Category Archives: Graduate Research

Vade Mecum

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A few months ago, in a post on medical manuscripts, I wrote about vade mecum and lamented that I couldn’t find any images online.  Reader Margie has come to the rescue with a great list of examples, and I’ve collected and annotated some of the images below.  Thanks Margie!

Vade mecum were carried by variety of professions, especially the mendicant religious orders, and not all included medical information.  Though the Welcome and UCLA examples below include medical diagrams, some of the others seem to be purely calendrical in nature.

Wellcome MS 40

This example was made in the late fifteenth-century.  Here we see the outer appearance of the vade mecum, including the folded pieces of parchment that make up the booklet and the two individual pieces that cover the front and back as a form of loose binding.

A calendar page fully opened from the front and displaying two months.  You can see the four folds that create the booklet – one horizontal and three vertical.  At the bottom the binding is visible.

A calendar page fully opened from the back.  On the lower half is the table of contents listing the three months written on this page.  When folded, the calendars are hidden and only the table of contents is visible while flipping through the almanac.

A zodiac man, with descriptions of each sign.

A phlebotomy, or bloodletting, man, showing the points to cut, as well as astrological charts.

Berkeley Huntington Library HM 47641 (please see correction in the comments below.  Thanks Justin!)

This example, from the Huntington Library at Berkeley, is unusual in that it has a brass cover.  It’s possible that other vade mecum had similar covers of metal or leather which have been lost.

The Berkeley manuscript opened – this liturgical calender has a different, and less commonly seen, orientation than the Welcome manuscript above.

Royal Observatory Edinburgh (scroll down)

This is a great photo, showing exactly how the booklets were opened and consulted.

Schoyen Collection (see MS 1581 and MS 2913)

MS in Norwegian and Latin on vellum, Uvdal, Norway, 1636, 30 ff. (complete), 5,5×5,5 cm, single column, (5×5 cm), 15 lines in capitals, Norwegian Gothic cursive script and a variant of Roman numbers, 80 miniatures of saints or their symbols, 12 circular diagrams, 12 miniatures of the occupations of the months, all in full colours; the book flattens out into a long strip, 67×11 cm, each section cut and folded around each month.

Binding: Norway, 1636, not bound but plied together to form a book, in its original girdle type leather covered wooden box.

Context: Very similar to 2 Norwegian girdle calendars dated 1558: the Hegra Calendar in Trondheim, Det Kgl. Norske Videnskabers Selskabs Bibliotek, and the Oslo Calendar, cf. MS 1581. Layout and illustrations are nearly identical, but the two earlier calendars are rather crudely executed compared to the present one.

This Norwegian almanac is very interesting in that it was created in 1636, long after the establishment of printing throughout Europe.  It would be interesting to learn more about manuscript calender production in this period, and why this format might have been chosen over printed calenders in this region.

More examples from the Bodleian Library and UCLA:

Bodleian MS Rawl. D. 939

Bodleian MS Ashmole 8

Bodleian Canon. Liturg. 237

Bodleian MS Rawl. D. 28

UCLA MS Rosenbach 1004/29 – Two medical images – a bloodletting man and a urine wheel (used to diagnose based on the color and texture of a patient’s urine).

Irony

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The world’s largest collection of sixteenth-century anatomical prints, or ‘fugitive sheets’ has been digitized and is available online, thanks to the Wellcome Library.  There are nineteen prints with pop-up action allowing the reader to see different organ systems in the order of dissection.  In this male and female set you can see both still images and video of the flaps being lifted—brilliant!  (I do wish that more of the entries offered stills, since the video is cool but it’s hard to get a detailed view of the different layers.)

I’m in the process of looking through all these, but I’m especially intrigued by this one.  Can you guess who’s making an unauthorized celebrity cameo?  It’s Vesalius’s head on that body, copied from his full-page portrait in the Fabrica.  Right next to an organ (on the right) taken from the same book.  Vesalius spent a great deal of energy, even prior to publication, in trying to forestall the plagiarism of his work.  I doubt, though, that even he imagined his own head would end up on a perpetually-being-dissected body.  One has to wonder about the motives of the artist—an ironic joke at the great dissector’s expense?

Here’s the original portrait for comparison:

What’s Your Sign?

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I know that I’ve been quiet lately, but it’s because my last set of essays was due in early June and since then I’ve been working intently on my dissertation.  I’m studying the Gildbook of the Barber-Surgeons of York, held at the British Library, and have been reading about medieval medicine and the types of books consulted by medieval practitioners.

Medicine during the Middle Ages and the Early Modern Era was practiced by a wide variety of people.  Most illnesses were treated at home by the women of the household or by members of the community with herbal and folk knowledge.  Barbers and surgeons were skilled laborers who undertook more complex treatments, notably cutting for cataract, surgically removing anal fistulas and cancers, repairing broken bones and disjointed limbs, trepanation for head injuries, treatment of venereal diseases, and leechcraft (bleeding).  At the highest level of medical care was the physicus, usually university-educated and Latinate, urban, and less likely to preform surgical procedures, which were considered undignified manual work.  Though these seem like hard and fast categories, dividing lines were actually blurry and many similarities are found between the groups.  Sources shows that educated physicians used folk knowledge and herbal remedies, and ‘uneducated’ barbers often owned and consulted books in Latin and other languages.  As skilled tradesmen, barbers and surgeons often formed guilds to regulate their trade and to promote education through apprenticeship.  The York guild was one of the most prominent outside of London and has left us excellent records of its activity.

Some of the most important books used by medical practitioners were those containing charts to assist in treatment.  Late medieval medicine was based on theories inherited from the ancient world that were filtered through classical thinkers such as Galen, preserved and annotated by Islamic scholars, and reintroduced to Europe in the thirteenth century.  Astrology was the most important of these, and while it influenced many aspects of medieval life it was most strongly tied to medicine.  It was a system in which humans were intimately tied to the movements of the cosmos, and an individual’s horoscope determined the ratio of humours that created his or her personality and body type.  Movements in the heavens (in addition to an individual’s age, sex, and behavior) could lead to humoral imbalances, and potential treatments had to be scrutinized to assure that the stars were aligned favorably.  A good example is bleeding: it was clear that the Moon affected tides, and was also believed to affect the ebb and flow of humours in the body.  If the Moon was located in the sign that corresponded to a specific body part then that member should not be bled, or the patient might die from the loss of humours.  Practicing astrology, though, was incredibly complex, so doctors developed helpful charts to assist in diagnosis and treatment.  The popular ‘Zodiac Man’ illustrated the signs that governed different parts of the body, while charts called volvelles used movable discs to determine favorable conditions for treatment.

The Gildbook of the Barber-Surgeons of York, which includes a variety of common medical charts, was begun in the 1480s and added to until the end of the eighteenth century.  Primarily a ceremonial text rather than one consulted on a daily basis, it is mostly in English and contains the gild’s ordinances and oath, portraits of monarchs, a liturgical calendar, and medical illustrations and texts.  (Click for bigger images.)

Page from the liturgical calendar for September.  The entries in red are feast days in honor of saints, which is where the term ‘red letter day’ originated.  Many of the red days celebrate saints associated with northern England or medicine.

The head of Christ and personifications of the four humours, clockwise from top left: melancholy man, sanguine man, phlegmatic man, and choleric man.

Vein Man: explanation of bleeding points, most of which are located on the arms and face.  These delicate illustrations are influenced by Flemish artwork of the period, possibly transmitted via trade links of the city of York, which was an important mercantile center.

Zodiac Man.  Pretty self-explanatory.  I’m enamoured of the lovely goat illustration for capricorn.  And amused by scorpio, which I’ve noticed is usually drawn as a multi-legged dragonish sort of creature.

The Volvelle.  The pointer determines the sun sign, and the piece that would determine the moon sign is missing.  The figures at the top are Saints John the Baptist and John the Evangelist, and below are Saints Cosmas and Damian, all traditional patron saints for medieval barbers and surgeons.  Cosmas is holding the ubiquitous symbol of medieval medicine, the urine flask, and Damian prepares medicine.

In addition to the Gildbook I’m looking at a variety of other medieval medical texts.  Some of my favorites are small handbooks called vade mecum, which means ‘bring me along.’  These were small pieces of parchment folded and sewn together at the bottom and attached to the belt or slipped into a pocket for quick reference.  They contained calenders and medical charts like the ones above, only in miniature.  I spent a delightful afternoon with six vade mecum in the British Library last week, and was pleased to see and feel the wear indicative of frequent use, not unlike my own notebook.  Sadly, there aren’t many digital versions of these texts, probably because they’re a bitch to unfold and photograph.  Below is an image from British Library MS Egerton 2724.  This image is part of a faded calendar showing activities for different months.  This specific text is unusual compared to the others I’ve looked at, being square rather than rectangular and using a different folding system.  I wish there were some others online I could show you, because I’ve seen some very beautiful examples.

Next week I’ll take a look at a few more interesting medical manuscripts, but now it’s time for bed.  I have to get up early tomorrow because I’m leaving for York to do research in the city archives.  Looking forward to exploring the city walls and cathedral, and I’ll be sure to twitter all sorts of useless things during my trip.

Memento Mori Part II

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A few weeks ago I wrote about the evolution of anatomy illustrations, promising that the second part of the series would appear the following week.  If you’ve been waiting, I apologize, but I have a good excuse—Scientific American contacted me about doing a similar slideshow for their website, which has just gone live.  Very exciting!  There are ten images, a couple are based on my previous post, but most completely new: check it out.

Memento Mori Part I

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Quid me mihi detrahis? Who is it that tears me from myself?     – Ovid, The Metamorphosis Book VI

I recently began an essay on the evolution of images in anatomy books between 1450 and 1800, and I thought I’d share some of my early research.  All the images I’ve used are from the National Library of Medicine, which has an excellent historical anatomy exhibit.  Clicking on the pictures below will take you to the appropriate section of the NLM website for more images, biographies, and bibliographies.  (And a word of warning, some might find the illustrations graphic, disturbing, or not safe for work.)  Part II will hopefully appear sometime next week.

Sources:

  • Books of the Body: Anatomical Ritual and Renaissance Learning by Andrea Carlino
  • The Body Emblazoned: Dissection and the Human Body in Renaissance Culture by Jonathan Sawday
  • The Art of Anatomy: Depicting the Body from the Renaissance to Today by Rifkin, Ackerman, and Folkenberg.

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Although curiosity about the body has long been a feature of human culture, anatomical science stagnated during the Middle Ages, a time when the words of classical authorities were valued over discovery.  Rather than working from observation or experimentation, medieval scholars compiled, rewrote, and annotated older medical works, particularly those of Galen.  It wasn’t until the late Middle Ages and Renaissance that increasingly literate and intellectual segments of society, renewed interest in science and discovery, and advances in printing resulted in the production of new anatomical treatises that eclipsed the achievements of the past and led to the foundation of modern anatomy.  But these new volumes were not purely scientific or didactic.  Luxury texts intended for an erudite, upper-class audience beyond the medical profession, they mixed art, science, and religion to create dramatic meditations on the natures of flesh and soul and the meaning of the body’s short existence.

Fasciculus de medicina

The first printed anatomy book was published in Venice in 1492 by the Gregorio brothers.  A Latin translation of a work by a little known German physician named Johannes de Ketham, it was planted firmly in the medieval medical tradition.  The book, which included treatises on subjects such as bloodletting, urinoscopy, and dissection, became an important teaching text, but its sumptuous woodcuts were also geared toward an audience of wealthy intellectuals.  A major success, it was republished in 1493 with new illustrations showing contemporary medical scenes including a dissection, and it appeared in twelve editions within a decade.  Though produced by a workshop, the designs are good examples of the clean, classical style of Venetian Renaissance illustration.  Below is the traditional zodiac man as well as a dissection scene, which portrays an anatomy lesson as performed in the late Middle Ages.  The young lector reads from an anatomical text, most likely Galen, while the sector, an uneducated barber/surgeon, preforms the dissection, and the ostensor, a high ranking professor, translates the words of the lector and directs the sector.  At this time dissection was not an act of observation and discovery, but was a tightly controlled public ritual intended to reinforce the authority of classical medical texts.  The illustration indicates the importance of the text by the prominent placement of the lector relative to the other figures, including the higher ranking ostensor.

Isagogae breves

This book, published in 1522 and 1523 by the humanist physician Jacopo Berengario da Carpi, is credited as the first printed anatomy text based on direct observation of the body.  Berengario was deeply skeptical of traditional anatomical practice, saying that a good anatomist ‘does not believe anything in his discipline simply because of the spoken or written word: what is required here is sight and touch.’  Though the woodcuts are artistically and anatomically crude, part of their importance lies in their reflection of Italian Renaissance culture.  Berengario was an art collector, and many of the figures are based on rediscovered classical art, religious images, and important works by Leonardo, Michelangelo, and Raphael.  Berengario recognized the importance of anatomical knowledge for artists, and he recommended his book for their use as well as that of medical students.  The half-flayed figure below is in the traditional pose of an Apollo with light rays.  Other illustrations represent the redemptive potential of dissection, which was believed to help atone for the sins of the criminals whose bodies were commonly used for this purpose.  Several images of partially draped female nudes indicate a tension between sexual modesty and the display of dissected reproductive organs.

De humani corporis fabrica

One of the most famous medical texts of all time, The Fabric of the Human Body (1543) by Andreas Vesalius, was the first truly modern anatomical book.  Vesalius was a Flemish surgeon of the University of Padua who had been trained in the Galenic tradition.  Based on his own experience with dissection he rejected Galen as the ultimate authority and argued that surgeons should make their own observations, and he corrected many Galenic mistakes, such as the multi-lobed liver, that had been passed from text to text through the Middle Ages.  Vesalius and his collaborators were also some of the first people to grasp the full potential of the printed book, using the title page, illustrations, initials, and chapter/paragraph subdivisions to create a harmonious and practical work.  Vesalius’s illustrations were most likely based on his own careful drawings, and he worked closely with the woodcut artist Jan Stefan van Kalkar, a member of Titian’s studio.  This partnership resulted in extremely accurate and detailed work, better than anything that proceeded it.  But these are not just sterile medical images—the cadavers display human emotions of sadness, despair, and mourning.  The skeleton below ponders mortality in a memento mori which would reappear throughout western culture, including in Shakespeare.  The second appears to pray, or to be bent in agony.  Throughout the book dead trees and barren landscapes, representing death, are contrasted with churches and the promise of eternal life.

De dissectione partium corporis humani

Charles Estienne, a member of the famous printing family of Paris, began work on this book during the 1530s, hoping it would replace the Isagogae breves of Berengario.  He had been a student in Paris at the same time as Vesalius, sharing the former’s interest in dissection and the belief that direct observation was more important than the words of authorities.  Unfortunately, while Estienne’s book contributed some new discoveries to the science of anatomy, it was plagued by legal issues regarding the artwork and was not published until two years after De humani corporis fabrica.  One of the interesting aspects of Estienne’s book is that it includes a number of woodcuts of nude women that were, according to Rifkin, originally intended as ‘genteel humanist erotica’, but were altered by partial dissection and the inclusion of anatomical information relating to reproductive anatomy.  Included are Bathsheba being spied upon by David (below), as well as the goddesses Venus, Antiope, and Proserpina.  A good example of the complex relationships between art, medicine, books, and sex during the early modern era.