In the Middle Ages, many babies die at birth, or in the days or weeks that follow, as a result of a traumatising delivery. Many young children die from childhood diseases. Roughly one child in two grows to be an adult.
Having escaped childhood, he is prematurely worn out by his work, or a victim of malnutrition, if not of famine. Or he dies from the insalubrity of the marsh lands or the banks of the Mediterranean Sea, where he catches “the fevers”, malaria, which provoked hecatombs for centuries. Unless his demise is caused by the lack of hygiene, or contagion.
The illnesses of the time are atrocious and invincible. We still suffer from some of them. Rabies kills (see previous post). So do the plague, leprosy, tetanos, appendicitis, peritonitis, tuberculosis, cancers, smallpox, among hundreds of other maladies. The art of healing in the Middle Ages includes bizarreries, apparent illogicisms, mixed with natural and surnatural therapies.
It is difficult for us to enter the mentality of the Middle Age man. What we call “science”, or the “age of reason”, only dates from the XVIIIth Century. The man of the Middle Ages lives in resonance with a totally religious universe, in which his every gesture is of sacred importance. Whether he is an ecclesiastic or a layman, his time is divided by the sound of bells, or the big passages of existence. Birth, marriage, death demand consecration and divine consent.
Based on this, the task of understanding what illness represented in the minds of the scholars or the profane, involves a rather vast field of exploration. Mediaeval medicine is firstly impregnated with God. But, at the same time, it is the heir to multiple customs and traditions, boiling with exotic or “barbarous” importations, often no longer understood by the people of the time. Antique knowledge, indefinitely transmitted without question, and repeated attempts to theorise irrational beliefs, add to the mix.
In the Middle Ages, there is no distinction between “official” medicine, stemming from scientific reasoning, and parallel medicine, which evolves in a magical and superstitious sphere. From the XIIth and XIIIth Centuries, there are recognized professional doctors, with university diplomas, who try to claim supremacy over those whom they call “charlatans”. However, the frontiers between their domains of intervention remain permeable.
Illness is seen as a divine warning or a punishment. This is a credo of the Church, unanimously shared by its submissive herd of sinners. The Old Testament already has this oriental vision: “Whosoever sins in the presence of the Creator, let him fall into the hands of the doctor.” Therefore, whomever receives this sort of punishment is receiving a salutary warning from his Creator to do penance and prepare for a good death. Another idea is that he is a victim because the strength of his faith in God is not enough to protect him. So, he has to strengthen it and follow the example of Job, who recognized the hand of God behind all of his suffering. If the punishment is collective, an epidemic for example, God is punishing the sins of the whole community.
The Church’s traditional teaching is that, although one must first think of saving one’s soul, it is indispensable to immediately afterward engage all possible and licite means to beat the illness. Theoretically, this means that surnatural means are excluded. However, this theory fluctuates somewhat.
The Church weighs mightily on medicine. Firstly, because it has the monopoly on it until the XIIth Century in the Christian West. In the name of Charity, it has always made an obligation of coming to the aid of the poor and the suffering. “Medical” assistance is therefore the business of monks and convents throughout the whole of the early Middle Ages.
From the VIth Century, the institution weaves a web of hospices destined to shelter those then known as “travellers”, on the pilgrim paths and near sanctuaries. These places more resembled hotels than hospitals. They offered a secure place to spend the night, or to go to bed in the case of illness. The help brought to the patient was more spiritual and humane, with confessions and comforting words, than therapeutic.
However, it is in the hortulus of the convents – the garden of simples – that the medicinal plants necessary for a minimal infirmary are grown. The monks found the symptoms and their treatments in the manuals of Antiquity. Their brothers in the scriptoria – workshops where manuscripts were made – recopied Pliny, Columella, Celsa or Theophraste from one generation to another.
In the VIth Century, the Benedictine Cassiodore recommends to the other monks: “Learn the properties of the simples and of the composed remedies, but place all of your hopes in the Lord who gives eternal life”. In 820, the Abbey of Saint-Gall, in Switzerland, disposes of six beds, a pharmacy and a botanical garden. The sixteen “sacred simples”, which are supposed to dispense certain virtues, are planted in it. They are sage, rue, iris, pennyroyal, rocket, cumin, levistica, fennel, white lily, rose, haricot, sarriette, mint, rosemary, cock-mint balsam and fenugreek.
Other remedies are popular. They are health liqueurs and other specialities whose recipes are concocted in the heart of the convents and of which the monks are very proud: the medicinal wine of Saint-Riquier; the liquorice of the Benedictines of Wurtzbourg; the rhubarb of the Franciscans; the angelica root of the Chartreux of Fribourg-en-Brisgau.
The unique and considerable merit of convent medicine is to have transmitted, thanks to its manuscripts and horticultural practices, the heritage of Antiquity. These pharmaceutical talents will be gathered later by the apothecary associations and by village healers. The manuscripts will serve as the basis of laic medicine which ecloses in the universities of Salerno, Montpellier, Paris and Bologna during the XIIth and XIIIth Centuries.
However, doctors will always keep their teaching within the bounds of the Church. God is the first cause of illness. No-one will deny either his existence or his power.