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.