The patients of the Middle Ages complain about the “blood-lettings, purges and clysters” which are continually inflicted on them.  It is firmly believed that the human body contains twenty-four litres of blood, and that it can lose twenty of them without risk.  Blood-letting is a cure for everything.  The act is so common that it can be found in a little poem from the XIIIth Century entitled The Tools of the Villain, a sort of catalogue of everything that is useful to the villain, or man from the country, to set up house.  Among the caldrons and bowls, we find the surgeon’s lancet, the blood-letting tool.

A German master doctor, observing his Parisian colleagues, reports a common opinion:  “Here are doctors who have administered so many blood-lettings to a patient, that he has died from them.”.

The more water that you take from a well, the purer will be the new water which rises from its depths.  This is the principle of blood-letting.  It stems from Talmudic thought, introduced into the West by Jewish medicine whose long tradition carries an obsessional fear of corporal impurety.  Letting the humours flow justifies the preventive blood-lettings practised at the change of each season.

But the surgeon and the barber, to whom these sorts of “lowly tasks” are abandoned, obey terrifying prescriptions which multiply evacuating treatments:  purges, enemas, dry or scarified cupping, leeches, setons installed in the neck, cauterisations with red-hot irons, “fontanelle”, that is to say, a scarifying incision maintained open by the introduction of a bean or pea between the lips of the wound.  The doctors of the Court of Charles V of France fostered a fistula on his arm like this for years.  It was supposed to be draining unhealthy humours and “venoms”.  The King’s death in 1380 was attributed to the closing of this wound, and the resulting accumulation of corruptions.

Official medecine is therefore of little help.  The doctor is mocked because of his obvious incompetence, particularly during epidemics.  In case of plague, he is the first to apply the only known medication, called “of the three adverbs”:  “flee fast, go far, return late”.  He is also mocked for his pretention, his treatments and his prohibitive tariffs.  People of modest means never enlist his help.  He rarely settles outside the big university cities, anyway.  In the country, whether field worker or lord, you rely on your own experience or the healer, the surgeon, the barber, and the matron for births, whose qualities are sometimes equivalent to those with diplomas, if not better.

The man who treats others inherits his skill for sewing up wounds, setting bones, excising… , and his recipes, from someone older than himself who has taught him his secrets.  Most of the time, this is his father.  And because illness does not yet have its own clear status – divine punishment?  demoniacal intervention?  breakdown of humours? – official medicine and parallel medicine prescribe identical remedies.  There are a few subtle differences in ingredients, the commonest being reserved for the smaller revenues of the people, the most exotic, imported from faraway countries, for the rich elite.

In town, the patient has to go to the apothecary’s boutique – a profession which is gradually reglemented and whose accounts are already proverbial – to obtain his drugs.  In the country, the healer collects his own gifts of Nature.

Continued tomorrow.

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