Menstruation?". [1] V.S. Skultans, Research Note. Vicarious Menstruation, Social Science and Medicine, 21.6 (1985), 713-14.[2] http://blogs.discovermagazine.com/discoblog/2010/09/10/ancient-greek-pill-poppers-dosed-themselves-with-carrots-and-yarrow/[3] F. Watkins et al., Anglo-Saxon pharmacopoeia revisited: a potential treasure in drug discovery, Drug Discovery Today, 16. 23–24 (2011), 1069-75.